{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:10:44Z","timestamp":1784005844500,"version":"3.55.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The aims of this study were to evaluate the validity of preoperative basal serum cortisol levels measured in predicting preoperative adrenal insufficiency and also the validity of basal serum cortisol levels and early postoperative insulin tolerance test (ITT) in predicting postoperative adrenal insufficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was prospectively designed and included 64 patients who underwent pituitary surgery for conditions other than Cushing's disease. An ITT was performed preoperatively, on the 6th postoperative day and at the 1st postoperative month. Basal serum cortisol levels were measured on the 2nd, 3rd, 4th, 5th, and 6th postoperative days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with a preoperative basal cortisol level of &lt;165\u200anmol\/l (6\u200a\u03bcg\/dl) showed insufficient cortisol response and those with levels higher than 500\u200anmol\/l (18\u200a\u03bcg\/dl) had sufficient cortisol response to the preoperative ITT. The positive predictive value of the ITT performed on the 6th postoperative day was 69.7%, and the negative predictive value in predicting adrenal insufficiency at the 1st postoperative month was 58%. Patients were considered to have an insufficient cortisol response to ITT at the 1st postoperative month if their basal cortisol levels were &lt;193\u200anmol\/l (7\u200a\u03bcg\/dl) or 220\u200anmol\/l (8\u200a\u03bcg\/dl) or 193\u200anmol\/l (7\u200a\u03bcg\/dl) or 165\u200anmol\/l (6\u200a\u03bcg\/dl) or 83\u200anmol\/l (3\u200a\u03bcg\/dl) on the 2nd\u20136th postoperative days respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Serum basal cortisol levels may be used as the first-line test in the assessment of the hypothalamic\u2013pituitary\u2013adrenal axis both preoperatively and postoperatively. Dynamic testing should be limited to the patients with indeterminate basal cortisol levels.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-10-0229","type":"journal-article","created":{"date-parts":[[2010,6,9]],"date-time":"2010-06-09T01:27:03Z","timestamp":1276046823000},"page":"377-382","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":44,"title":["Can basal cortisol measurement be an alternative to the insulin tolerance test in the assessment of the hypothalamic\u2013pituitary\u2013adrenal axis before and after pituitary surgery?"],"prefix":"10.1093","volume":"163","author":[{"given":"Z","family":"Karaca","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Tanriverdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Atmaca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Gokce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Elbuken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Selcuklu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Unluhizarci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Kelestimur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"issue":"8","key":"1_13892602","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1016\/0026-0495(86)90245-3","volume":"35","author":"Fish","year":"1986","journal-title":"Metabolism: clinical and experimental","ISSN":"https:\/\/id.crossref.org\/issn\/0026-0495","issn-type":"print"},{"issue":"4","key":"2_15662750","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1210\/jc.79.4.923","volume":"79","author":"Grinspoon","year":"1994","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"3","key":"3_7643827","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1002\/bjs.1800560315","volume":"56","author":"Plumpton","year":"1969","journal-title":"The British journal of surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0007-1323","issn-type":"print"},{"issue":"1","key":"4_11036244","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1046\/j.1365-2265.2001.01179.x","volume":"54","author":"Pfeifer","year":"2001","journal-title":"Clinical endocrinology","ISSN":"https:\/\/id.crossref.org\/issn\/0300-0664","issn-type":"print"},{"issue":"3","key":"5_16770323","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1055\/s-2007-979000","volume":"29","author":"Vestergaard","year":"1997","journal-title":"Hormone and metabolic research. 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