Ana Torrano Guillamón, Casandra Juárez Sarrión, Eva Prosper Asensi, Jorge Castro López, Paula García San José, Carolina Arenas Bermejo
{"title":"临床诊断性能的皮质醇测定在狗与怀疑肾上腺皮质功能低下。","authors":"Ana Torrano Guillamón, Casandra Juárez Sarrión, Eva Prosper Asensi, Jorge Castro López, Paula García San José, Carolina Arenas Bermejo","doi":"10.2460/ajvr.25.04.0132","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the diagnostic accuracy of the rapid point-of-care ELISA by IDEXX (SNAP) for detecting hypoadrenocorticism (HA) in dogs. A secondary aim was to evaluate the agreement between the SNAP and the veterinary reference laboratory (VRL) using chemiluminescent enzyme immunoassay (IMMULITE 2000) cortisol measurements. We hypothesized that the SNAP would correlate well with the VRL and aid in HA diagnosis.</p><p><strong>Methods: </strong>A prospective observational diagnostic accuracy study was conducted from January 2023 through January 2024, enrolling dogs with suspected HA. Hypoadrenocorticism was diagnosed using an ACTH stimulation test, with basal serum cortisol (BSC) used for screening in some cases. Samples were analyzed by the SNAP and VRL, with the VRL serving as the gold standard.</p><p><strong>Results: </strong>96 dogs were enrolled; 21 were diagnosed with HA. The SNAP showed correlation with the VRL (Spearman ρ = 0.923; P < .001). Median BSC and post-ACTH cortisol concentrations did not differ significantly between methods. A BSC < 2 µg/dL yielded 100% sensitivity for both, with the SNAP showing higher specificity (73.1%) than the VRL (64.2%). Post-ACTH cortisol < 2 µg/dL was 100% specific by both methods, with 95.2% sensitivity using the SNAP. A 10.5% clinical discordance was observed. Passing-Bablok regression revealed proportional and constant bias, with the SNAP test tending to overestimate cortisol concentrations, but in the low cortisol range this overestimation appears minimal.</p><p><strong>Conclusions: </strong>The SNAP correlated with the VRL for HA diagnosis; however, borderline post-ACTH SNAP results should be confirmed with the VRL. The SNAP-derived BSC may be more specific than the VRL for ruling out HA.</p><p><strong>Clinical relevance: </strong>The SNAP test aids HA diagnosis in urgent care.</p>","PeriodicalId":7754,"journal":{"name":"American journal of veterinary research","volume":" ","pages":"1-7"},"PeriodicalIF":1.4000,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic performance of an in-clinic cortisol assay in dogs with suspected hypoadrenocorticism.\",\"authors\":\"Ana Torrano Guillamón, Casandra Juárez Sarrión, Eva Prosper Asensi, Jorge Castro López, Paula García San José, Carolina Arenas Bermejo\",\"doi\":\"10.2460/ajvr.25.04.0132\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To assess the diagnostic accuracy of the rapid point-of-care ELISA by IDEXX (SNAP) for detecting hypoadrenocorticism (HA) in dogs. A secondary aim was to evaluate the agreement between the SNAP and the veterinary reference laboratory (VRL) using chemiluminescent enzyme immunoassay (IMMULITE 2000) cortisol measurements. We hypothesized that the SNAP would correlate well with the VRL and aid in HA diagnosis.</p><p><strong>Methods: </strong>A prospective observational diagnostic accuracy study was conducted from January 2023 through January 2024, enrolling dogs with suspected HA. Hypoadrenocorticism was diagnosed using an ACTH stimulation test, with basal serum cortisol (BSC) used for screening in some cases. Samples were analyzed by the SNAP and VRL, with the VRL serving as the gold standard.</p><p><strong>Results: </strong>96 dogs were enrolled; 21 were diagnosed with HA. The SNAP showed correlation with the VRL (Spearman ρ = 0.923; P < .001). Median BSC and post-ACTH cortisol concentrations did not differ significantly between methods. A BSC < 2 µg/dL yielded 100% sensitivity for both, with the SNAP showing higher specificity (73.1%) than the VRL (64.2%). Post-ACTH cortisol < 2 µg/dL was 100% specific by both methods, with 95.2% sensitivity using the SNAP. A 10.5% clinical discordance was observed. Passing-Bablok regression revealed proportional and constant bias, with the SNAP test tending to overestimate cortisol concentrations, but in the low cortisol range this overestimation appears minimal.</p><p><strong>Conclusions: </strong>The SNAP correlated with the VRL for HA diagnosis; however, borderline post-ACTH SNAP results should be confirmed with the VRL. The SNAP-derived BSC may be more specific than the VRL for ruling out HA.</p><p><strong>Clinical relevance: </strong>The SNAP test aids HA diagnosis in urgent care.</p>\",\"PeriodicalId\":7754,\"journal\":{\"name\":\"American journal of veterinary research\",\"volume\":\" \",\"pages\":\"1-7\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of veterinary research\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://doi.org/10.2460/ajvr.25.04.0132\",\"RegionNum\":3,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of veterinary research","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.2460/ajvr.25.04.0132","RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
Diagnostic performance of an in-clinic cortisol assay in dogs with suspected hypoadrenocorticism.
