The use of baseline cortisol level in predicting the outcome of 1 μg Synacthen tests in an outpatient endocrinology unit

Autor: Najoua Lassoued, Baha Zantour, Wafa Alaya, Mohamed Hbib Sfar
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Heliyon, Vol 8, Iss 6, Pp e09559- (2022)
Druh dokumentu: article
ISSN: 2405-8440
DOI: 10.1016/j.heliyon.2022.e09559
Popis: Introduction: The clinical requirements and the indication of the Synacthen test are increasing. The objective of our study is to determine a baseline cortisol level that reliably predicts the response to Synacthen test in a low-risk group of patients. Materials and methods: We performed a cross-sectional analysis of all Synacthen tests conducted between January 2017 and June 2018. The diagnostic accuracy of basal cortisol levels as a predictor of an adequate response to Synacthen test was evaluated by ROC curve analysis. Results: One hundred and fifty-three patients were included. A baseline cortisol level 147.5 ng/mL showed a specificity of 100% but a sensitivity of 1.2% for an adequate response to the Synacthen test. According to the ROC curve, the optimal baseline cortisol level for predicting an adequate response to the Synacthen test was 85 ng/mL with an AUC of 0.808 (95% CI [0.738–0.877]). Conclusion: We propose a basal cortisol level assay as a first step in the evaluation of patients with suspected adrenal insufficiency.
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