ECE2019 Poster Presentations Adrenal and Neuroendocrine Tumours 1 (60 abstracts)
Ninety-four serum steroids measured by gas chromatography tandem mass spectrometry (GC-MS/MS) in patients with Cushing’s syndrome
Václav Hána Jr 1 , Jana Ježková 1 , Mikuláš Kosák 1 , Michal Kršek 1 , Václav Hána 1 & Martin Hill 2
13rd Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic; 2Steroid Hormone Unit, Institute of Endocrinology, Prague, Czech Republic.
Introduction: Gas chromatography tandem mass spectrometry (GC-MS/MS) quantitatively detects many steroids at one time in a single serum sample. Cushing’s syndrome (CS) caused by adrenal adenoma is often associated with decreased DHEAS, whereas low levels of aldosterone in ACTH dependent CS and also low levels of 18-oxocortisol were observed in ectopic CS. We aimed to evaluate steroid differences in various types of CS.
Methods: In serum from patients with CS (51 with Cushing’s disease, 6 with ectopic ACTH-dependent CS, 16 with adrenal adenoma, 7 bilateral adrenal hyperplasia (BMAH) with overt CS, 23 controls) using novel gas chromatography-tandem mass spectrometry (GC-MS/MS) method we measured 94 steroids to evaluate differences between groups.
Results: In Cushing’s disease and ectopic ACTH producing tumors we observed elevated levels of androgens and their metabolites when compared with healthy controls. Mineralocorticoid precursors were elevated in ectopic ACTH syndrome. The levels of androgens were decreased in adrenal adenomas and BMAH. ROC analysis showed 100% sensitivity and 93.6% specificity of 11β-hydroxyepiandrosterone sulfate for discrimination of Cushing’s disease from ectopic ACTH secretion (where it was more elevated). We did not find any significant (P<0.05) difference in steroids that would discriminate BMAH from unilateral adenomas causing Cushing’s syndrome.
Conclusion: Steroid profiling in CS patients shows significant differences between CS types that could ease the achievement of appropriate diagnosis. Further prospective studies are needed for the confirmation of these results.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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