EYES2022 ESE Young Endocrinologists and Scientists (EYES) 2022 Adrenal and Cardiovascular (12 abstracts)
Is it time for age and sex specific diagnostic criteria for patients with adrenal incidentalomas?
Petković T 1 , Marina Lj. 1,2 , Ivović M. 1,2 , Arizanović Z 1 , Tančić Gajić M. 1,2 , Dugić B 3 , Šojat A. S. 1 , Antić N 1 , Saravinovska K 2 , Petković D. S. 2 & Vujović S. 1,2
1Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre of Serbia, National Centre for Infertility and Endocrinology of Gender; 2University of Belgrade, Serbia, Faculty of Medicine; 3University of Belgrade, Serbia, School of Electrical Engineering
Background: Recent studies showed that cortisol autonomy is age and sex dependent and highly associated with higher all-cause mortality in patients with adrenal incidentalomas (AI). Dehydroepiandrosterone sulphate (DHEAS) has been recognized as a valuable diagnostic tool in patients with (possible) autonomous cortisol secretion.
Objectives: As DHEAS levels are sex and age specific we aimed to evaluate its value as a diagnostic tool in patients with adrenal incidentalomas.
Methods: We evaluated 306 patients, the mean age was 59.8 ± 9.6 years, 95 men aged 60.05 ± 9.59 and 211 women aged 59.74 ± 9.65 years. Based on average menopause age of 51, we stratified women in two groups: < 51 and ≥ 51. For the sake of comparison, we age-matched the male group.
Results: The area under the receiver operating characteristic (AUC-ROC) curve for detection of mild cortisol excess in men was 0.65 (95% CI, 0.539 – 0.760, P = 0.012) with a cutoff value of 2.45 μmol/l. In women the AUC-ROC curve was 0.68 (95% CI, 0.610-0.753, P = 0.000) with a cutoff value of 1.27 μmol/l. However, DHEAS lost its significance as a diagnostic tool in age specific groups in men. Whereas, in women, there was an age specific difference between the groups: in women <51 years old the AUC-ROC curve was 0.72 (95% CI, 0.558-0.896, P = 0.022) with a cutoff value of 1.85 μmol/l and in women ≥ 51 years old the AUC-ROC curve was 0.67 (95% CI, 0.595-0.752, P = 0.000) with a cutoff value of 1.05 μmol/l.
Conclusion: DHEAS is a reliable sex specific diagnostic tool for detection of mild cortisol excess but in female patients DHEAS is also age specific.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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