Loading...
Please wait, while we are loading the content...
Similar Documents
Dehydroepiandrosterone sulfate in the assessment of the hypothalamic-pituitary-adrenal axis.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Fischli, Stefan Jenni, Stefan Allemann, Sabin Zwahlen, Marcel Diem, Peter Stettler, Christoph |
| Copyright Year | 2008 |
| Abstract | CONTEXT The role of dehydroepiandrosterone-sulfate (DHEA-S) in assessing the integrity of the hypothalamic-pituitary-adrenal (HPA) axis in patients with suspected insufficiency is uncertain. OBJECTIVE The objective of the study was to prospectively evaluate the diagnostic value of DHEA-S on HPA function in consecutive patients with suspected HPA insufficiency with and without pituitary lesions at a tertiary referral center. DESIGN AND PATIENTS In 70 consecutive patients, insulin tolerance test was accompanied by measurement of basal DHEA-S. Assessment of HPA axis was based on peak cortisol response in insulin tolerance test (normal > or = 550 nmol/liter). To account for the age and gender dependency of DHEA-S, a z-score was calculated using age- and gender-specific reference values of the assay. RESULTS Individuals with HPA insufficiency had significantly lower z-scores than those with normal HPA function (-1.66 vs. -0.62, P < 0.0001). In individuals up to 30 yr of age, a z-score of -2.0 had 100% sensitivity and specificity regarding HPA function [area under receiver operating characteristics (ROC) curve 1.00], whereas z-scores proved less useful in older individuals. In individuals with pituitary macroadenoma, a z-score below -2.0 had 100% specificity to predict HPA insufficiency (area under ROC curve 0.82). In the absence of a pituitary adenoma, the diagnostic value of the z-score was reduced (area under ROC curve 0.71). CONCLUSIONS Individuals with HPA insufficiency have lower z-scores for DHEA-S than those with normal HPA function. There is evidence that a z-score could be of diagnostic value in assessing HPA integrity, especially in younger patients and patients with pituitary macroadenoma, but further studies are needed to consolidate these findings. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://boris.unibe.ch/22082/1/Fischli%20JClinEndocrinolMetab%202008.pdf |
| Alternate Webpage(s) | http://boris.unibe.ch/22082/1/Fischli%20JClinEndocrinolMetab%202008.pdf |
| PubMed reference number | 17986637v1 |
| Volume Number | 93 |
| Issue Number | 2 |
| Journal | The Journal of clinical endocrinology and metabolism |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Adrenal Glands Adrenal cortical hypofunction Axis vertebra Dehydroepiandrosterone Sulfate Epinephrine Hydrocortisone Nanomole Patients Pituitary Adenoma Posterior Pituitary Hormones Pulmonary Valve Insufficiency Receiver Operating Characteristic Renal Insufficiency emotional dependency hypothalamic-pituitary-adrenal axis liter z-score |
| Content Type | Text |
| Resource Type | Article |
