ArticleEndocrine2015
DHEAS for the prediction of subclinical Cushing's syndrome: perplexing or advantageous?
Article in Endocrine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Subclinical Cushing's syndrome in patients with bilateral compared to unilateral adrenal incidentalomas: a systematic review and meta-analysis.Endocrine · 2016Pooled it
- Diagnostic Utility of ACTH, Cortisol, DHEAS, and Their Derived Ratios in Cushing's Syndrome Subtypes.Journal of clinical medicine · 2026Article
- Adrenalectomy Improves Muscle Strength in Patients with Mild Autonomous Cortisol Secretion: A Comparative Study.Medicina (Kaunas, Lithuania) · 2026Article
- Dehydroepiandrosterone Sulfate in Diagnosing Mild Autonomous Cortisol Secretion and Adrenal Insufficiency.Journal of the Endocrine Society · 2025Review
- Case Report: Adrenocortical adenoma harboring atypical subclinical Cushing's syndrome with dehydroepiandrosterone sulfate transferase and cytochrome b5 expression in tumor cells.Frontiers in endocrinology · 2025Article
- Utilizing dehydroepiandrosterone sulfate and its ratio for detecting mild autonomous cortisol excess in patients with adrenal incidentaloma.Journal of medicine and life · 2023Article
- Pitfalls in the Diagnosis and Management of Hypercortisolism (Cushing Syndrome) in Humans; A Review of the Laboratory Medicine Perspective.Diagnostics (Basel, Switzerland) · 2023Review
- High prevalence of adrenal cortical adenomas in patients with cerebral meningiomas.Journal of endocrinological investigation · 2023Article
- Distinct serum steroid profiles between adrenal Cushing syndrome and Cushing disease.Frontiers in endocrinology · 2023Article
- Association between contralateral adrenal and hypothalamus-pituitary-adrenal axis in benign adrenocortical tumors.Frontiers in endocrinology · 2023Article
- Predictive Factors of Functioning Adrenal Incidentaloma: A 15-Year Retrospective Study.Medicina (Kaunas, Lithuania) · 2022Article
- Approach to the Patient with an Incidental Adrenal Mass.The Medical clinics of North America · 2021Review
- Approach to the Patient With Adrenal Incidentaloma.The Journal of clinical endocrinology and metabolism · 2021Review
- Diagnostic accuracy of the different hormonal tests used for the diagnosis of autonomous cortisol secretion.Scientific reports · 2021Article
- Metabolic Subtyping of Adrenal Tumors: Prospective Multi-Center Cohort Study in Korea.Endocrinology and metabolism (Seoul, Korea) · 2021Article
- Circadian rhythms of 11-oxygenated C19 steroids and ∆5-steroid sulfates in healthy men.European journal of endocrinology · 2021Article
- Diagnostic Accuracy of Dehydroepiandrosterone Sulfate and Corticotropin in Autonomous Cortisol Secretion.Biomedicines · 2021Article
- Repeat Adrenal Vein Sampling in Aldosteronism: Reproducibility and Interpretation of Persistently Discordant Results.The Journal of clinical endocrinology and metabolism · 2021Article
- Steroid profiling in the diagnosis of mild and overt Cushing's syndrome.Best practice & research. Clinical endocrinology & metabolism · 2021Review
- Diagnostic testing of autonomous cortisol secretion in adrenal incidentalomas.Endocrine connections · 2020Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The diagnostic accuracy of dehydroepiandrosterone sulfate (DHEAS) to predict subclinical Cushing's syndrome (sCS) has been a matter of debate. The primary objective of this study was to assess the diagnostic power of DHEAS in predicting sCS. This retrospective study was conducted in a tertiary referral center and based on subjects referred between 2004 and 2014. Data of 249 subjects with adrenal incidentalomas were evaluated. We also reviewed 604 DHEAS measurements from adults, which were performed during the same period in our laboratory (LB group). Adrenocortical function, tumor size, and clinical characteristics were assessed. We diagnosed sCS in 15.2 % of the participants in the presence of ≥2 of the following; 1 mg dexamethasone suppression test >3.0 μg/dl, urinary free cortisol >70 μg/24 h, and corticotrophin (ACTH) <10 pg/ml. DHEAS levels were significantly reduced in patients with sCS (n = 38) compared to sCS (-) (n = 141) and LB groups (n = 604) (27.95, 65.90, and 66.80 µg/dl, respectively, p < 0.001) while age was comparable. The ROC curve analysis showed that the cut-off of the DHEAS with the best diagnostic accuracy for detecting sCS was 40.0 μg/dl (SN, 68 %; SP, 75; PPV, 43 %; NPV, 90 %, AUC: 0.788, p < 0.001). Logistic regression assessed the impact of age, BMI, low DHEAS (<40 μg/dl), bilateral tumors, and tumor size on the likelihood of having sCS. The strongest predictor was low DHEAS, recording an OR of 9.41. DHEAS levels are inversely associated with the extent of cortisol excess. In subjects with intermediate laboratory findings, detection of low DHEAS could be advantageous for distinguishing sCS.
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