A very low dose intravenous dexamethasone suppression test as an index of glucocorticoid sensitivity

作者：Faria Claudia Dutra Costantin; Cobra Jayme F; Silva Tatiane Sousa e; Melo Murilo Rezende^*; Rocha Mylene Neves; Hayashi Lilian Sukusima; Faria Thelma Gomes; Almeida Julio Antonio de Souza e; Kater Claudio Elias; Longui Carlos Alberto

来源：Hormone Research, 2008, 69(6): 357-362.

DOI：10.1159/000117392

• dexamethasone
• intravenous dexamethasone suppression test
• glucocorticoid
• glucocorticoid sensitivity

Background/Aims: The wide variability of responses to corticotherapy suggests a role for individual recognition of steroid sensitivity in order to customize treatment. Oral dexamethasone (DEX) administration may be hindered by the rate of its intestinal absorption and the liver first-passage effect. In this study we suggest that an intravenous very low dose DEX suppression test (VLD IV-DST) can be used as an index for glucocorticoid (GC) sensitivity. Methods: We evaluated 87 normal subjects: 44 prepubertal children, 23 adolescents and 20 adults with a VLD IV-DST using 20 mu g/m(2) of DEX (dose able to recognize GC sensitivity). Cortisol was initially measured at several time-points after DEX prompting us to establish its nadir and subsequent simplification of the test by measuring cortisol at baseline and after 120 min. Results: Baseline cortisol was similar in adolescents and in adults, but lower in children. There was a spectrum of individual responses in all age groups. The percent reduction of cortisol after 120 min was different in these three age groups, with median values of 44.4% in children, 25.9% in adolescents and 61.6% in adults. Conclusion: This simplified VLD IV-DST using 20 mu g/m(2) of DEX is useful to evaluate individual sensitivity to GC in different age groups.

• 出版日期2008