Dehydroepiandrosterone Sulfate in the Assessment of the Hypothalamic-Pituitary-Adrenal Axis

Fischli, Stefan; Jenni, Stefan; Allemann, Sabin; Zwahlen, Marcel; Diem, Peter; Christ, Emanuel; Stettler, Christoph

doi:10.1210/jc.2007-1780

Cited by 43 publications

(32 citation statements)

References 11 publications

(14 reference statements)

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“…One potential explanation for the discrepancy between these results and those found in previous reports [20,21] may be the fact that in the study by Nasrallah and Arafah [20] only adult patients were evaluated. Additionally, in the younger group of patients studied by Fischli et al [21], only 11 patients with an age range between 14 and 30 years were included.…”

Section: Discussioncontrasting

confidence: 82%

“…Previous studies [20,21,23,30], particularly in adult patients, reported that basal serum DHEAS levels were an excellent diagnostic tool to confirm the diagnosis of CAI, with a sensitivity of 100% [20]. Nevertheless, in the present study, even though median basal serum DHEAS levels were significantly lower in the insufficient compared to the sufficient LDT cortisol response groups, basal serum DHEAS levels within the normal range were found in a high percentage of patients included in the former group.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, in the younger group of patients studied by Fischli et al [21], only 11 patients with an age range between 14 and 30 years were included. In our study, median (interquartile range) age was clearly younger.…”

Section: Discussionmentioning

confidence: 99%

“…Even though the regulation of DHEAS production by the zona reticularis of the adrenal cortex at the time of adrenarche is poorly understood [19], it is well known that a trophic adrenal cortex is necessary for DHEAS synthesis. Therefore, in adult patients, it has been proposed that serum DHEAS levels might be a good marker for the analysis of the HPA axis [20,21,22,23]. …”

Section: Introductionmentioning

confidence: 99%

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Central Adrenal Insufficiency Could Not Be Confirmed by Measurement of Basal Serum DHEAS Levels in Pubertal Children

Vaiani

Maceiras²,

Chaler³

et al. 2014

Horm Res Paediatr

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Background: Central adrenal insufficiency (CAI) is due to a decrease of CRH and/or ACTH secretion. ACTH-dependent dehydroepiandrosterone sulphate (DHEAS) has been postulated as a possible marker of adrenal function in adult patients. Aims: To evaluate the usefulness of basal serum DHEAS determination to diagnose CAI in pubertal patients with a suspected diagnosis of CAI. Methods: Ninety-four pubertal patients suspected of having CAI were divided into two groups according to sufficient (group 1) or insufficient (group 2) low-dose ACTH test serum cortisol response. Concordance with low (<2.5th percentile) or normal (≥2.5th percentile) basal serum DHEAS levels for age and sex, respectively, was analysed. Results: Fifty patients (53.2%) in group 1 and 44 (46.8%) in group 2 were included. The median value of serum DHEAS levels in group 2 (0.7 µmol/l, interquartile range 0.44-1.49) was significantly lower than in group 1 (2.13 µmol/l, interquartile range 0.87-3.5; p < 0.03). Nevertheless, serum basal DHEAS levels as a diagnostic marker of CAI showed 39% sensitivity and 80% specificity. Conclusion: In pubertal patients, basal serum DHEAS levels do not seem to be a useful tool to diagnose either sufficiency or insufficiency of secondary adrenal function.

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Section: Discussioncontrasting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Central Adrenal Insufficiency Could Not Be Confirmed by Measurement of Basal Serum DHEAS Levels in Pubertal Children

Vaiani

Maceiras²,

Chaler³

et al. 2014

Horm Res Paediatr

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“…Similar diurnal patterns have also been reported for dehydroepiandrosterone sulfate (DHEAS) [14,15]. Moreover, abnormal concentrations of cortisol and DHEAS have been linked to HPA axis dysfunction [16][17][18][19].…”

Section: Introductionsupporting

confidence: 67%

The Association of 5-HTTLPR XLL Genotype with Higher Cortisol Levels in African Americans

Contreras-Sesvold

Abraham

Devaney

et al. 2015

International Journal of Medical Genetics

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Genetic variants of the human serotonin transporter (SERT) may contribute to HPA axis dysregulation. SERT has two promoter region polymorphisms (5-HTTLPR: VNTR and SNP: rs25531), which may alter levels of SERT protein and its function. Combining these polymorphisms creates a functional polymorphism (FN) which may modulate mRNA expression. This study examines the relationship between these genetic variants and morning and evening salivary samples of both cortisol and dehydroepiandrosterone sulfate (DHEAS) concentrations in 269 African American (AA) adults. Resultant allele frequencies for the VNTR, SNP, and FN genotypes were 70% L (2% XLL), 84% A, and 54% LA (2% XLLA), respectively. The XLL genotype was associated with significantly higher concentrations of cortisol (∼3X) and DHEAS (∼2X) for both VNTR and FN polymorphisms. No significant differences were found for SNP genotypes. Conclusions were that persons with VNTR and FN XLL polymorphisms had significantly higher cortisol and DHEAS concentrations than other genotypes. AAs also appear to have a higher frequency of the rare XL allele than Caucasians. Whether the XLL genotype predisposes AAs to greater health challenges will require further research to determine the implications of these findings.

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Secondary Adrenal Insufficiency

Else

Auchus

2013

Pituitary Disorders

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Dehydroepiandrosterone Sulfate in the Assessment of the Hypothalamic-Pituitary-Adrenal Axis

Cited by 43 publications

References 11 publications

Central Adrenal Insufficiency Could Not Be Confirmed by Measurement of Basal Serum DHEAS Levels in Pubertal Children

Central Adrenal Insufficiency Could Not Be Confirmed by Measurement of Basal Serum DHEAS Levels in Pubertal Children

The Association of 5-HTTLPR XLL Genotype with Higher Cortisol Levels in African Americans

Secondary Adrenal Insufficiency

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