{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T10:32:54Z","timestamp":1776249174738,"version":"3.50.1"},"reference-count":31,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Endocrinolog\u00eda, Diabetes y Nutrici\u00f3n (English ed.)"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1016\/j.endien.2025.501685","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T12:42:19Z","timestamp":1770727339000},"page":"501685","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["New cortisol assay-specific thresholds for the biochemical diagnosis of adrenal insufficiency after ACTH stimulation"],"prefix":"10.1016","volume":"73","author":[{"given":"Pablo","family":"Fern\u00e1ndez Velasco","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Est\u00e9vez Asensio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Torres Torres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Ortol\u00e1 Buigues","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilia","family":"G\u00f3mez Hoyos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Delgado Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"de Luis Rom\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonzalo","family":"D\u00edaz Soto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.endien.2025.501685_bib0160","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/S2213-8587(14)70142-1","article-title":"Diagnosis and management of adrenal insufficiency","volume":"3","author":"Bancos","year":"2015","journal-title":"Lancet Diabetes Endocrinol"},{"key":"10.1016\/j.endien.2025.501685_bib0165","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/MAJ.0b013e3181db6b7a","article-title":"Delayed diagnosis of adrenal insufficiency is common: a cross-sectional study in 216 patients","volume":"339","author":"Bleicken","year":"2010","journal-title":"Am J Med Sci"},{"key":"10.1016\/j.endien.2025.501685_bib0170","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1210\/jc.2011-2227","article-title":"Estimation of maximal cortisol secretion rate in healthy humans","volume":"97","author":"Dorin","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.endien.2025.501685_bib0175","doi-asserted-by":"crossref","first-page":"949","DOI":"10.4158\/EP171861.OR","article-title":"Diagnostic accuracy of basal cortisol level to predict adrenal insufficiency in cosyntropin testing: results from an observational cohort study with 804 patients","volume":"23","author":"Struja","year":"2017","journal-title":"Endocr Pract"},{"key":"10.1016\/j.endien.2025.501685_bib0180","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1111\/cen.14388","article-title":"Morning serum cortisol is superior to salivary cortisone and cortisol in predicting normal adrenal function in suspected adrenal insufficiency","volume":"96","author":"Kalaria","year":"2022","journal-title":"Clin Endocrinol (Oxf)"},{"key":"10.1016\/j.endien.2025.501685_bib0185","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1210\/jc.2015-1710","article-title":"Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society clinical practice guideline","volume":"101","author":"Bornstein","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.endien.2025.501685_bib0190","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/joim.12162","article-title":"Consensus statement on the diagnosis, treatment and follow-up of patients with primary adrenal insufficiency","volume":"275","author":"Husebye","year":"2014","journal-title":"J Intern Med"},{"key":"10.1016\/j.endien.2025.501685_bib0195","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/MED.0000000000000806","article-title":"Diagnostic strategies in adrenal insufficiency","volume":"30","author":"Siampanopoulou","year":"2023","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"10.1016\/j.endien.2025.501685_bib0200","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.clinbiochem.2017.02.008","article-title":"Clinical implications for biochemical diagnostic thresholds of adrenal sufficiency using a highly specific cortisol immunoassay","volume":"50","author":"Kline","year":"2017","journal-title":"Clin Biochem"},{"key":"10.1016\/j.endien.2025.501685_bib0205","article-title":"New cutoffs for the biochemical diagnosis of adrenal insufficiency after ACTH stimulation using specific cortisol assays","volume":"5","author":"Javorsky","year":"2021","journal-title":"J Endocr Soc"},{"key":"10.1016\/j.endien.2025.501685_bib0210","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1515\/cclm-2016-0400","article-title":"Multicenter performance evaluation of a second-generation cortisol assay","volume":"55","author":"Vogeser","year":"2017","journal-title":"Clin Chem Lab Med"},{"key":"10.1016\/j.endien.2025.501685_bib0215","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.978238","article-title":"Cortisol values during the standard-dose cosyntropin stimulation test: personal experience with Elecsys cortisol II assay","volume":"13","author":"Husni","year":"2022","journal-title":"Front Endocrinol"},{"key":"10.1016\/j.endien.2025.501685_bib0220","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.eprac.2022.04.003","article-title":"New diagnostic cutoffs for adrenal insufficiency after cosyntropin stimulation using Abbott Architect cortisol immunoassay","volume":"28","author":"Zha","year":"2022","journal-title":"Endocr Pract"},{"key":"10.1016\/j.endien.2025.501685_bib0225","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.ando.2016.05.002","article-title":"Establishment of revised diagnostic cut-offs for adrenal laboratory investigation using the new Roche Diagnostics Elecsys Cortisol II assay","volume":"77","author":"Raverot","year":"2016","journal-title":"Ann Endocrinol"},{"key":"10.1016\/j.endien.2025.501685_bib0230","doi-asserted-by":"crossref","first-page":"806","DOI":"10.3390\/jcm8060806","article-title":"Accuracy of the low-dose ACTH stimulation test for adrenal insufficiency diagnosis: a re-assessment of the cut-off value","volume":"8","author":"Mongio\u00ec","year":"2019","journal-title":"J