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Factors associated with an inadequate hypoglycemia in the insulin tolerance test in Japanese patients with suspected or proven hypopituitarism

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Title: Factors associated with an inadequate hypoglycemia in the insulin tolerance test in Japanese patients with suspected or proven hypopituitarism
Authors: Takahashi, Kiyohiko Browse this author
Nakamura, Akinobu Browse this author →KAKEN DB
Miyoshi, Hideaki Browse this author →KAKEN DB
Nomoto, Hiroshi Browse this author
Kameda, Hiraku Browse this author
Cho, Kyu Yong Browse this author
Nagai, So Browse this author →KAKEN DB
Shimizu, Chikara Browse this author →KAKEN DB
Taguri, Masataka Browse this author
Terauchi, Yasuo Browse this author
Atsumi, Tatsuya Browse this author →KAKEN DB
Keywords: Insulin tolerance test
Hypopituitarism
Insulin
Homeostasis model assessment of insulin resistance
Issue Date: Apr-2017
Publisher: The Japan Endocrine Society
Journal Title: Endocrine Journal
Volume: 64
Issue: 4
Start Page: 387
End Page: 392
Publisher DOI: 10.1507/endocrj.EJ16-0332
PMID: 28260701
Abstract: We attempted to identify the predictors of an inadequate hypoglycemia in insulin tolerance test (ITT), defined as a blood glucose level higher than 2.8 mmol/L after insulin injection, in Japanese patients with suspected or proven hypopituitarism. A total of 78 patients who had undergone ITT were divided into adequate and inadequate hypoglycemia groups. The relationships between the subjects' clinical parameters and inadequate hypoglycemia in ITT were analyzed. Stepwise logistic regression analysis identified high systolic blood pressure (SBP) and high homeostasis model assessment of insulin resistance (HOMA-IR) as being independent factors associated with inadequate hypoglycemia in ITT. Receiver operating characteristic (ROC) curve analysis revealed the cutoff value for inadequate hypoglycemia was 109 mmHg for SBP and 1.4 for HOMA-IR. The areas under ROC curve for SBP and HOMA-IR were 0.72 and 0.86, respectively. We confirmed that high values of SBP and HOMA-IR were associated with inadequate hypoglycemia in ITT, regardless of the degree of reduction of pituitary hormone levels. Furthermore, the strongest predictor of inadequate hypoglycemia was obtained by using the cutoff value of HOMA-IR. Our results suggest that HOMA-IR is a useful pre-screening tool for ITT in these populations.
Type: article
URI: http://hdl.handle.net/2115/68405
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 三好 秀明

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