Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (647 page)

   Useful marker for postprandial hyperglycemia

   Performs better than hemoglobin A
_1C
for monitoring glucose profile in pregnancies complicated by type 1 diabetes

   Interpretation

Increased In

   1,5-AG may be increased during IV hyperalimentation.

Decreased In

   Individuals with renal glucose thresholds that are markedly different from 180 mg/dL (e.g., chronic renal failure, pregnancy, and dialysis) and in those undergoing steroid therapy.

   α-Glucosidase inhibitors can decrease 1,5-AG by interfering with its intestinal absorption.

   Limitations

   In patients with poorly controlled DM, 1,5-AG is less sensitive to modest changes in glycemic control because of continuous glycosuria.

   Levels can be influenced by factors such as dairy product, races, uric acid, triglycerides, liver disease, gastrectomy state, and cystic fibrosis.

11-DEOXYCORTISOL

   Definition

   11-Deoxycortisol, also known as cortodoxone, corticosterone, and compound S, is a steroid and an immediate precursor to the production of cortisol. It can be synthesized from 17-hydroxyprogesterone. Excretion in urine is included in 17-ketogenic steroid (17-KGS) and Porter-Silber 17-OHKS measurements, which were originally used to provide some measure of cortisol production. The direct measurement of cortisol has replaced determinations of 17-KS and 17-OHKS.

   
Normal range:
<50 ng/dL in males; <33 ng/dL in females.

   Use