Objective: To assess the diagnostic accuracy of the rapid point-of-care ELISA by IDEXX (SNAP) for detecting hypoadrenocorticism (HA) in dogs. A secondary aim was to evaluate the agreement between the SNAP and the veterinary reference laboratory (VRL) using chemiluminescent enzyme immunoassay (IMMULITE 2000) cortisol measurements. We hypothesized that the SNAP would correlate well with the VRL and aid in HA diagnosis.
Methods: A prospective observational diagnostic accuracy study was conducted from January 2023 through January 2024, enrolling dogs with suspected HA. Hypoadrenocorticism was diagnosed using an ACTH stimulation test, with basal serum cortisol (BSC) used for screening in some cases. Samples were analyzed by the SNAP and VRL, with the VRL serving as the gold standard.
Results: 96 dogs were enrolled; 21 were diagnosed with HA. The SNAP showed correlation with the VRL (Spearman ρ = 0.923; P < .001). Median BSC and post-ACTH cortisol concentrations did not differ significantly between methods. A BSC < 2 µg/dL yielded 100% sensitivity for both, with the SNAP showing higher specificity (73.1%) than the VRL (64.2%). Post-ACTH cortisol < 2 µg/dL was 100% specific by both methods, with 95.2% sensitivity using the SNAP. A 10.5% clinical discordance was observed. Passing-Bablok regression revealed proportional and constant bias, with the SNAP test tending to overestimate cortisol concentrations, but in the low cortisol range this overestimation appears minimal.
Conclusions: The SNAP correlated with the VRL for HA diagnosis; however, borderline post-ACTH SNAP results should be confirmed with the VRL. The SNAP-derived BSC may be more specific than the VRL for ruling out HA.
Clinical relevance: The SNAP test aids HA diagnosis in urgent care.
期刊介绍：
The American Journal of Veterinary Research supports the collaborative exchange of information between researchers and clinicians by publishing novel research findings that bridge the gulf between basic research and clinical practice or that help to translate laboratory research and preclinical studies to the development of clinical trials and clinical practice. The journal welcomes submission of high-quality original studies and review articles in a wide range of scientific fields, including anatomy, anesthesiology, animal welfare, behavior, epidemiology, genetics, heredity, infectious disease, molecular biology, oncology, pharmacology, pathogenic mechanisms, physiology, surgery, theriogenology, toxicology, and vaccinology. Species of interest include production animals, companion animals, equids, exotic animals, birds, reptiles, and wild and marine animals. Reports of laboratory animal studies and studies involving the use of animals as experimental models of human diseases are considered only when the study results are of demonstrable benefit to the species used in the research or to another species of veterinary interest. Other fields of interest or animals species are not necessarily excluded from consideration, but such reports must focus on novel research findings. Submitted papers must make an original and substantial contribution to the veterinary medicine knowledge base; preliminary studies are not appropriate.
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