{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:46:40Z","timestamp":1787014000525,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,4,19]],"date-time":"2017-04-19T00:00:00Z","timestamp":1492560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2017,7]]},"abstract":"Summary<\/jats:title>\n \n Objective<\/jats:title>\n \n To determine whether an overnight metyrapone test (\n OMT<\/jats:styled-content>\n ) within the first week postpituitary surgery can definitively assess the hypothalamic\u2010pituitary\u2010adrenal (\n HPA<\/jats:styled-content>\n ) axis, compared with subsequent dynamic tests and glucocorticoid requirement at 6\u00a0months.\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n \n Prospective study measuring morning cortisol levels on days 3 and 4 post\u2010operatively,\n OMT<\/jats:styled-content>\n day 5\u20107 and week 6, week 6 250\u00a0\u03bcg short Synacthen test (\n SST<\/jats:styled-content>\n ) and week 7 insulin tolerance test (\n ITT<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Measurements<\/jats:title>\n Forty participants who underwent pituitary surgery at a single centre (Cushing's disease excluded) were followed for at least 6\u00a0months. 46% had pre\u2010operative adrenal insufficiency.<\/jats:p>\n \n Primary outcome: week 1\n OMT<\/jats:styled-content>\n compared to glucocorticoid requirement at 6\u00a0months. Secondary outcomes: the performance of\n ITT<\/jats:styled-content>\n as a \u201cdefinitive\u201d test and all tests compared to glucocorticoid requirement at 6\u00a0months.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Week 1\n OMT<\/jats:styled-content>\n showed concordance with\n ITT<\/jats:styled-content>\n at week 7 of 78% and glucocorticoid requirement at 6\u00a0months of 81% respectively which was not significantly different from post\u2010operative morning cortisol levels; 37% of participants with an abnormal\n OMT<\/jats:styled-content>\n on day 6 had a normal\n OMT<\/jats:styled-content>\n at week 6. All\n HPA<\/jats:styled-content>\n axis tests showed similar concordance with glucocorticoid requirement at 6\u00a0months of 80%\u201085%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Overnight metyrapone test within the first week after pituitary surgery was no better than an early morning cortisol level at predicting glucocorticoid requirement at 6\u00a0months.\n OMT<\/jats:styled-content>\n at week 6 demonstrated recovery of\n HPA<\/jats:styled-content>\n axis in a substantial proportion of participants who failed earlier assessments; thus, definitive testing should be delayed until 6\u00a0weeks post\u2010operatively.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cen.13334","type":"journal-article","created":{"date-parts":[[2017,3,23]],"date-time":"2017-03-23T08:54:59Z","timestamp":1490259299000},"page":"35-43","source":"Crossref","is-referenced-by-count":13,"title":["Prospective evaluation of a week one overnight metyrapone test with subsequent dynamic assessments of hypothalamic\u2010pituitary\u2010adrenal axis function after pituitary surgery"],"prefix":"10.1111","volume":"87","author":[{"given":"Katherine","family":"English","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology Princess Alexandra Hospital Brisbane Queensland Australia"},{"name":"Faculty of Medicine University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5078-4980","authenticated-orcid":false,"given":"Warrick J.","family":"Inder","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Princess Alexandra Hospital Brisbane Queensland Australia"},{"name":"Faculty of Medicine University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zara","family":"Weedon","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Princess Alexandra Hospital Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goce","family":"Dimeski","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Queensland Brisbane Queensland Australia"},{"name":"Department of Chemical Pathology Princess Alexandra Hospital Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Sorbello","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Princess Alexandra Hospital Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony W.","family":"Russell","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Princess Alexandra Hospital Brisbane Queensland Australia"},{"name":"Faculty of Medicine University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma L","family":"Duncan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Queensland Brisbane Queensland Australia"},{"name":"Department of Endocrinology and Diabetes Royal Brisbane and Women's Hospital Brisbane Queensland Australia"},{"name":"Institute of Health and Biomedical Innovation Faculty of Health Queensland University of Technology Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Cuneo","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Princess Alexandra Hospital Brisbane Queensland 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