Determination of cut-off values and sensitivities of tests for the diagnosis of subclinical cushing's syndrome in functional investigation of adrenal incidentalomas

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dc.contributor.authorYıldırım, Abdurrahim
dc.contributor.authorGökosmanoğlu, Feyzi
dc.contributor.authorÖnmez, Attila
dc.date.accessioned2020-05-01T09:11:20Z
dc.date.available2020-05-01T09:11:20Z
dc.date.issued2019
dc.departmentDÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.descriptionWOS: 000486455600001en_US
dc.description.abstractAim: 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.en_US
dc.identifier.doi10.4328/ACAM.5988en_US
dc.identifier.endpage420en_US
dc.identifier.issn2667-663X
dc.identifier.issue4en_US
dc.identifier.startpage417en_US
dc.identifier.urihttps://doi.org/10.4328/ACAM.5988
dc.identifier.urihttps://hdl.handle.net/20.500.12684/5511
dc.identifier.volume10en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.language.isoenen_US
dc.publisherBayrakol Medical Publisheren_US
dc.relation.ispartofAnnals Of Clinical And Analytical Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectCushing's Syndromeen_US
dc.subjectAdrenal Incidentalomasen_US
dc.subjectSalivary Cortisolen_US
dc.titleDetermination of cut-off values and sensitivities of tests for the diagnosis of subclinical cushing's syndrome in functional investigation of adrenal incidentalomasen_US
dc.typeArticleen_US

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