Is evaluation of cortisol after dexamethasone suppression test enough? Analysis of steroid profile after dexamethasone suppression test using tandem mass spectrometry

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F25%3A00085962" target="_blank" >RIV/00023001:_____/25:00085962 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/25:10501594 RIV/00064165:_____/25:10501594

Výsledek na webu

<a href="https://ec.bioscientifica.com/view/journals/ec/14/9/EC-25-0281.xml" target="_blank" >https://ec.bioscientifica.com/view/journals/ec/14/9/EC-25-0281.xml</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1530/EC-25-0281" target="_blank" >10.1530/EC-25-0281</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Is evaluation of cortisol after dexamethasone suppression test enough? Analysis of steroid profile after dexamethasone suppression test using tandem mass spectrometry

Popis výsledku v původním jazyce

Introduction The overnight dexamethasone suppression test (DST) is recommended for the initial testing of Cushing&apos;s syndrome. Simultaneous measurement of dexamethasone and cortisol is recommended. This study aimed to determine the cutoff value for dexamethasone measured in DST analyzed via liquid chromatography tandem mass spectrometry (2D-LC-MS/MS) and to assess whether analysis of adrenal steroids other than cortisol may improve diagnostic accuracy. Methods A prospective study was conducted including patients with adrenal incidentalomas (n = 55), pituitary incidentalomas and symptoms of Cushing&apos;s disease (n = 18), and healthy controls (n = 100) undergoing DST. Plasma levels of ten steroids and dexamethasone were determined via 2D-LC-MS/MS, while cortisol levels were also determined via a chemiluminescence immunoassay. Results The lower 2.5th percentile of plasma dexamethasone in the control group (cortisol level &lt;50 nmol/L) was 3.48 nmol/L, which was set as the cutoff. In the subgroup of patients with adrenal incidentalomas, regardless of the results of DST, subjects exhibited identical changes in the basal adrenal steroid profile: increased 11-deoxycortisol and decreased DHEA and DHEAS levels. After 1 mg dexamethasone administration, cortisol and cortisone levels increased, while decreased androstenedione and 17-OHP levels were detected. Statistically significant changes were found in the subgroup of patients with pituitary incidentalomas: increased levels of 11-deoxycortisol, plasma cortisol, cortisone, and androstenedione were observed only in those with serum cortisol levels &gt;50 nmol/L. Based on the ROC curves, none of the steroid hormones exhibited higher specificity than cortisol. Conclusion Simultaneous measurement of cortisol and dexamethasone increases DST specificity. The cutoff value for dexamethasone was set at 3.48 nmol/L. None of the adrenal steroids in the DST demonstrated increased specificity; thus, a cortisol concentration &lt;50 nmol/L remains the gold standard for ruling out Cushing&apos;s syndrome.

Název v anglickém jazyce

Is evaluation of cortisol after dexamethasone suppression test enough? Analysis of steroid profile after dexamethasone suppression test using tandem mass spectrometry

Popis výsledku anglicky

Introduction The overnight dexamethasone suppression test (DST) is recommended for the initial testing of Cushing&apos;s syndrome. Simultaneous measurement of dexamethasone and cortisol is recommended. This study aimed to determine the cutoff value for dexamethasone measured in DST analyzed via liquid chromatography tandem mass spectrometry (2D-LC-MS/MS) and to assess whether analysis of adrenal steroids other than cortisol may improve diagnostic accuracy. Methods A prospective study was conducted including patients with adrenal incidentalomas (n = 55), pituitary incidentalomas and symptoms of Cushing&apos;s disease (n = 18), and healthy controls (n = 100) undergoing DST. Plasma levels of ten steroids and dexamethasone were determined via 2D-LC-MS/MS, while cortisol levels were also determined via a chemiluminescence immunoassay. Results The lower 2.5th percentile of plasma dexamethasone in the control group (cortisol level &lt;50 nmol/L) was 3.48 nmol/L, which was set as the cutoff. In the subgroup of patients with adrenal incidentalomas, regardless of the results of DST, subjects exhibited identical changes in the basal adrenal steroid profile: increased 11-deoxycortisol and decreased DHEA and DHEAS levels. After 1 mg dexamethasone administration, cortisol and cortisone levels increased, while decreased androstenedione and 17-OHP levels were detected. Statistically significant changes were found in the subgroup of patients with pituitary incidentalomas: increased levels of 11-deoxycortisol, plasma cortisol, cortisone, and androstenedione were observed only in those with serum cortisol levels &gt;50 nmol/L. Based on the ROC curves, none of the steroid hormones exhibited higher specificity than cortisol. Conclusion Simultaneous measurement of cortisol and dexamethasone increases DST specificity. The cutoff value for dexamethasone was set at 3.48 nmol/L. None of the adrenal steroids in the DST demonstrated increased specificity; thus, a cortisol concentration &lt;50 nmol/L remains the gold standard for ruling out Cushing&apos;s syndrome.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30202 - Endocrinology and metabolism (including diabetes, hormones)

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Endocrine Connections

ISSN

2049-3614

e-ISSN

2049-3614

Svazek periodika

14

Číslo periodika v rámci svazku

9

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

11

Strana od-do

"art. no. e250281"

Kód UT WoS článku

001614836500011

EID výsledku v databázi Scopus

2-s2.0-105016153438