Serum Cortisol Levels via Radioimmunoassay vs Liquid Chromatography Mass Spectrophotometry in Healthy Control Subjects and Patients With Adrenal Incidentalomas

Huayllas, Martha Katherine Paniagua; Netzel, Brian C.; Singh, Ravinder J.; Kater, Cláudio E.

doi:10.1093/labmed/lmy005

Cited by 8 publications

(6 citation statements)

References 34 publications

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“…Also, this meta-analysis demonstrated no significant difference in the concentrations of DHEA-S between AD patients and healthy controls, when plasma DHEA-S was measured or assayed methods were not RIA. Our result may suggest that studies using serum sample and RIA when measuring the relationship between DHEA-S and AD may have higher homogeneity (Huayllas et al, 2018). However, considering that most of the eligible studies did not report the time lag between the sample collection and analysis, assay results might have been affected significantly.…”

Section: Discussionmentioning

confidence: 83%

Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate in Alzheimer's Disease: A Systematic Review and Meta-Analysis

Pan

Kaminga

et al. 2019

Front. Aging Neurosci.

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Background and Purpose: Previous studies found inconsistent results for the relationship between Alzheimer's disease and the levels of dehydroepiandrosterone and dehydroepiandrosterone sulfate. This study performed a systematic review and meta-analysis to evaluate previous studies' results on this relationship. Method: Studies related to this outcome were obtained using a systematic search from the electronic databases of PubMed, Embase, Web of Science, and Psyc-ARTICLES in March 2018. The random-effects model was used to measure the strength of the association between Alzheimer's disease and the levels of dehydroepiandrosterone and dehydroepiandrosterone sulfate, using the standardized mean difference. Results: Thirty-one eligible studies were included in the final analysis. There was no statistically significant association between the level of dehydroepiandrosterone and Alzheimer's disease (standardized mean difference: 0.51, 95% confidence interval: −0.44 to 1.45, Z = 1.06, p = 0.29). On the other hand, lower level dehydroepiandrosterone sulfate was observed in patients with Alzheimer's disease than in controls (standardized mean difference: −0.69, 95% confidence interval: −1.17 to −0.22, Z = −2.84, p < 0.01). Conclusion: Decreased dehydroepiandrosterone sulfate concentrations may be an important indicator for Alzheimer's disease, although whether dehydroepiandrosterone sulfate could be used as a diagnostic tool requires further research.

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Section: Discussionmentioning

confidence: 83%

Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate in Alzheimer's Disease: A Systematic Review and Meta-Analysis

Pan

Kaminga

et al. 2019

Front. Aging Neurosci.

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“…Conflicting results may also be the consequence of methodological shortcomings, e. g. determination of DHEAS concentrations using different approaches, including immunoassays that show more cross-reactivity in comparison to mass spectronomy-based techniques which may become a problem in patients with lower DHEAS concentrations. Though cortisol assays seem to render more or less similar results [52]. determination of other adrenal steroids may even render opposite information as shown for aldosterone [53].…”

Section: Discussionmentioning

confidence: 99%

DHEAS and Differential Blood Counts as Indirect Signs of Glucocorticoid Excess in Adrenal Non-Producing Adenomas

et al. 2021

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The majority of incidentally discovered adrenal tumors are later characterized as non-producing adrenocortical adenomas (NPA). We asked whether laboratory abnormalities in parameters that reflect glucocorticoid action can be found in patients with NPA despite their nature of being clinically unapparent. Since glucocorticoids are potent immunosuppressants we studied blood counts and differential blood counts along with corticotropin and dehydroepiandrostenedione sulfate (DHEAS) blood concentrations, as well as cortisol values before and after an overnight 1 mg dexamethasone suppression test. We compared the results of normal individuals, of patients with adrenal adenomas and normal hormone profiles and with subclinical autonomous glucocorticoid hypersecretion, as well as overt cortisol excess. We found that almost all indices of the blood counts were significantly different between the patients groups. In particular, patients with adrenal non-producing adenomas already showed signs of glucocorticoid excess, including relative lymphocytopenia, lowered DHEAS, and ACTH concentrations than control individuals. We also found that the extent of lymphocytopenia correlated with the concentrations of DHEAS and ACTH, and DHEAS correlated well with ACTH. We conclude that the basal ACTH and DHEAS values along with the differential blood counts give good information on the extent of glucocorticoid excess and that silent adrenal adenomas seem to oversecrete glucocorticoids at concentrations that already alter these parameters.

