The dex/CRH test - Is it better than the DST?

被引：75

作者：

Watson, Stuart ^{[1
]}

Gallagher, Peter ^{[1
]}

Smith, Margaret S. ^{[1
]}

Ferrier, I. Nicol ^{[1
]}

Young, Allan H. ^{[1
]}

机构：

[1] Univ Newcastle Upon Tyne, Royal Infirm, Stanley Res Ctr, Sch Neurol Neurobiol & Psychiat, Newcastle Upon Tyne NE1 4LP, Tyne & Wear, England

来源：

PSYCHONEUROENDOCRINOLOGY | 2006年 / 31卷 / 07期

关键词：

cortisol; corticotrophin releasing hormone; adrenal cortex hormones; dexamethasone; DST; Dex/CRH test; depression;

D O I：

10.1016/j.psyneuen.2006.03.001

中图分类号：

R5 [内科学];

学科分类号：

1002 [临床医学]; 100201 [内科学];

摘要：

The dexamethasone suppression test (DST), frequently abnormal in mood disorder patients, is considered to measure glucocorticoid receptor-mediated negative feedback. We examined the hypothesis that the, apparently more sensitive, dexamethasone/corticotrophin-releasing-hormone (dex/CRH) test unveils subtle hypothalamic-pituitary-adrenal axis disturbance not detected by the DST in 82 patients with mood disorders and 28 controls. There was a close correlation between the cortisol responses on the two tests (r(s) = 0.73, p < 0.0005). However, ROC analysis revealed that the dex/CRH test had better diagnostic performance than the DST (p=0.031). The sensitivity of delta cortisol (from the dex/CRH) was 61.9% and the specificity 71.4%. The sensitivity of 1500 h cortisol (the DST) was 66.6% and the specificity was 47.6%. This suggests that the two tests measure common pathology but that the dex/CRH test has better diagnostic utility. (c) 2006 Elsevier Ltd. All rights reserved.

引用

页码：889 / 894

页数：6

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