Clinical Utility of 30- and 60-min Serum Cortisol Values in Cosyntropin Stimulation Test for Diagnosis of Adrenal Insufficiency

Objective: Order to diagnose AI, we examined the usefulness of thirty mints and sixty mints blood cortisol concentrations in the CST. Study Design: Cross-sectional Study Place and Duration of Study: This study was conducted at the Department of Clinical Biochemistry, Aga Khan University Hospital (AKUH), Karachi December 2016 and December 2019. Materials and Methods: After receiving clearance from the hospital's ethical review committee, this investigation was started. All patients who underwent the CST at the AKUH laboratory were included. Results: At 30 and 60 minutes, 519 (70.2%) of the 739 patients included had a satisfactory reaction. While 158 (21.4%) individuals had insufficient reaction at both time periods and were identified as AI. At 30 minutes, 219 people in total shown a subpar reaction. At 60 minutes, only 61 (27.9%) of these participants had a sufficient reaction, while the remaining 158 patients still had an inadequate response. When the gold standard was 30 or 60 minutes, according to receiver operating characteristic curve study, the area under the curve was 98.4% and 99%, respectively. Conclusion: The value for cortisol at 60 minutes is more helpful than at 30 minutes. Therefore, The CST test may be simplified by assessing blood cortisol levels at baseline and after 60 minutes. In nations where cost is the primary barrier to diagnosis and therapy of AI, this simple test may be adequate.