{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:03:11Z","timestamp":1790420591239,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T00:00:00Z","timestamp":1700784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23DK121888"],"award-info":[{"award-number":["K23DK121888"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R03DK132121"],"award-info":[{"award-number":["R03DK132121"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Overnight metyrapone test (OMT) is a dynamic test used to diagnose secondary adrenal insufficiency (SAI). Data on OMT use and its safety are scarce. We aimed to describe the indications and safety of outpatient OMT and compare OMT to the cosyntropin stimulation test (CST).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Single\u2010centre retrospective study of adult patients undergoing OMT between 1 April 2018 and 27 January 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>OMT\u2010related adverse events, post\u2010OMT diagnosis of SAI,\u00a0and OMT comparison to CST.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>OMT was performed in 114 patients (81, 71% women) at a median age of 48 (interquartile range\u00a037\u201358). The pretest probability for SAI was low in 52 (46%) patients, moderate in 48 (42%) patients\u00a0and high in 14 (12%) patients. Adverse events were reported in 7 (6.1%) patients and were mild except for one hospitalization. No baseline or OMT\u2010related factors were associated with the development of adverse events. Prevalence of the OMT\u2010based SAI diagnosis was 26 (23%) and 47 (46%) using 11\u2010deoxycortisol cutoff &lt;7\u00a0and &lt;10\u2009mcg\/dL, respectively. Higher pretest probability was associated with the OMT\u2010based diagnosis of SAI. Post\u2010OMT 11\u2010deoxycortisol cutoff of 10\u2009mcg\/dL was used most to diagnose SAI. Compared to the OMT\u2010based diagnosis of SAI (11\u2010deoxycortisol cutoff of 10\u2009mcg\/dL), the specificity of CST was 100%, but the sensitivity was only 52%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>OMT was well tolerated and used in patients with low and moderate pretest probability for SAI. CST can erroneously exclude patients with SAI. Thus, OMT should be considered in selected patients with normal CST.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.14989","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T20:53:57Z","timestamp":1700859237000},"page":"203-211","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Use of overnight metyrapone test in suspected secondary adrenal insufficiency: A retrospective single\u00a0centre\u2010study"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7156-6229","authenticated-orcid":false,"given":"Jasmine","family":"Saini","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism Mayo Clinic Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul Gregg","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism Mayo Clinic Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5665-0617","authenticated-orcid":false,"given":"Justine","family":"Herndon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism Mayo Clinic Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Erickson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism Mayo Clinic Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4329-3352","authenticated-orcid":false,"given":"Lucinda","family":"Gruber","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism Mayo Clinic Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9332-2524","authenticated-orcid":false,"given":"Irina","family":"Bancos","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism Mayo Clinic Rochester New York USA"},{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70142-1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61684-0"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-3-200308050-00009"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-1700"},{"issue":"7","key":"e_1_2_8_6_1","first-page":"2350","article-title":"Evaluation of the integrity of the hypothalamic\u2010pituitary\u2010adrenal axis by insulin hypoglycemia test","volume":"83","author":"Erturk E","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.79.4.923"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0026-0495(86)90245-3"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/edrv-5-3-371"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1994.tb03011.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1211262"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2002.01509.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2000.01093.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0154"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1983.00350120066016"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1970.00310030082008"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.03141.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2001-011959"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1004129"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13334"},{"issue":"11","key":"e_1_2_8_21_1","first-page":"435","article-title":"Establishment of reference values for endocrine tests. Part IV: adrenal insufficiency","volume":"63","author":"Endert E","year":"2005","journal-title":"Neth J Med"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03350909"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14989","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T03:44:42Z","timestamp":1707277482000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.14989"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,24]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1111\/cen.14989"],"URL":"https:\/\/doi.org\/10.1111\/cen.14989","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,24]]},"assertion":[{"value":"2023-06-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}