Performance of Dehydroepiandrosterone Sulfate and Baseline Cortisol in Assessing Adrenal Insufficiency
Authors' conclusion
DHEAS has good diagnostic performance in assessing AI. Measuring both baseline cortisol and DHEAS concentrations may eliminate the need for further dynamic testing in many patients.
Study context
- Population
- Adults who underwent cosyntropin stimulation testing (CST) 2005–2023 with dehydroepiandrosterone sulfate (DHEAS) measured within 3 months prior to CST195 (17.2%) had adrenal insufficiency (AI)
- Participants
- 1,135 adults
- Exposure
- DHEAS vs baseline cortisol for diagnosing AI
- Outcome
- AUROC for DHEAS and baseline cortisol; prevalence of AI by DHEAS and baseline cortisol concentrations
Methodological detailssingle-centre, referral center
- Single-centre
- Referral center
Main finding
As reported in the abstract
AUROC for AI
| Group | Value | AUROC |
|---|---|---|
| Baseline cortisol | 0.81 (95% CI 0.77–0.84) | 0.81 |
| DHEAS | 0.81 (95% CI 0.78–0.85) | 0.81 |
Value
Baseline cortisol0.81 (95% CI 0.77–0.84)
DHEAS0.81 (95% CI 0.78–0.85)
AUROC
Baseline cortisol0.81
DHEAS0.81
Observational data: associations, not effects.
Further findings
Prevalence of AI by baseline cortisol and DHEAS concentrations
- AI with baseline cortisol ≥10 mcg/dL
- 1.2%
- AI with baseline cortisol 5–9.9 mcg/dL and DHEAS ≥60 mcg/dL
- 1.3%
- AI with baseline cortisol <5 mcg/dL and DHEAS <25 mcg/dL
- 72.2%
Effect of CST timing and recent glucocorticoid use
- Time of CST had no significant effect on diagnostic accuracy of baseline cortisol
- Recent glucocorticoid use decreased DHEAS performance (AUROC 0.72 vs 0.83)
Original publication
Performance of Dehydroepiandrosterone Sulfate and Baseline Cortisol in Assessing Adrenal Insufficiency. J Clin Endocrinol Metab. Published 9 December 2024. doi:10.
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