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Makale Tam Makale Uluslararası 2022

The Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis?

Sema Ciftci, Ozlem Soyluk, ALEV SELEK, Selvinaz Erol, ZELİHA HEKİMSOY, Ayse Esen, HÜSEYİN DURSUN, Serdar Sahin, Gonca Oruk, Meral Mert, Huseyin Soylu, BANU PINAR ŞARER YÜREKLİ, Melek Eda Ertorer, Tulay Omma, MEHTAP EVRAN, Mine Adas, Seher Tanrikulu, Kadriye Aydin, ZAFER PEKKOLAY, BÜLENT CAN, ERSEN KARAKILIÇ, ZÜLEYHA CİHAN ÖZDAMAR KARACA, Habib Bilen, ZEYNEP CANTÜRK, Berrin Cetinarslan, Pinar Kadioglu, Sema Yarman

HORMONE AND METABOLIC RESEARCH Cilt 54 · Sayı 04 · ss. 232–237 · 01.04.2022
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Özet

The purpose of this study was to determine possible cut-off levels of basal DHEA-S percentile rank in the differential diagnosis of patients with Cushing's syndrome (CS) with ACTH levels in the gray zone and normal DHEA-S levels. In this retrospective study including 623 pathologically confirmed CS, the DHEA-S percentile rank was calculated in 389 patients with DHEA-S levels within reference interval. The patients were classified as group 1 (n=265 Cushing's disease; CD), group 2 (n=104 adrenal CS) and group 3 (n=20 ectopic ACTH syndrome).ROC-curve analyses were used to calculate the optimal cut-off level of DHEA-S percentile rank in the reference interval in the differential diagnosis of CS, and the effectiveness of this cut-off level in the identification of the accurate etiology of CS was assessed in patients who were in gray zone according to their ACTH levels. The DHEA-S percentile rank in the reference interval were significantly lower in group 2 compared to the other two groups (p<0.001), while group 1 and group 3 had similar levels. The optimal cut-off level of DHEA-S percentile rank in the reference interval providing differential diagnosis between group 1 and group 2 was calculated as 19.5th percentile (80.8% sensitivity, 81.5% specificity) and the level demonstrated the accurate etiology in 100% of CD and 76% of adrenal CS patients who were in the gray zone. This study showed that the cut-off value of DHEA-S level less than 20% of the reference interval could be used for differential diagnosis of CD and adrenal CS with high sensitivity and specificity, and it should be taken into the initial evaluation.

Anahtar kelimeler

DIFFERENTIAL-DIAGNOSIS Cushing's disease adrenal Cushing's syndrome ectopic ACTH syndrome dehydroepiandrosterone-sulfate DHEA-S cut-off

Atıf için künye

Ciftci, S., Soyluk, O., SELEK, A., Erol, S., HEKİMSOY, Z., Esen, A., DURSUN, H., Sahin, S., Oruk, G., Mert, M., Soylu, H., ŞARER YÜREKLİ, B. P., Ertorer, M. E., Omma, T., EVRAN, M., Adas, M., Tanrikulu, S., Aydin, K., PEKKOLAY, Z., … Yarman, S. (2022). The Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis? HORMONE AND METABOLIC RESEARCH, 54(04), 232–237. https://doi.org/10.1055/a-1783-7901

BibTeX 
@article{ciftci2022-228727,
  author = {Ciftci, Sema and Soyluk, Ozlem and SELEK, ALEV and Erol, Selvinaz and HEKİMSOY, ZELİHA and Esen, Ayse and DURSUN, HÜSEYİN and Sahin, Serdar and Oruk, Gonca and Mert, Meral and Soylu, Huseyin and ŞARER YÜREKLİ, BANU PINAR and Ertorer, Melek Eda and Omma, Tulay and EVRAN, MEHTAP and Adas, Mine and Tanrikulu, Seher and Aydin, Kadriye and PEKKOLAY, ZAFER and CAN, BÜLENT and KARAKILIÇ, ERSEN and ÖZDAMAR KARACA, ZÜLEYHA CİHAN and Bilen, Habib and CANTÜRK, ZEYNEP and Cetinarslan, Berrin and Kadioglu, Pinar and Yarman, Sema},
  title = {The Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis?},
  journal = {HORMONE AND METABOLIC RESEARCH},
  year = {2022},
  volume = {54},
  number = {04},
  pages = {232--237},
  issn = {0018-5043},
  doi = {10.1055/a-1783-7901},
  url = {https://akademik.atauni.edu.tr/yayinlar/228727-the-importance-of-dhea-s-levels-in-cushings-syndrome-is-there-a-cut-off-value-in}
}