ArticleThe Journal of clinical endocrinology and metabolism2023
Diurnal Range and Intra-patient Variability of ACTH Is Restored With Remission in Cushing's Disease.
Article in The Journal of clinical endocrinology and metabolism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
3 citing papers in PubMed, 4 citations in OpenAlex.
- The prevalence and predictors of Cushing disease recurrence: a 10-year experience of a pituitary tumor center of excellence.Endocrine · 2025Article
- The constrained-disorder principle defines the functions of systems in nature.Frontiers in network physiology · 2024Review
- Diurnal Range and Intra-patient Variability of ACTH Is Restored With Remission in Cushing's Disease.The Journal of clinical endocrinology and metabolism · 2023Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
contextSingle ACTH measurements have limited ability to distinguish patients with Cushing's disease (CD) from those in remission or with other conditions.
objectiveTo investigate the changes in ACTH levels before and after transsphenoidal surgery (TSS) to identify trends that could confirm remission from CD and help establish ACTH cutoffs for targeted clinical trials in CD.
designRetrospective analysis of CD patients who underwent TSS from 2005 to -2019.
settingReferral center. PATIENTS: CD patients (n = 253) with ACTH measurements before and after TSS.
interventionsTSS for CD.
main outcome measuresRemission after TSS.
resultsRemission was observed in 223 patients after TSS. Those in remission had higher ACTH variability at AM (P = .02) and PM (P < .001) time points compared to nonremission. The nonremission group had a significantly narrower diurnal range compared to the remission group (P = <.0001). A decrease in plasma ACTH of ≥50% from mean preoperative levels predicted CD remission after TSS, especially when using PM values. The absolute plasma ACTH concentration and ratio of preoperative to postoperative values were significantly associated with nonremission after multivariable logistic regression (adj P < .001 and .001, respectively).
conclusionsOur findings suggest that ACTH variability is suppressed in CD, and remission from CD is associated with the restoration of this variability. Furthermore, a decrease in plasma ACTH by 50% or more may serve as a predictor of remission post-TSS. These insights could guide clinicians in developing rational outcome measures for interventions targeting CD adenomas.
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