ECE2017 Eposter Presentations: Adrenal and Neuroendocrine Tumours Adrenal cortex (to include Cushing's) (86 abstracts)
Ippokrateion General Hospital of Thessaloniki, Thessaloniki, Greece.
Introduction: Subclinical hypercortisolism (SH) has been reported in 520% of patients with adrenal incidentalomas (AIs), with various cardiometabolic consequences. We intended to investigate the contribution of DHEAS to standard testing, as another indicator of autonomous cortisol secretion in AIs.
Materials and methods: Ninety consecutive patients (n=90) with AIs were included in a prospective cohort study. SH was diagnosed if ≥2 criteria were fulfilled: an overnight dexamethasone suppression test (DST) ≥1.8 μg/dl, a 24 h urinary free cortisol (UFC) above the upper limit of normal, midnight/morning serum cortisol ≥0.5 and plasma ACTH <10 pg/ml. Age- and sex-specific DHEAS ratios were calculated and a ratio of 1.25 was considered the cut off. Data are expressed as median (interquartile range).
Results: Ten cases of SH were found among the 90 patients (11%), harboring 112 AIs. DHEAS ratio in patients with SH was 1.55 (2.5) and 1.85 (2.67) in non-functional AIs. A DHEAS ratio ≤1.25 was not predictive of SH.
Conclusion: DHEAS failed to prove a useful screening tool for SH in patients with AIs in this study. Further study is needed to evaluate its potential as an adjunct to DST.