Evaluation of dihydroepiandrostenedione sulfate (DHEASO4) levels in patients with adrenal adenoma with autonomic cortisol secretion

Objective: The aim of this study was to evaluate the biochemical tests used during the diagnosis of our patients we follow up in our clinic for autonomic cortisol secretion (ACS), to check the DHEASO4 level of our patients, and to repeat the patient's examination in terms of metabolic syndrome components. Materials and methods: Thirty-five patients over the age of 18 who were followed up in the endocrinology clinic of Çukurova University Medical Faculty Hospital between January 2015 and June 2021 with the diagnosis of ACS and 32 patients with age- and gender-matched nonfunctional adenomas were included in this study. The parameters to be examined in the study were determined using the automation system (MergenTech EBYS) used in Çukurova University Balcalı Hospital. From here, the biochemical parameters of the patients at the time of admission and the imaging results were obtained and these data were recorded. Results: 65.7% of the patients were female and 34.3% were male. The mean age of the OCS patients included in the study was 58.57±7.81; the mean age of the control group was 57.41±9.09 years. The most common disease in the patients was hypertension (HT) and diabetes mellitus (DM) was the second most common disease. When the biochemical data were examined, a statistically significant difference was found only in triglyceride (TG) values (p= 0.004). When the adenoma sizes and directions of both patient groups were compared, the adenoma sizes of the patients with left adenoma were found to be smaller in those with nonfunctional adenomas (p=0.032). The mean DHEASO4 level was 46.29±31.56 µg/dL in patients with ACS; in patients with nonfunctional adenoma, the mean was calculated as 82.81±47.96 µg/dL, and these results were found to be statistically significant (p=0.001). In this study, the cut-off for DHEASO4 in diagnosing ACS was 53.35 µg/dL, with a sensitivity of 74.3% and a specificity of 74.2%. Conclusion: DHEASO4 levels can be used to diagnose ACS, but more research is needed in more individuals. Keywords: Adrenal incidentaloma, DHEASO4 level, nonfunctional adenoma, autonomic cortisol secretion