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, Sema
dc.contributor.authorSoyluk, Ozlem
dc.contributor.authorSelek, Alev
dc.contributor.authorErol, Selvinaz
dc.contributor.authorHekimsoy, Zeliha
dc.contributor.authorEsen, Ayse
dc.contributor.authorDursun, Huseyin
dc.date.accessioned2024-04-24T16:24:08Z
dc.date.available2024-04-24T16:24:08Z
dc.date.issued2022
dc.departmentDicle Üniversitesien_US
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.en_US
dc.identifier.doi10.1055/a-1783-7901
dc.identifier.endpage237en_US
dc.identifier.issn0018-5043
dc.identifier.issn1439-4286
dc.identifier.issue4en_US
dc.identifier.pmid35413744
dc.identifier.startpage232en_US
dc.identifier.urihttps://doi.org/10.1055/a-1783-7901
dc.identifier.urihttps://hdl.handle.net/11468/16523
dc.identifier.volume54en_US
dc.identifier.wosWOS:000782182600005
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherGeorg Thieme Verlag Kgen_US
dc.relation.ispartofHormone and Metabolic Research
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectCushing's Diseaseen_US
dc.subjectAdrenal Cushing's Syndromeen_US
dc.subjectEctopic Acth Syndromeen_US
dc.subjectDehydroepiandrosterone-Sulfateen_US
dc.subjectDhea-S Cut-Offen_US
dc.subjectDifferential Diagnosisen_US
dc.titleThe Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis?en_US
dc.titleThe Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis?
dc.typeArticleen_US

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