Clin Med"},{"key":"10.1016\/j.endien.2025.501685_bib0235","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s42000-020-00185-y","article-title":"Minding the gap between cortisol levels measured with second-generation assays and current diagnostic thresholds for the diagnosis of adrenal insufficiency: a single-center experience","volume":"19","author":"Grassi","year":"2020","journal-title":"Hormones"},{"key":"10.1016\/j.endien.2025.501685_bib0240","doi-asserted-by":"crossref","DOI":"10.1056\/EVIDoa2200182","article-title":"Home waking salivary cortisone to screen for adrenal insufficiency","volume":"2","author":"Debono","year":"2023","journal-title":"NEJM Evid"},{"key":"10.1016\/j.endien.2025.501685_bib0245","doi-asserted-by":"crossref","first-page":"3888","DOI":"10.1210\/jc.2016-2118","article-title":"Hormonal replacement in hypopituitarism in adults: an Endocrine Society clinical practice guideline","volume":"101","author":"Fleseriu","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.endien.2025.501685_bib0250","first-page":"1101","article-title":"Chronic fatigue syndrome","volume":"2015","author":"Cleare","year":"2015","journal-title":"BMJ Clin Evid"},{"key":"10.1016\/j.endien.2025.501685_bib0255","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12902-016-0128-4","article-title":"Adrenal fatigue does not exist: a systematic review","volume":"16","author":"Cadegiani","year":"2016","journal-title":"BMC Endocr Disord"},{"key":"10.1016\/j.endien.2025.501685_bib0260","doi-asserted-by":"crossref","first-page":"258","DOI":"10.7861\/clinmedicine.17-3-258","article-title":"Adrenal insufficiency \u2013 recognition and management","volume":"17","author":"Pazderska","year":"2017","journal-title":"Clin Med"},{"key":"10.1016\/j.endien.2025.501685_bib0265","doi-asserted-by":"crossref","first-page":"3655","DOI":"10.1210\/jc.2012-1806","article-title":"Measurements of serum DHEA and DHEA sulphate levels improve the accuracy of the low-dose cosyntropin test in the diagnosis of central adrenal insufficiency","volume":"97","author":"Sayyed Kassem","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.endien.2025.501685_bib0270","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2152\/jmi.67.95","article-title":"30-minute delta cortisol post-ACTH stimulation test and proposed cut-off levels for adrenal insufficiency diagnosis","volume":"67","author":"Manosroi","year":"2020","journal-title":"J Med Invest"},{"key":"10.1016\/j.endien.2025.501685_bib0275","doi-asserted-by":"crossref","first-page":"4587","DOI":"10.1210\/jc.2019-00295","article-title":"Evaluating the low-dose ACTH stimulation test in children: ideal times for cortisol measurement","volume":"104","author":"Gill","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.endien.2025.501685_bib0280","doi-asserted-by":"crossref","first-page":"508","DOI":"10.4158\/EP14423.OR","article-title":"The low-dose ACTH stimulation test: is 30 minutes long enough?","volume":"21","author":"Cartaya","year":"2015","journal-title":"Endocr Pract"},{"key":"10.1016\/j.endien.2025.501685_bib0285","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.1210\/jc.2012-3576","article-title":"Free and total plasma cortisol measured by immunoassay and mass spectrometry following ACTH1-24 stimulation in the assessment of pituitary patients","volume":"98","author":"Burt","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.endien.2025.501685_bib0290","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1210\/jc.2017-02602","article-title":"The short cosyntropin test revisited: new normal reference range using LC-MS\/MS","volume":"103","author":"Ueland","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.endien.2025.501685_bib0295","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/j.1365-2265.2010.03944.x","article-title":"Does recovery of adrenal function occur in patients with autoimmune Addison's disease? Recovery in Addison's disease","volume":"74","author":"Smans","year":"2011","journal-title":"Clin Endocrinol (Oxf)"},{"key":"10.1016\/j.endien.2025.501685_bib0300","doi-asserted-by":"crossref","first-page":"4245","DOI":"10.1210\/jc.2008-0710","article-title":"Corticotropin tests for hypothalamic\u2013pituitary\u2013adrenal insufficiency: a meta-analysis","volume":"93","author":"Kazlauskaite","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.endien.2025.501685_bib0305","doi-asserted-by":"crossref","DOI":"10.1177\/11795514221093316","article-title":"Pre-test cortisol levels in predicting short Synacthen test outcome: a retrospective analysis","volume":"15","author":"Ravindran","year":"2022","journal-title":"Clin Med Insights Endocrinol Diabetes"},{"key":"10.1016\/j.endien.2025.501685_bib0310","series-title":"Comprehensive physiology [Internet]","first-page":"889","article-title":"Steroidogenesis\u2014adrenal cell signal transduction","author":"Gallo-Payet","year":"2014"}],"container-title":["Endocrinolog\u00eda, Diabetes y Nutrici\u00f3n (English ed.)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2530018025001660?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2530018025001660?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T17:26:28Z","timestamp":1773163588000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2530018025001660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["S2530018025001660"],"URL":"https:\/\/doi.org\/10.1016\/j.endien.2025.501685","relation":{},"ISSN":["2530-0180"],"issn-type":[{"value":"2530-0180","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"New cortisol assay-specific thresholds for the biochemical diagnosis of adrenal insufficiency after ACTH stimulation","name":"articletitle","label":"Article Title"},{"value":"Endocrinolog\u00eda, Diabetes y Nutrici\u00f3n (English ed.)","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.endien.2025.501685","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 SEEN and SED. Published by Elsevier Espa\u00f1a, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"501685"}}