Wagmode Nalini B, Mathew Vivek, Bantwal Ganapathy, Ayyar Vageesh, George Belinda, Patanjali C P, Michael John
Department of Endocrinology, St. John's Hospital and Medical College, Bengaluru, Karnataka, India.
Indian J Endocrinol Metab. 2018 Sep-Oct;22(5):636-640. doi: 10.4103/ijem.IJEM_114_18.
Our literature search revealed that the use of porcine sequence corticotropin has not been validated against tetracosactide hexaacetate in a healthy population.
To study the efficacy of using porcine sequence corticotropin in comparison with tetracosactide hexaacetate in the evaluation of hypothalamo pituitary adrenal (HPA) axis.
Fifteen healthy volunteers were enrolled. Serum cortisol was measured at 0 minute in all subjects and at 30 and 60 minutes after tetracosactide hexaacetate 250 μg intravenously. Four weeks later, serum cortisol level was measured at 0 minute and at 30 and 60 minutes following 24 units of porcine sequence corticotropin given intramuscularly.
Mean serum cortisol values with tetracosactide were 30.3 (±7.83) μg/dl and 31.27 (±7.36) μg/dl at 30 and 60 minutes, respectively. The mean cortisol values with porcine sequence corticotropin were 26.33 (±5.47) μg/dl and 31.59 (±6.40) μg/dl at 30 and 60 minutes, respectively. All subjects had a response qualified as normal or adequate at 30 minutes itself. Mean peak serum cortisol response was 32.65 (±7.76) μg/dl in tetracosactide group and 31.59 (±6.4) μg/dl in porcine sequence corticotropin group, and the responses in two groups were comparable ( = 0.686). There were no immediate side effects in both groups, with a lower cost of procedure in the porcine corticotropin group.
Our study established the efficacy of porcine sequence corticotropin in testing the adequacy of HPA axis in healthy individuals. Our study also revealed that, the intactness of the HPA axis could be confirmed as early as 30 minutes in healthy individuals.
我们的文献检索显示，在健康人群中，猪序列促肾上腺皮质激素的使用尚未与醋酸二十四肽促皮质素进行过对比验证。
研究猪序列促肾上腺皮质激素与醋酸二十四肽促皮质素相比，在评估下丘脑 - 垂体 - 肾上腺（HPA）轴方面的疗效。
招募了15名健康志愿者。所有受试者在0分钟时测量血清皮质醇，静脉注射250μg醋酸二十四肽促皮质素后30分钟和60分钟时再次测量。四周后，肌肉注射24单位猪序列促肾上腺皮质激素，在0分钟、30分钟和60分钟时测量血清皮质醇水平。
使用醋酸二十四肽促皮质素时，30分钟和60分钟时血清皮质醇的平均水平分别为30.3（±7.83）μg/dl和31.27（±7.36）μg/dl。使用猪序列促肾上腺皮质激素时，30分钟和60分钟时皮质醇的平均水平分别为26.33（±5.47）μg/dl和31.59（±6.40）μg/dl。所有受试者在30分钟时的反应均符合正常或充分的标准。醋酸二十四肽促皮质素组血清皮质醇反应峰值平均为32.65（±7.76）μg/dl，猪序列促肾上腺皮质激素组为31.59（±6.4）μg/dl，两组反应具有可比性（P = 0.686）。两组均无即刻副作用，猪促肾上腺皮质激素组的操作成本更低。
我们的研究证实了猪序列促肾上腺皮质激素在检测健康个体HPA轴功能是否正常方面的有效性。我们的研究还表明，在健康个体中，早在30分钟时就能确认HPA轴的完整性。
