Reliability of hormonal levels for assessing the hypothalamic-pituitary-adrenocortical system in clinical pharmacology.
Few data are available on the reliability of measurements of adrenocortical and corticotroph hormones for use in clinical pharmacology. Two placebo controlled cross-over trials in 20 normal healthy male subjects offered the opportunity to perform three repeat samplings of adrenocortical and corticotroph hormones at 1 to 5 week intervals during the placebo periods. Measurements of baseline levels of plasma, salivary and urinary cortisol, plasma adrenocorticotroph hormone (ACTH), lipotrophic hormone (LPH), beta-endorphin, post tetracosactrin levels of plasma and salivary cortisol, post corticotrophin releasing hormone (CRH)-lysine vasopressine (LVP) levels of plasma cortisol, ACTH and LPH; and post metyrapone levels of plasma cortisol and 11-deoxycortisol (compound S), ACTH, LPH, beta-endorphin were performed in the same laboratory. The reliability of the measurements was estimated by computing the intraclass correlation coefficient (R) and by using Altman-Bland graphical method. The Rs of baseline parameters varied from 0.18 (for 08.00 h salivary cortisol) to 0.55 (for 08.00 h plasma cortisol and nocturnal urinary cortisol). In contrast, parameters obtained after direct stimulation or inhibition of the producing targets were much more reliable: Rs were above 0.80 for post tetracosactrin levels of plasma and salivary cortisol, post CRH-LVP levels of plasma ACTH and LPH. The Rs were below 0.50 for post metyrapone levels of plasma 11-deoxycortisol, ACTH, LPH and beta-endorphin. The interval between sampling did not affect R estimates. These data show that peak levels of plasma cortisol and ACTH after direct stimulation are highly reliable whereas baseline and main post-metyrapone levels are not.(ABSTRACT TRUNCATED AT 250 WORDS)
Coste
J
J
Département de Biostatistique et d'Informatique Médicale, Hôpital Cochin, Paris, France.
Strauch
G
G
Letrait
M
M
Bertagna
X
X
D000324:Adrenocorticotropic Hormone / Q000008:administration & dosage / Q000097:blood / Q000652:urine; D000328:Adult; D003346:Corticotropin-Releasing Hormone / Q000008:administration & dosage / Q000097:blood / Q000652:urine; D003350:Cortodoxone / Q000008:administration & dosage / Q000097:blood / Q000652:urine; D018592:Cross-Over Studies; D004311:Double-Blind Method; D006728:Hormones / Q000032:analysis*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000097:blood / Q000652:urine; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D015592:Immunoradiometric Assay; D008236:Lypressin / Q000008:administration & dosage / Q000097:blood / Q000652:urine; D008297:Male; D010913:Pituitary-Adrenal System / Q000502:physiology*; D015203:Reproducibility of Results; D012463:Saliva / Q000378:metabolism; D001615:beta-Endorphin / Q000008:administration & dosage / Q000097:blood / Q000652:urine; D008083:beta-Lipotropin / Q000008:administration & dosage / Q000097:blood / Q000652:urine
D006728:Hormones; D008236:Lypressin; D001615:beta-Endorphin; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D008083:beta-Lipotropin; D003350:Cortodoxone; D006854:Hydrocortisone