在评估上腺功能缺陷时,脱水二二酸盐和基线皮质醇的性能
Ashley J Han1, Malavika Suresh2, Lucinda Gruber3
1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, 55905.
The Journal of clinical endocrinology and metabolism
|December 10, 2024
概括
脱氨二酸盐 (DHEAS) 显示了对上腺功能不全 (AI) 的强烈诊断性能. 将DHEAS与基线皮质醇结合使用可能会减少许多患者复杂检测的需要.
科学领域:
- 内分泌学 在内分泌学.
- 临床诊断 临床诊断 临床诊断
背景情况:
- 诊断上腺功能缺陷 (AI) 通常需要复杂,耗时和昂贵的测试.
- 脱氨硫酸 (DHEAS) 是潜在的生物标志物,用于下丘脑-垂体-上腺 (HPA) 轴的功能.
- 之前对DHEAS进行的大规模AI诊断的评估是有限的.
研究的目的:
- 评估DHEAS和基线皮质醇在识别AI方面的诊断效用.
- 为了比较DHEAS和基线皮质醇的表现与已建立的诊断标准.
主要方法:
- 进行了一项单中心回顾性队列研究.
- 分析了在2005-2023年期间接受了Cosyntropin刺激测试 (CST) 的1135名成年患者.
- 用DHEAS和基线皮质醇的接收器操作特征曲线 (AUROC) 下的面积来评估诊断性能.
主要成果:
- 无论是DHEAS还是基线皮质醇,都表现出良好的独立诊断性能 (两者的AUROC为0.81).
- 最近使用葡萄糖皮质激素对DHEAS的诊断准确性产生了负面影响.
- 对DHEAS和基线皮质醇的特定值确定了AI病例的可能性较低,可能避免进一步测试.
结论:
- 在评估AI方面,DHEAS表现出强大的诊断能力.
- 同时测量基线皮质醇和DHEAS可以避免在大量患者中进行额外的动态测试的必要性.
- 这种方法可以简化人工智能诊断并降低医疗保健成本.
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