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Table 5 Cortisol and ACTH response by indication for testing

From: Peak cortisol response to corticotropin-releasing hormone is associated with age and body size in children referred for clinical testing: a retrospective review

Indication for testing

Presumed GH sufficient short stature (GH ≥ 10 μg/L)

Possible GHD (GH < 10 μg/L)

Concern for multiple pituitary abnormalities

Neoplasm with risk to pituitary

Exogenous glucocorticoid exposure

Known multiple pituitary abnormalities

p-valuea

n

35

33

52

50

35

17

 

Baseline cortisol (nmol/L)

231.0 (124.3)

203.3 (136.6)

221.1 (182.0)

199.1 (119.4)

145.7 (139.8)

202.2 (139.6)

0.18

Delta cortisol (nmol/L)

454.9 (168.1)

485.2 (139.7)

399.8 (160.4)

470.2 (189.2)

215.9 (218.4)

349.6 (219.5)

<0.0005

Peak cortisol (nmol/L)

685.9 (161.8)

688 .5 (179.8)

620.9 (178.6)

675.8 (138.5)

373.2 (246.1)

552.2 (227.0)

<0.0005

Baseline ACTH (pmol/L)

3.2 (1.8)

5.9 (6.6)

4.2 (2.6)

3.6 (1.9)

3.7 (4.1)

4.7 (2.8)

0.036

Delta ACTH (pmol/L)

14.9 (9.3)

23.0 (18.5)

13.2 (11.6)

21.4 (26.6)

6.3 (4.9)

18.3 (25.6)

0.0007

Peak ACTH (pmol/L)

18.1 (9.6)

28.9 (17.9)

17.4 (11.5)

25.0 (27.0)

10.1 (7.5)

23.0 (26.3)

0.0003

Failure Rate (peak cortisol < 500 nmol/L)

11.4 %

9.1 %

21.2 %

6.0 %

62.9 %

29.4 %

<0.0005

  1. Data are presented as mean (SD)
  2. aAs determined by ANOVA across indication for testing for cortisol and ACTH values; by Chi-square for Failure Rate