ArticleChonnam medical journal2026
Diagnostic Value of Serum Neutrophil Gelatinase-Associated Lipocalin for Adrenal Insufficiency.
Article in Chonnam medical journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The adrenocorticotropic hormone (ACTH) stimulation test is the gold standard for confirming adrenal insufficiency (AI); however, its requirement for frequent blood draws and pharmacologic stimulation can be a barrier to early diagnosis. This study aims to evaluate the diagnostic value of serum neutrophil gelatinase-associated lipocalin (NGAL) as a novel biomarker for diagnosing AI. This prospective study was conducted at Chonnam National University Hwasun Hospital between June 2020 and November 2021. Patients with either pituitary tumors or a history of exogenous steroid use who underwent the rapid ACTH stimulation test were included in the analysis. A total of 75 patients suspected of having AI were analyzed, with 31 patients (41.3%) being diagnosed with AI. Serum NGAL levels were significantly higher in the secondary AI group with pituitary tumors compared to the non-AI group (92.2±33.6 ng/mL vs. 74.7±24.1 ng/mL, p=0.037). There was a negative correlation between serum NGAL levels and cortisol levels 60 minutes after ACTH administration in patients with pituitary tumors (r=-0.246, p=0.043). A positive correlation was found between serum NGAL and baseline serum creatinine levels in the secondary AI group with pituitary tumors (r=0.400, p=0.002). The Receiver operating characteristic curve analysis revealed that the area under the curve for secondary AI was 0.673, with an optimal cut-off value of 78.4 ng/mL, yielding a sensitivity of 60.0% and specificity of 59.4% (p=0.038). Serum NGAL may serve as a supportive diagnostic tool for secondary AI when confirmatory tests are not feasible.
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