Sieber-Ruckstuhl N S, Boretti F S, Wenger M, Maser-Gluth C, Reusch C E
Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.
Vet Rec. 2008 May 24;162(21):673-8. doi: 10.1136/vr.162.21.673.
The serum concentrations of cortisol, 17alpha-hydroxypregnenolone, 17alpha-hydroxyprogesterone, 21-deoxycortisol and 11-deoxycortisol were measured in 19 healthy dogs, 15 dogs with pituitary-dependent hypercortisolism (pdh) and eight dogs with other diseases before and one hour after an injection of synthetic adrenocorticotrophic hormone (acth). At both times the dogs with pdh had significantly higher concentrations of cortisol, 17alpha-hydroxypregnenolone, 17alpha-hydroxyprogesterone and 21-deoxycortisol than the healthy dogs. Basal 11-deoxycortisol concentrations were also significantly higher in dogs with pdh compared with healthy dogs. When compared with the dogs with other diseases, the dogs with pdh had significantly higher basal and post-acth cortisol and basal 21-deoxycortisol, and significantly lower post-acth 11-deoxycortisol concentrations. The dogs with other diseases had significantly higher post-acth cortisol, 17alpha-hydroxyprogesterone and 11-deoxycortisol concentrations than the healthy dogs. In general, the post-acth concentrations of 17alpha-hydroxypregnenolone, 17alpha-hydroxyprogesterone, 11-deoxycortisol and 21-deoxycortisol were more variable than the post-acth concentrations of cortisol, resulting in large overlaps of the concentrations of these hormones between the three groups. A two-graph receiver operating characteristic (ROC) analysis was used to maximise the sensitivity and specificity of each hormone for diagnosing hypercortisolism; it showed that the post-acth concentration of cortisol had the highest sensitivity and specificity. The overlaps between the healthy dogs, the dogs with pdh and the dogs with other diseases suggested that the individual precursor hormones would not be useful as a screening test for hypercortisolism.
在19只健康犬、15只垂体依赖性皮质醇增多症（pdh）犬和8只患有其他疾病的犬中，于注射合成促肾上腺皮质激素（acth）前及注射后1小时测定了皮质醇、17α-羟孕烯醇酮、17α-羟孕酮、21-脱氧皮质醇和11-脱氧皮质醇的血清浓度。在两个时间点，患有pdh的犬的皮质醇、17α-羟孕烯醇酮、17α-羟孕酮和21-脱氧皮质醇浓度均显著高于健康犬。患有pdh的犬的基础11-脱氧皮质醇浓度也显著高于健康犬。与患有其他疾病的犬相比，患有pdh的犬的基础和acth刺激后皮质醇以及基础21-脱氧皮质醇显著更高，而acth刺激后11-脱氧皮质醇浓度显著更低。患有其他疾病的犬的acth刺激后皮质醇、17α-羟孕酮和11-脱氧皮质醇浓度显著高于健康犬。一般来说，17α-羟孕烯醇酮、17α-羟孕酮、11-脱氧皮质醇和21-脱氧皮质醇的acth刺激后浓度比皮质醇的acth刺激后浓度变化更大，导致这三组之间这些激素的浓度有很大重叠。采用双图受试者操作特征（ROC）分析来最大化每种激素诊断皮质醇增多症的敏感性和特异性；结果显示，acth刺激后皮质醇浓度具有最高的敏感性和特异性。健康犬、患有pdh的犬和患有其他疾病的犬之间的重叠表明，单个前体激素作为皮质醇增多症的筛查试验并无用处。
