{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T12:57:35Z","timestamp":1746190655723,"version":"3.37.3"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>While it has been established within the first 4 months of life that there is no circadian rhythm, what is unclear is the usefulness of a random serum cortisol (rSC) level in determining neonatal central adrenal insufficiency (CAI). The objective of the study is to determine the utility of using rSC in infants less than 4 months old in the evaluation of CAI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Patients<\/jats:title><jats:p>Retrospective chart review of infants who underwent a low dose cosyntropin stimulation test \u22644 months of life with rSC taken as baseline cortisol before stimulation. Infants were divided into three groups: those diagnosed with CAI, those at risk for CAI (ARF\u2010CAI) and a non\u2010CAI group. Mean rSC for each group was compared, and ROC analysis was used to identify rSC cut\u2010off for the diagnosis of CAI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and fifty one infants with the mean age of 50.5\u2009\u00b1\u200938.08 days, and 37% of these were born at term gestation. The mean rSC were lower in the CAI group (1.98\u2009\u00b1\u20091.88\u2009mcg\/dl) as compared to the ARF\u2010CAI (6.27\u2009\u00b1\u20095.48\u2009mcg\/dl, <jats:italic>p<\/jats:italic>\u2009=\u2009.002) and non\u2010CAI (4.6\u2009\u00b1\u20094.02\u2009mcg\/dl, <jats:italic>p<\/jats:italic>\u2009=\u2009.007) groups. ROC analysis identified a cut\u2010off of rSC level of 5.6\u2009mcg\/dL is associated with 42.6% sensitivity and 100% specificity for the diagnosis of CAI in term infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrates that though an\u00a0rSC can be used within the first 4 months of life, its value is best when done \u226430 days of life. Moreover, a diagnostic cut\u2010off for CAI using rSC levels was identified for term infants.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14903","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T05:45:00Z","timestamp":1677735900000},"page":"779-787","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The utility of a random cortisol level in determining neonatal central adrenal insufficiency"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2717-7247","authenticated-orcid":false,"given":"Ayse","family":"Bulan","sequence":"first","affiliation":[{"name":"Section of Endocrinology, Department of Pediatrics Nationwide Children's Hospital\/The Ohio State University College of Medicine Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy 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