Determination of cut-off values and sensitivities of tests for the diagnosis of subclinical cushing's syndrome in functional investigation of adrenal incidentalomas
Küçük Resim Yok
Tarih
2019
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bayrakol Medical Publisher
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Aim: The aim of our study was to determine the sensitivities of tests used in the diagnosis of subclinical Cushing's syndrome (SCS) in patients with adrenal incidentalomas using clinical findings and other biochemical parameters. Material and Method: One hundred and twenty-nine patients with adrenal incidentalomas who were followed up by our endocrinology clinic were included in the study. Patients were divided into 4 groups according to the 1-mg DST results and these groups were compared in terms of age, gender, hormonal parameters, and comorbidities associated with Cushing's syndrome. The cut-off value of salivary cortisol level for the diagnosis of SCS was calculated by ROC curve analysis. Result: If the cut-off values of plasma cortisol levels after the 1-mg DST were considered >= 1,8 mu g/dL, >= 3 mu g/dL, and >= 5 mu g/dL, the detection rates of SCS were respectively 22,4%, 1,4%, and 3,8%. When the cut-off value of plasma cortisol levels after the 1-mg DST was considered >= 1,8 mu g/dL, the sensitivity, specificity, and cut-off value of salivary cortisol levels were calculated as 68%, 57%, and 0.195 mu g/dL by ROC curve analysis. Discussion: As the adrenal mass size and patient age increased, cortisol suppression decreased according to the 1-mg DST. As the cut-off value of plasma cortisol level used in the 1-mg DST decreased, the incidence of SCS increased significantly. This leads to overdiagnosis of SCS in asymptomatic patients with adrenal incidentalomas. New cut-off values should be determined for salivary cortisol level according to different populations.
Açıklama
WOS: 000486455600001
Anahtar Kelimeler
Cushing's Syndrome, Adrenal Incidentalomas, Salivary Cortisol
Kaynak
Annals Of Clinical And Analytical Medicine
WoS Q Değeri
N/A
Scopus Q Değeri
Cilt
10
Sayı
4
