{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:32:01Z","timestamp":1740173521873,"version":"3.37.3"},"reference-count":16,"publisher":"Endocrinology Research Centre","issue":"6","license":[{"start":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T00:00:00Z","timestamp":1609286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.probl-endojournals.ru\/jour\/about\/editorialPolicies#openAccessPolicy"}],"content-domain":{"domain":["www.probl-endojournals.ru"],"crossmark-restriction":true},"short-container-title":["Probl Endokrinol (Mosk)"],"abstract":"<jats:p><jats:bold>BACKGROUND<\/jats:bold>: Diagnostics of growth hormone deficiency (GHD) and secondary adrenal insufficiency (SAI) is based on estimation of peak GH and cortisol concentrations in provocation tests. Russian consensus on diagnostics and treatment of hypopituitarism in children and adolescences recommends to measure GH and cortisol concentrations in every time-point of insulin test (IT). Glucagon test (GT) is discussed in literature as alternative to IT.<jats:bold>AIMS<\/jats:bold>: To estimate the possibility to use provocation GT for diagnostics of SAI and GHD in children and adolescents.<jats:bold>MATERIALS AND METHODS<\/jats:bold>: We investigated blood and urine cortisol levels, IT, and GT in 20 patients 6.5\u201317.8 years (Me 13.0 (10.4; 15.3)) after surgery and\/or radiology and\/or chemical therapy of head and neck tumors; remission for 0.4\u20137.5 years (\u041c\u0435 2.1 (1.5; 5.2)).<jats:bold>RESULTS<\/jats:bold>: With cut-off point 550 nmol\/L sensitivity and specifity of IT was 100% and 60%, GT \u2014 100% and 53% respectively. Minimal cortisol cut-off level for GT with sensitivity 100% was 500 nmol\/L, maximal with specifity 100% \u2014 400 nmol\/L.Early morning cortisol levels did not exceed 250 nmol\/l in 2 patients with SAI; and were above 500 nmol\/l in 8 patients without SAI while primary or repeated examination.GHD was reviled by IT in all patients. Maximal GH concentrations in GT and IT did not differ significantly (p&gt;0.05) but GT results of 4 patients exceeded or met cut-off for this test (7 ng\/ml).GT was characterized by less severity compared with IT.<jats:bold>CONCLUSIONS<\/jats:bold>: For diagnostics of SAI by GT we can advise cut-off points of cortisol level 500 (sensitivity 100%, specifty 53%) and 400 nmol\/L (sensitivity 80%, specifity 100%). Measuring of cortisol levels in 2\u20133 early morning blood samples allows to exclude or to suspect SAI in half of patients before tests. GH peaks in GT can exceed similarly data in IT that needs future investigation.<\/jats:p><jats:p>\u00a0<\/jats:p>","DOI":"10.14341\/probl12528","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T11:42:21Z","timestamp":1610451741000},"page":"50-58","update-policy":"https:\/\/doi.org\/10.14341\/crossmarkpolicy2018","source":"Crossref","is-referenced-by-count":0,"title":["Comparative study of glucagon and insulin tests for diagnostics of secondary adrenal insufficiency and growth hormone deficiency in children and adolescents"],"prefix":"10.14341","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5689-0194","authenticated-orcid":true,"given":"A. V.","family":"Vitebskaya","sequence":"first","affiliation":[{"name":"I.M. Sechenov First Moscow State Medical University (Sechenov University)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4184-2605","authenticated-orcid":true,"given":"E. A.","family":"Pisareva","sequence":"additional","affiliation":[{"name":"I.M. Sechenov First Moscow State Medical University (Sechenov University)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9660-8795","authenticated-orcid":true,"given":"A. V.","family":"Popovich","sequence":"additional","affiliation":[{"name":"I.M. Sechenov First Moscow State Medical University (Sechenov University)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5458","published-online":{"date-parts":[[2020,12,30]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Nagaeva EV. Clinical guidelines on diagnostics and treatment of hypopituitarism in children and adolescences. Problems of Endocrinology. 2013;59(6):27-43. (In Russ.). doi: https:\/\/doi.org\/10.14341\/probl201359627-43","DOI":"10.14341\/probl201359627-43"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Nagaeva EV, Shiryaeva TY, Peterkova VA, et al. Russian national consensus. Diagnostics and treatment of hypopituitarism in children and adolescences. Problems of Endocrinology. 2018;64(6):402-411. (In Russ.). doi: https:\/\/doi.org\/10.14341\/probl10091","DOI":"10.14341\/probl10091"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Society GR. Consensus Guidelines for the Diagnosis and Treatment of Growth Hormone (GH) Deficiency in Childhood and Adolescence: Summary Statement of the GH Research Society1. J Clin Endocrinol Metab. 2000;85(11):3990-3993. doi: https:\/\/doi.org\/10.1210\/jcem.85.11.6984","DOI":"10.1210\/jcem.85.11.6984"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Grimberg A, DiVall SA, Polychronakos C, et al. Guidelines for Growth Hormone and Insulin-Like Growth Factor-I Treatment in Children and Adolescents: Growth Hormone Deficiency, Idiopathic Short Stature, and Primary Insulin-Like Growth Factor-I Deficiency. 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