Dhananjaya Melkunte Shanthaiah, Revanasiddappa Shashidhara, Kansal Nimmi, Lila Anurag Ranjan, Sarathi Vijaya
Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Center, Bengaluru, Karnataka, India.
Department of Clinical Chemistry & Biochemical Genetics, Dr Lal PathLabs Ltd, New Delhi, India.
Endocrine. 2025 May;88(2):426-430. doi: 10.1007/s12020-025-04172-4. Epub 2025 Jan 25.
Intramuscular acton prolongatum is most often used as an alternative for intramuscular or intravenous tetracosactide for ACTH stimulation in some countries. Intramuscular administration of acton prolongatum is cumbersome whereas intended intramuscular acton prolongatum or tetracosactide may often turn subcutaneous. Hence, we compared the subcutaneous ACTH-stimulated steroid profiling with those of the intramuscular routes.
The study included 60 apparently-healthy adult females aged 18-40 years who were randomised to intramuscular tetracosactide (250 µg), intramuscular acton prolongatum (24 IU), subcutaneous tetracosactide (250 µg), and subcutaneous acton prolongatum (24 IU) groups in (1:1:1:1) ratio. Serum steroid profile consisting of 13 steroids was measured at baseline and 60 minutes after ACTH stimulation by liquid chromatography-tandem mass spectrometry.
Baseline steroid levels, stimulated steroid levels, and the percentage increase in all the steroids after subcutaneous tetracosactide and acton prolongatum stimulation were comparable to those after intramuscular tetracosactide and acton prolongatum stimulation, respectively.
Intramuscular acton prolongatum, subcutaneous tetracosactide and subcutaneous acton prolongatum are simpler and reliable alternatives for ACTH-stimulated steroid profiling.
在一些国家，长效促肾上腺皮质激素（acton prolongatum）肌肉注射常被用作促肾上腺皮质激素（ACTH）刺激试验中肌肉注射或静脉注射替可克肽的替代方法。长效促肾上腺皮质激素肌肉注射操作繁琐，而预期的长效促肾上腺皮质激素或替可克肽肌肉注射往往会变成皮下注射。因此，我们比较了皮下注射ACTH刺激后的类固醇谱与肌肉注射途径的类固醇谱。
该研究纳入了60名年龄在18 - 40岁之间、表面健康的成年女性，她们被随机分为肌肉注射替可克肽（250µg）、肌肉注射长效促肾上腺皮质激素（24IU）、皮下注射替可克肽（250µg）和皮下注射长效促肾上腺皮质激素（24IU）组，比例为（1:1:1:1）。在基线时以及ACTH刺激后60分钟，通过液相色谱 - 串联质谱法测量由13种类固醇组成的血清类固醇谱。
皮下注射替可克肽和长效促肾上腺皮质激素刺激后，所有类固醇的基线类固醇水平、刺激后的类固醇水平以及增加百分比分别与肌肉注射替可克肽和长效促肾上腺皮质激素刺激后的情况相当。
肌肉注射长效促肾上腺皮质激素、皮下注射替可克肽和皮下注射长效促肾上腺皮质激素是ACTH刺激类固醇谱分析更简单且可靠的替代方法。
