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Endocrine Abstracts (2017) 49 EP14 | DOI: 10.1530/endoabs.49.EP14

1Institute of Endocrinology, Praha, Czech Republic; 2Third Department of Medicine, General University Hospital and First Faculty of Medicine, Charles University, Praha, Czech Republic.


Diagnostic tests of the hypothalamic–pituitary–adrenal axis (HPA axis), measuring of free cortisol and use of other adrenal steroids are the subject of debate.

We investigated 15 healthy men with mean/median age 27.4/26 (±4.8) years, and mean/median BMI 25.38/24.82 (±3.2) kg/m2. All subjects underwent four dynamic tests of the HPA axis, specifically 1, 10, and 250 μg synacthen tests and an insulin tolerance test (ITT). Salivary cortisol, cortisone, pregnenolone, and DHEA were analysed using liquid chromatography-tandem mass spectrometry.

During the ITT maximum salivary cortisol levels of over 12.5 nmol/l were found at 60 min. Maximum cortisol levels in all of the Synacthen tests were higher than stimulation in the ITT. Cortisone reacted similarly as cortisol, i.e. we did not find any change in the ratio of cortisol to cortisone. Pregnenolone and DHEA were higher during the ITT, and their peaks preceded the cortisol peak. There was no increase of pregnenolone or DHEA in any of the Synacthen tests.

Our results indicate that a 10 μg Synacthen dose is a safe and cost-effective choice.

This study was supported by the project MZCR for conceptual development of research organization 00023761 Institute of Endocrinology and grant 17-28692A.

Volume 49

19th European Congress of Endocrinology

Lisbon, Portugal
20 May 2017 - 23 May 2017

European Society of Endocrinology 

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