ECE2011 Poster Presentations Adrenal cortex (41 abstracts)
The role of insulin tolerance test (ITT) and ACTH/cortisol ratio in chronic fatigue patients
F Coucke 1 , T Hertoghe 2 , G Rindsig 1 , L Coucke 1 & H Lammens 1
1Metares VZW, Gentofte/Charlottenlund, Denmark; 2University de Charleroi, Charleroi, Belgium.
Rationale: In chronic fatigue syndrome (CFS) there is a great controversy about the role of the ACTH/cortisol axis. To examine this phenomena we performed ITT tests in CFS patients with low fasting cortisol (<20 μg/dl). A group of CFS patients with other hypofysal dysfunction were also examined.
Methods: One hundred and one patients who underwent classical fasting ITT were registered and analyzed: glucose, cortisol, ACTH and GH were measured and patients were divided in five groups according to the cortisol response or the presence of other hypofyse deficiency. ACTH/cortisol in groups was measured with the peak values during ITT.
Result/conclusion: Sixty-seven patients have an elevated ACTH/cortisol ratio: 8 and 29 had a normal ratio of 1.9. Patients with peak cortisol response above 30 show no ACTH increase. The elevated ACTH/cortisol ratio is a very useful tool in the early detection of adrenal insufficiency.
Therefore, ITT testing is preferred in CFS patients, instead of synacthen testing, because the phenomenon of ACTH compensation can be measured and reflected in the ACTH/cortisol ratio.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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