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

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dc.contributor.authorCiftci, S
dc.contributor.authorSoyluk, O
dc.contributor.authorSelek, A
dc.contributor.authorErol, S
dc.contributor.authorHekimsoy, Z
dc.contributor.authorEsen, A
dc.contributor.authorDursun, H
dc.contributor.authorSahin, S
dc.contributor.authorOruk, G
dc.contributor.authorMert, M
dc.contributor.authorSoylu, H
dc.contributor.authorYurekli, BS
dc.contributor.authorErtorer, ME
dc.contributor.authorOmma, T
dc.contributor.authorEvran, M
dc.contributor.authorAdas, M
dc.contributor.authorTanrikulu, S
dc.contributor.authorAydin, K
dc.contributor.authorPekkolay, Z
dc.contributor.authorCan, B
dc.contributor.authorKarakilic, E
dc.contributor.authorKaraca, Z
dc.contributor.authorBilen, H
dc.contributor.authorCanturk, Z
dc.contributor.authorCetinarslan, B
dc.contributor.authorKadioglu, P
dc.contributor.authorYarman, S
dc.date.accessioned2024-07-18T12:08:14Z
dc.date.available2024-07-18T12:08:14Z
dc.description.abstractThe 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.
dc.identifier.issn0018-5043
dc.identifier.other1439-4286
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/10862
dc.language.isoEnglish
dc.publisherGEORG THIEME VERLAG KG
dc.subjectDEHYDROEPIANDROSTERONE-SULFATE
dc.subjectADRENAL ANDROGEN
dc.subjectACTH
dc.subjectSECRETION
dc.subjectCORTISOL
dc.subjectDISSOCIATION
dc.subjectRECURRENCE
dc.subjectDISEASE
dc.subjectTUMOR
dc.titleThe Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis?
dc.typeArticle

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