Biomaterial Database

A rational approach for assessing the hypothalamo-pituitary-adrenal axis. 1988

P M Stewart, and J Corrie, and J R Seckl, and C R Edwards, and P L Padfield

Department of Medicine, Western General Hospital, Edinburgh.

In 70 paired insulin tolerance tests (ITTs) and short 'Synacthen' tests (SSTs), both of which have been advocated for assessment of the hypothalamo-pituitary-adrenal (HPA) axis, there were 51 passes on both tests, 9 failures on both, and 10 discrepant results (9 failures on the SST, 1 failure on the ITT). There was a close correlation between the maximum cortisol value achieved in the two tests. A survey of British endocrinologists showed that only 24% used the SST to assess the HPA axis. It is suggested that the SST should be used for the initial assessment of the HPA axis and the ITT reserved for patients who fail the SST, those on corticosteroid therapy, and those who have had an acute pituitary insult within 14 days.

UI	MeSH Term	Description	Entries
D007027	Hypothalamic Diseases	Neoplastic, inflammatory, infectious, and other diseases of the hypothalamus. Clinical manifestations include appetite disorders; AUTONOMIC NERVOUS SYSTEM DISEASES; SLEEP DISORDERS; behavioral symptoms related to dysfunction of the LIMBIC SYSTEM; and neuroendocrine disorders.	Froehlich's Syndrome,Hypothalamic-Neurohypophyseal Disorders,Pituitary Diencephalic Syndrome,Hypothalamic Dysfunction Syndromes,Hypothalamic Dysinhibition Syndrome,Hypothalamic Overactivity Syndrome,Hypothalamic Pseudopuberty,Hypothalamic-Adenohypophyseal Disorders,Diencephalic Syndrome, Pituitary,Diencephalic Syndromes, Pituitary,Disease, Hypothalamic,Diseases, Hypothalamic,Disorder, Hypothalamic-Adenohypophyseal,Disorder, Hypothalamic-Neurohypophyseal,Disorders, Hypothalamic-Adenohypophyseal,Disorders, Hypothalamic-Neurohypophyseal,Dysfunction Syndrome, Hypothalamic,Dysfunction Syndromes, Hypothalamic,Dysinhibition Syndrome, Hypothalamic,Dysinhibition Syndromes, Hypothalamic,Froehlich Syndrome,Froehlichs Syndrome,Hypothalamic Adenohypophyseal Disorders,Hypothalamic Disease,Hypothalamic Dysfunction Syndrome,Hypothalamic Dysinhibition Syndromes,Hypothalamic Neurohypophyseal Disorders,Hypothalamic Overactivity Syndromes,Hypothalamic Pseudopuberties,Hypothalamic-Adenohypophyseal Disorder,Hypothalamic-Neurohypophyseal Disorder,Overactivity Syndrome, Hypothalamic,Overactivity Syndromes, Hypothalamic,Pituitary Diencephalic Syndromes,Pseudopuberties, Hypothalamic,Pseudopuberty, Hypothalamic,Syndrome, Froehlich's,Syndrome, Hypothalamic Dysfunction,Syndrome, Hypothalamic Dysinhibition,Syndrome, Hypothalamic Overactivity,Syndromes, Hypothalamic Dysfunction,Syndromes, Hypothalamic Dysinhibition,Syndromes, Hypothalamic Overactivity,Syndromes, Pituitary Diencephalic
D007030	Hypothalamo-Hypophyseal System	A collection of NEURONS, tracts of NERVE FIBERS, endocrine tissue, and blood vessels in the HYPOTHALAMUS and the PITUITARY GLAND. This hypothalamo-hypophyseal portal circulation provides the mechanism for hypothalamic neuroendocrine (HYPOTHALAMIC HORMONES) regulation of pituitary function and the release of various PITUITARY HORMONES into the systemic circulation to maintain HOMEOSTASIS.	Hypothalamic Hypophyseal System,Hypothalamo-Pituitary-Adrenal Axis,Hypophyseal Portal System,Hypothalamic-Pituitary Unit,Hypothalamic Hypophyseal Systems,Hypothalamic Pituitary Unit,Hypothalamo Hypophyseal System,Hypothalamo Pituitary Adrenal Axis,Portal System, Hypophyseal
