DHEA(S)--a novel marker in Cushing's disease
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DHEA(S)--a novel marker in Cushing's disease. / Burkhardt, T; Schmidt, N O; Vettorazzi, E; Aberle, J; Mengel, M; Flitsch, J.
in: ACTA NEUROCHIR, Jahrgang 155, Nr. 3, 01.03.2013, S. 479-84; discussion 484.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - DHEA(S)--a novel marker in Cushing's disease
AU - Burkhardt, T
AU - Schmidt, N O
AU - Vettorazzi, E
AU - Aberle, J
AU - Mengel, M
AU - Flitsch, J
PY - 2013/3/1
Y1 - 2013/3/1
N2 - INTRODUCTION: Dehydroepiandrosterone sulfate (DHEA(S)) is a multi-functional steroid implicated in a broad range of biological effects, including obesity, diabetes, bone metabolism, neuroprotection, and anti-tumorigenesis. It has not yet undergone wider research in the context of Cushing's disease. The objective of this study was to determine if perioperative blood levels of DHEA(S) correlate with levels of ACTH and cortisol, and therefore may be useful as a new, additional marker for the early definition of cure in patients suffering from Cushing's disease.METHODS: Forty-two consecutive patients undergoing transsphenoidal surgery for Cushing's disease from September 2009 to September 2010 were perioperatively monitored for ACTH, cortisol, and DHEA(S).RESULTS: Pre-operative blood samples revealed ACTH levels of median 65 ng/l (range 11-1,183 ng/l, standard deviation 183.76), cortisol of median 257 μg/l (range 93-803 μg/l, standard deviation 140.88), and DHEA(S) of median 2.22 mg/l (range 0.44-7.79 mg/l, standard deviation 1.82) according to the pathology of Cushing's disease. Postoperative blood samples drawn over a 7-day time span showed a drop in median ACTH to just 14.5 % (median: 9 ng/l, range 2-44, standard deviation 12.75) of its median preoperative figure. Median cortisol levels were reduced to 6.9 % (median: 18 μg/l, range 10-190 μg/l, standard deviation 38.04) of their preoperative values and DHEA(S) levels decreased to 17 % (median: 0.38 mg/l, range 0.05-2.29, standard deviation 0.51). In persistent disease, no patient showed a drop in DHEA(S) below 38 % of its preoperative figures.CONCLUSIONS: DHEA(S) shows the potential to become an additional marker in the diagnosis and follow-up of patients. However, it needs to be examined further, including whether DHEA(S) may also be a useful predictor of recovery of the HPA-axis after successful surgery.
AB - INTRODUCTION: Dehydroepiandrosterone sulfate (DHEA(S)) is a multi-functional steroid implicated in a broad range of biological effects, including obesity, diabetes, bone metabolism, neuroprotection, and anti-tumorigenesis. It has not yet undergone wider research in the context of Cushing's disease. The objective of this study was to determine if perioperative blood levels of DHEA(S) correlate with levels of ACTH and cortisol, and therefore may be useful as a new, additional marker for the early definition of cure in patients suffering from Cushing's disease.METHODS: Forty-two consecutive patients undergoing transsphenoidal surgery for Cushing's disease from September 2009 to September 2010 were perioperatively monitored for ACTH, cortisol, and DHEA(S).RESULTS: Pre-operative blood samples revealed ACTH levels of median 65 ng/l (range 11-1,183 ng/l, standard deviation 183.76), cortisol of median 257 μg/l (range 93-803 μg/l, standard deviation 140.88), and DHEA(S) of median 2.22 mg/l (range 0.44-7.79 mg/l, standard deviation 1.82) according to the pathology of Cushing's disease. Postoperative blood samples drawn over a 7-day time span showed a drop in median ACTH to just 14.5 % (median: 9 ng/l, range 2-44, standard deviation 12.75) of its median preoperative figure. Median cortisol levels were reduced to 6.9 % (median: 18 μg/l, range 10-190 μg/l, standard deviation 38.04) of their preoperative values and DHEA(S) levels decreased to 17 % (median: 0.38 mg/l, range 0.05-2.29, standard deviation 0.51). In persistent disease, no patient showed a drop in DHEA(S) below 38 % of its preoperative figures.CONCLUSIONS: DHEA(S) shows the potential to become an additional marker in the diagnosis and follow-up of patients. However, it needs to be examined further, including whether DHEA(S) may also be a useful predictor of recovery of the HPA-axis after successful surgery.
KW - Adenoma
KW - Adolescent
KW - Adrenocorticotropic Hormone
KW - Adult
KW - Aged
KW - Child
KW - Dehydroepiandrosterone Sulfate
KW - Female
KW - Humans
KW - Hydrocortisone
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Pituitary ACTH Hypersecretion
KW - Pituitary Neoplasms
KW - Postoperative Complications
KW - Predictive Value of Tests
KW - Reference Values
KW - Tumor Markers, Biological
KW - Young Adult
U2 - 10.1007/s00701-012-1596-6
DO - 10.1007/s00701-012-1596-6
M3 - SCORING: Journal article
C2 - 23314986
VL - 155
SP - 479-84; discussion 484
JO - ACTA NEUROCHIR
JF - ACTA NEUROCHIR
SN - 0001-6268
IS - 3
ER -