Performance of Dehydroepiandrosterone Sulfate and Baseline Cortisol in Assessing Adrenal Insufficiency

Created/Updated: #dec2024

Research by : Ashley J. Han and Malavika Suresh et al.
Summary by: GPT-4o
Edited and Curated by : Dr. Om J Lakhani
Article Recommendations: Dr. NK Singh, Dr Umesh Garg

  1. Title of the article
    Performance of Dehydroepiandrosterone Sulfate and Baseline Cortisol in Assessing Adrenal Insufficiency

  2. First two Authors followed by et al
    Ashley J. Han and Malavika Suresh et al.

  3. One-line summary of the article
    This study evaluates the diagnostic performance of DHEAS and baseline cortisol in identifying adrenal insufficiency, aiming to simplify and reduce the need for dynamic testing.

  4. Six key points from the article

    1. Both DHEAS and baseline cortisol independently exhibited good diagnostic performance for adrenal insufficiency, with AUROC values of 0.81.
    2. Baseline cortisol levels ≥10 mcg/dL effectively ruled out adrenal insufficiency in 98.8% of patients.
    3. DHEAS ≥60 mcg/dL in patients with baseline cortisol between 5-9.9 mcg/dL made adrenal insufficiency highly unlikely.
    4. Patients with baseline cortisol <5 mcg/dL and DHEAS <25 mcg/dL had a 72.2% prevalence of adrenal insufficiency.
    5. Recent glucocorticoid use reduced the diagnostic accuracy of DHEAS but did not affect baseline cortisol performance.
    6. Incorporating DHEAS with baseline cortisol measurements may reduce the need for cosyntropin stimulation tests in many cases.

  5. Practical take-home message
    Combining DHEAS and baseline cortisol measurements offers a practical approach to diagnosing adrenal insufficiency, minimizing the reliance on dynamic tests, particularly in patients with intermediate baseline cortisol values.

Baseline cortisol concentration.png

  1. Citation for the article in Vancouver format
    Han AJ, Suresh M, Gruber LM, Algeciras-Schimnich A, Achenbach SJ, Atkinson EJ, et al. Performance of Dehydroepiandrosterone Sulfate and Baseline Cortisol in Assessing Adrenal Insufficiency. J Clin Endocrinol Metab. 2024;00:1–8. doi:10.1210/clinem/dgae855.

Additional Notes

Associated notes

Diagnosis of Adrenal insufficiency

Associated Mini-Application

Adrenal Insufficiency Diagnostic Calculator using DHEAS based on Han Suresh et al