Comparison of the effects of the l-dopa and insulin tolerance tests on cortisol secretion

Acar, Sezer; Paketçi, Ahu; Tuhan, Hale; Demir, Korcan; Böber, Ece; Abacı, Ayhan

doi:10.1007/s40618-017-0815-7

Cited by 1 publication

(5 citation statements)

References 30 publications

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“…In addition, nausea/vomiting was observed in 53 (62.4%) of the patients during the L-dopa test, and peak cortisol responses were similar in patients with and without side effects. This finding was similar to the results of our previous study and the two studies of Marakaki et al [5][6][7] Taken together, these findings suggest that the hypothesis that an increase in cortisol and ACTH secretion occurs as a result of side effects such as nausea/vomiting during the L-dopa test is not valid.…”

Section: Discussionsupporting

confidence: 91%

“…18 The results of the experimental studies support that the dopamine agonist stimulates the HPA axis through various pathways and therefore increases the secretion of cortisol from the adrenal gland. In our previous study 7 and in the study by Marakaki et al 5 , ACTH levels were also shown to increase in correlation with serum cortisol responses during the L-dopa test, suggesting that the possible physiological mechanism of the cortisol-secreting effect of L-dopa is the increase in ACTH.…”

Section: Discussionmentioning

confidence: 55%

“…Similarly, in our previous study, the L-dopa test revealed that 26 of the 29 children (89.7%) had an adequate cortisol response (this rate was 79.3% in ITT, the gold standard test). 7 In the current study, in which the baseline and 120 th -minute cortisol levels were evaluated in subjects who underwent the L-dopa test, the frequency of cases with an adequate cortisol response was found to be 89.4%. Considering the previous study results, the current study with a very high number of cases suggested that the stimulating effect of L-dopa on cortisol secretion is as effective as the gold standard test, ITT.…”

Section: Discussionmentioning

confidence: 64%

“…Considering the previous studies, it was shown that the peak cortisol response was obtained at the 120 th minute in most of the cases during the L-dopa test. [5][6][7] Therefore, in our daily practice in our center, we measure serum cortisol at the baseline and at the 120 th minute during the L-dopa test. Therefore, serum cortisol levels at these time-points were considered in this retrospective study.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 The results of our previous study investigating the effect of L-dopa on cortisol secretion in patients being evaluated for suspected GH deficiency confirmed the findings of previous studies. 7 Therefore, in our center, we started routinely using the L-dopa test to measure cortisol secretion in patients being evaluated for suspected GH deficiency. In addition to GH levels, we routinely measured serum cortisol levels at the baseline and 120 th minutes in the patients who underwent the L-dopa test for suspected GH deficiency.…”

Section: Introductionmentioning

confidence: 99%

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Results confirming the efficacy of oral L-dopa on cortisol secretion in patients being evaluated for suspected growth hormone deficiency

Kirkgöz¹,

Acar²,

Nalbantoğlu³

et al. 2023

Trends in Pediatrics

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Objective: Adrenal insufficiency is a life-threatening disease and therefore, accurate diagnosis and prompt treatment are life-saving. The main purpose of this study was to retrospectively evaluate the serum cortisol levels measured during the L-dopa test in cases suspected GH deficiency and to compare the effect of L-dopa on cortisol secretion with the results of previous studies. Method:Between January 2019 and January 2021, patients who underwent the L-dopa test for the evaluation of GH deficiency in our Pediatric Endocrinology Clinic and whose basal cortisol levels were measured at the baseline and at the 120th minutes of the test were included. The clinical, anthropometric, and laboratory data of the patients were obtained from the medical records.Results: Eighty-five patients (38 girls, 47 boys) were included in the study. The mean age of the patients was 10.3 ± 3.5 years (range, 4.1 -14.9 years). The mean serum cortisol level was 11.1 ± 3.6 µg/dL at baseline and 20.9 ± 3.8 µg/dL at 120th minutes (the mean cortisol increase was 9.8 ± 4.1 µg/dL). Cortisol response was adequate (> 18 µg / dL) in 76 cases (89.4%). Nausea/vomiting was observed in 53 (62.4%) of the patients during the L-dopa test. Peak cortisol responses of the cases with and without side effects were similar (20.9 ± 3.8; 20.8 ± 3.7; p = 0.945). Conclusion:In conclusion, the L-dopa test is easy to apply, effective, and safe and can be performed to evaluate cortisol adequacy at least in patients being evaluated for suspected GH deficiency.

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Section: Discussionsupporting

confidence: 91%