Vurdering av verdien til tre ulike stimulasjonstester, sammenlignet med måling av basale hormonprøver ved postoperativ kontroll av pasienter med mulig hypofysesvikt

Abstract

For several years it has been standard procedure at Aker Universitetssykehus to test every patient suspected of having reduced pituitary secretorial function with a set of function tests including Combined Pituitary stimulation test, Metopiron test and Hypoglycemia test, together with measuring basal hormone levels. Our goal was to determine if one or more of these tests could be excluded from the testing regime on part of the pasient population, as their results didn´t produce additional information needed for the diagnosis, nor for the treatment. As for the Thyreoid axis, it was not seen any obvious correlation between the different tests, or the basal hormone values. For male patients there was a strong correlation between the combined test and the basal hormone values, and the test gave next to no additional information. Interpretation of sex hormone values proved a lot more difficult in women, and our testing gave no conclusive results. The basal Cortisol level were to a large extent correlated to the ACTH and cortisol values in both the combined test and the hypoglcemia test. It could be possible to define a cut off basal value, and only perform the other tests on those who score under this value. Regarding growth hormone we weren´t able to reach sertein conclussion. We were only able to find 29 patients to include in our study. The sertainty of our conclussions is therefore little, and we suggest that more reserch be done on the subject.