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Arch Phys Med Rehabil. 1999 Aug;80(8):863-6.

Impaired adrenal reserve in men with spinal cord injury: results of low- and high-dose adrenocorticotropin stimulation tests.

Author information

1
Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei.

Abstract

OBJECTIVE:

To use low- and high-dose adrenocorticotropin (ACTH) tests to assess adrenal reserve in men with spinal cord injury (SCI).

DESIGN:

After an overnight fast, 1 microg and 200 microg ACTH were injected intravenously at time 0 and 60 minutes between 8 AM and 9 AM. Blood was withdrawn at 30-minute intervals from time 0 to 120 minutes.

SETTING:

All participants were recruited from the outpatient clinic of a university hospital that is a tertiary referral center.

PARTICIPANTS:

Forty-two men with traumatic neurologically complete SCI that had occurred more than 1 year before the study.

MAIN OUTCOME MEASURES:

Serum cortisol response to ACTH at times 0, 30, 60, 90, and 120 minutes.

RESULTS:

Twenty subjects had a serum cortisol response of <20 microg/dL 30 minutes after a 1-microg ACTH injection; 10 of these remained at this level at 30 minutes after a 200-microg ACTH injection.

CONCLUSION:

There is a high prevalence of impaired adrenal reserve in persons with chronic SCI. The 1-microg (low dose) ACTH test is more sensitive for detecting subclinical adrenal insufficiency than is the 200-microg (high dose) ACTH test.

PMID:
10453760
DOI:
10.1016/s0003-9993(99)90075-8
[Indexed for MEDLINE]

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