D007328	Insulin	A 51-amino acid pancreatic hormone that plays a major role in the regulation of glucose metabolism, directly by suppressing endogenous glucose production (GLYCOGENOLYSIS; GLUCONEOGENESIS) and indirectly by suppressing GLUCAGON secretion and LIPOLYSIS. Native insulin is a globular protein comprised of a zinc-coordinated hexamer. Each insulin monomer containing two chains, A (21 residues) and B (30 residues), linked by two disulfide bonds. Insulin is used as a drug to control insulin-dependent diabetes mellitus (DIABETES MELLITUS, TYPE 1).	Iletin,Insulin A Chain,Insulin B Chain,Insulin, Regular,Novolin,Sodium Insulin,Soluble Insulin,Chain, Insulin B,Insulin, Sodium,Insulin, Soluble,Regular Insulin
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010900	Pituitary Diseases	Disorders involving either the ADENOHYPOPHYSIS or the NEUROHYPOPHYSIS. These diseases usually manifest as hypersecretion or hyposecretion of PITUITARY HORMONES. Neoplastic pituitary masses can also cause compression of the OPTIC CHIASM and other adjacent structures.	Adenohypophyseal Diseases,Hypophyseal Disorders,Neurohypophyseal Diseases,Anterior Pituitary Diseases,Pituitary Disorders,Pituitary Gland Diseases,Posterior Pituitary Diseases,Adenohypophyseal Disease,Anterior Pituitary Disease,Disease, Adenohypophyseal,Disease, Anterior Pituitary,Disease, Neurohypophyseal,Disease, Pituitary,Disease, Pituitary Gland,Disease, Posterior Pituitary,Diseases, Adenohypophyseal,Diseases, Anterior Pituitary,Diseases, Neurohypophyseal,Diseases, Pituitary,Diseases, Pituitary Gland,Diseases, Posterior Pituitary,Disorder, Hypophyseal,Disorder, Pituitary,Disorders, Hypophyseal,Disorders, Pituitary,Hypophyseal Disorder,Neurohypophyseal Disease,Pituitary Disease,Pituitary Disease, Anterior,Pituitary Disease, Posterior,Pituitary Diseases, Anterior,Pituitary Diseases, Posterior,Pituitary Disorder,Pituitary Gland Disease,Posterior Pituitary Disease
D010912	Pituitary-Adrenal Function Tests	Tests that evaluate the adrenal glands controlled by pituitary hormones.	Function Test, Pituitary-Adrenal,Function Tests, Pituitary-Adrenal,Pituitary Adrenal Function Tests,Pituitary-Adrenal Function Test,Test, Pituitary-Adrenal Function,Tests, Pituitary-Adrenal Function
D010913	Pituitary-Adrenal System	The interactions between the anterior pituitary and adrenal glands, in which corticotropin (ACTH) stimulates the adrenal cortex and adrenal cortical hormones suppress the production of corticotropin by the anterior pituitary.	Pituitary Adrenal System,Pituitary-Adrenal Systems,System, Pituitary-Adrenal,Systems, Pituitary-Adrenal
D004361	Drug Tolerance	Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from DRUG RESISTANCE wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from MAXIMUM TOLERATED DOSE and NO-OBSERVED-ADVERSE-EFFECT LEVEL.	Drug Tolerances,Tolerance, Drug,Tolerances, Drug
D004704	Endocrinology	A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the ENDOCRINE SYSTEM.	Endocrinology and Metabolism Specialty,Metabolism and Endocrinology Specialty