{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T07:46:40Z","timestamp":1776844000312,"version":"3.51.2"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T00:00:00Z","timestamp":1676419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Children with a pituitary hormone deficiency are at risk for secondary adrenal insufficiency (AI). A stimulation test is usually performed for diagnosing AI, evaluating both the hypothalamic\u2010pituitary\u2010adrenal\u00a0and growth hormone (GH)\u2010IGF\u20101 axes. This single test is preferred by clinicians and is considerably more tolerable by patients. The objective of this study was to evaluate the glucagon stimulation test (GST), which is commonly used to assess both axes. Its diagnostic capability for GH\u00a0deficiency\u00a0is high and well accepted, however its utility for determining secondary AI has not been well established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study involved 120 patients under 18 years of age with short stature who had undergone both a GST and low dose ACTH stimulation test (LDACTH test). Twenty\u2010six children who had more than 6\u00a0months elapsed between the two tests were excluded from the study. The study was conducted on patients of the Pediatric Endocrinology Department at Soroka University Hospital, a tertiary medical centre in Beer Sheva, Israel. Statistical analyses were carried out via IBM SPSS (v. 22), with a significance level determined at <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Different cortisol cut\u2010off values were assessed for GST and it was determined that the highest combined sensitivity and specificity yielded a cut\u2010off point of 320\u2009nmol\/L (56% sensitivity and 83% specificity) while the currently accepted cut\u2010off value (500\u2009nmol\/L) yielded 100% sensitivity and 6% specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of this study show that GST is not an optimal tool for diagnosing secondary AI. Therefore, clinicians using this test should interpret its results with caution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14887","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T04:25:01Z","timestamp":1675830301000},"page":"678-681","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of glucagon stimulation test and low dose ACTH test in assessing hypothalamic\u2010pituitary\u2010adrenal (HPA) axis in children"],"prefix":"10.1111","volume":"98","author":[{"given":"Guy","family":"Yalovitsky","sequence":"first","affiliation":[{"name":"Goldman Medical School at the Faculty of Health Sciences Ben\u2010Gurion University of the Negev Be'er Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Shaki","sequence":"additional","affiliation":[{"name":"Goldman Medical School at the Faculty of Health Sciences Ben\u2010Gurion University of the Negev Be'er Sheva Israel"},{"name":"Pediatric Endocrinology Unit Soroka University Medical Center Be'er Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1624-1960","authenticated-orcid":false,"given":"Eli","family":"Hershkovitz","sequence":"additional","affiliation":[{"name":"Goldman Medical School at the Faculty of Health Sciences Ben\u2010Gurion University of the Negev Be'er Sheva Israel"},{"name":"Pediatric Endocrinology Unit Soroka University Medical Center Be'er Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Friger","sequence":"additional","affiliation":[{"name":"Goldman Medical School at the Faculty of Health Sciences Ben\u2010Gurion University of the Negev Be'er Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alon","family":"Haim","sequence":"additional","affiliation":[{"name":"Goldman Medical School at the Faculty of Health Sciences 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