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在上腺库希综合征和库希病之间有明显的血清类固醇特征
Chang Gao1, Li Ding1, Xiaona Zhang1
1Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.
Frontiers in endocrinology
|June 1, 2023
概括
血清类固醇特征,包括脱水氨二硫酸 (DHEA-S) 和脱水氨 (DHEA) 的比例,可以有效地区分上腺库希综合征 (CS) 和库希病 (CD). 这些生物标志物特别有用,当上腺皮质激素 (ACTH) 水平不清楚时.
科学领域:
- 内分泌学 在内分泌学.
- 质谱测量质量谱测量
- 生物标志物发现发现
背景情况:
- 区分上腺库希综合征 (CS) 和库希病 (CD) 是具有挑战性的,因为潜在的模两可或错误地提高了上腺皮质激素 (ACTH) 水平.
- 准确的差异诊断对于适当的患者管理和治疗策略至关重要.
研究的目的:
- 调查血清类固醇资料在区分上腺CS和CD的诊断实用性.
- 为了确定特定的类固醇生物标志物,可以帮助在ACTH水平模两可的情况下进行差异诊断.
主要方法:
- 使用液体染色学-并列质谱法 (LC-MS/MS) 对上腺CS (n=13) 和CD (n=15) 患者的11种血清类固醇的分析.
- 通过将测量度与参考范围的上限进行比较,生成特定年龄和性别的类固醇比率.
- 应用主要成分分析 (PCA) 和直角部分最小方程区分分析 (OPLS-DA) 来分析类固醇配置文件.
主要成果:
- 在使用PCA和OPLS-DA的副腎CS和CD组之间观察到明显的血清类固醇配置文件.
- 确定了脱水素二二酸盐 (DHEA-S),脱水素二 (DHEA) 和二的比率是显著的歧视性生物标志物.
- DHEA-S比率<0.40显示92.31%的灵敏度和93.33%的特异性用于识别上腺CS.
- DHEA比率<0.18显示100%的灵敏度和100%的特异性在确定上腺的CS.
结论:
- 血清DHEA-S和DHEA比率是对上腺CS和CD的差异诊断有价值的工具.
- 这些类固醇比率在临床场景中特别有用,因为错误的ACTH水平增加使诊断复杂化.
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