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“…A possible limitation of our study was the use of RIA instead of LC-MS/MS to determine post-DST cortisol levels. However, our in-house RIA has recently been validated against LC-MS/MS by comparing 318 pairs of serum cortisol values obtained from patients with adrenal incidentalomas and normal subjects, disclosing a significant ( P < 0.001) positive correlation of 0.9345 [18].…”

Section: Discussionmentioning

confidence: 99%

“…Serum cortisol and dexamethasone were determined in all samples by in-house RIAs [16, 17] as well as baseline ACTH and dehydroepiandrosterone sulfate (DHEAS) (in most patients) by commercially available kits. Our in-house cortisol RIA has been used routinely for more than 40 years and was recently validated against liquid chromatography–tandem mass spectrometry (LC-MS/MS) [18].…”

Section: Methodsmentioning

confidence: 99%

Cyclic Subclinical Hypercortisolism: A Previously Unidentified Hypersecretory Form of Adrenal Incidentalomas

Giorgi

Corrêa

Costa-Barbosa

et al. 2019

Journal of the Endocrine Society

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Purpose Most adrenal incidentalomas (AIs) are nonfunctioning adenomas (NFAs), but up to 30% may secrete cortisol autonomously without clinical evidence of Cushing syndrome (CS), which nevertheless may increase cardiovascular mortality. This subclinical hypercortisolism (SCH) is confirmed by cortisol resistance to a dexamethasone suppression test (DST). Cyclic cortisol secretion occurs in classic CS but was not reported in SCH. Objective Investigate cyclic cortisol production/autonomy in AIs using sequential DSTs. Methods A total of 251 patients with AI underwent 487 DSTs over 12 years; patients with at least three DSTs were selected. DSTs were validated by measuring serum dexamethasone. Cyclic SCH was defined when at least two abnormal and two normal DSTs were documented. Results A total of 44 patients had three or more DSTs during follow-up: 9 of 44 patients (20.4%) had all negative test results (post-DST cortisol ≤1.8 μg/dL) and were classified as NFA; another nine patients had all positive results (cortisol >1.8 μg/dL) and were classified as sustained SCH. The remaining 26 (59.2%) had discordant responses: 8 of 44 (18.3%) had at least two positive and two negative tests, matching the criterion for cyclic SCH, whereas 18 of 44 (40.9%) had only one discordant test and were classified as possibly cyclic SCH. Eleven of 20 (55%) patients initially classified as NFA did not maintain their cortisol pattern. Conclusions Extended follow-up with repeated DSTs uncovered an unusual subset of AIs with cyclic SCH. Recurring production of cortisol may affect determination of AI subtypes if based on just one DST. Lack of recognition of this phenomenon makes follow-up of patients with AI misleading because even cyclic SCH may result in potential cardiovascular risk.

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Serum Cortisol Levels via Radioimmunoassay vs Liquid Chromatography Mass Spectrophotometry in Healthy Control Subjects and Patients With Adrenal Incidentalomas

Abstract: Serum cortisol concentrations in patients with AI and in control subjects were very similar, as measured by RIA and LC/MS-MS.

Cited by 8 publications

References 34 publications

Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate in Alzheimer's Disease: A Systematic Review and Meta-Analysis

Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate in Alzheimer's Disease: A Systematic Review and Meta-Analysis

DHEAS and Differential Blood Counts as Indirect Signs of Glucocorticoid Excess in Adrenal Non-Producing Adenomas

Cyclic Subclinical Hypercortisolism: A Previously Unidentified Hypersecretory Form of Adrenal Incidentalomas

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