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OPTIMIZING DIAGNOSTIC ACCURACY IN CUSHING SYNDROME USING 1 MG DEXAMETHASONE SUPPRESSION TEST CUT-OFFS
D S Yaman Kalender1, Mehmet Çalan2, Seçil Özışık3
1Department of Internal Medicine, Dokuz Eylul University Medical School, Izmir.
Acta Endocrinologica (Bucharest, Romania : 2005)
|October 10, 2025
Summary
Optimized cut-off values for the 1 mg dexamethasone suppression test (DST) improve Cushing Syndrome (CS) diagnosis. New thresholds enhance accuracy for differentiating CS subtypes, aiding timely treatment.
Area of Science:
- Endocrinology
- Clinical Diagnostics
Background:
- Diagnosing Cushing Syndrome (CS) is complex due to varied symptoms and subtypes.
- The 1 mg dexamethasone suppression test (DST) is crucial but requires optimized cut-offs for precision.
Purpose of the Study:
- To optimize diagnostic cut-off values for the 1 mg DST in differentiating CS subtypes.
- To enhance diagnostic accuracy and reduce delays in CS management.
Main Methods:
- Retrospective analysis of 237 patients with non-functional adrenal adenomas (NFA), mild autonomous cortisol secretion (MACS), adrenal CS, and pituitary CS.
- Receiver operating characteristic (ROC) curve analysis to evaluate morning cortisol levels post-DST.
Main Results:
- Optimal morning cortisol cut-off levels were identified: 2.14 μg/dL for MACS, 2.3 μg/dL for adrenal CS, and 2.33 μg/dL for pituitary CS.
- These thresholds showed higher sensitivity and specificity compared to the conventional 1.8 μg/dL cut-off.
Conclusions:
- Tailored cut-off values significantly improve diagnostic precision for CS subtypes.
- Personalized diagnostic approaches are essential for accurate CS diagnosis and timely intervention.
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