Ahn, Chang Ho Lee, Chaelin Shim, Jaeyoon Kong, Sung Hye Kim, Su-Jin Kim, Yong Hwy Lee, Kyu Eun Shin, Chan Soo Kim, Jung Hee Choi, Man Ho 2024-01-19T14:32:46Z 2024-01-19T14:32:46Z 2021-09-05 2021-06 0960-0760 https://pubs.kist.re.kr/handle/201004/116936 To evaluate the diagnostic value of serum levels of adrenal steroids for diagnosing and subtyping Cushing's syndrome. Patients diagnosed with endogenous Cushing's syndrome (34 and 19 patients with adrenal and pi-tuitary Cushing's syndrome, respectively) and healthy controls (n = 34) were consecutively enrolled at Seoul National University from 2016 to 2020. Morning serum samples were collected before and 3 months after treatment. Serum steroids were profiled using liquid chromatography-mass spectrometry. The diagnostic value of each and the combination of steroids were assessed using the area under the curve of receiver operating char-acteristic (AUROC) and decision tree analysis. Tetrahydrocortisone and 68-hydroxycortisol showed the highest AUROC (0.893 and 0.890, respectively) for the diagnosis of endogenous Cushing's syndrome. The decision tree composed of tetrahydrocortisone and 68-hydroxycortisol correctly classified 79/87 (90.8 %) subjects. For sub-typing into adrenal or pituitary Cushing's syndrome, dehydroepiandrosterone sulfate (DHEA-S) showed the highest AUROC (0.988), which was similar to that of plasma ACTH (0.994, P = 0.458). The decision tree composed of only DHEA-S correctly classified 51/53 (96.2 %) of the Cushing's syndrome subtype. DHEA-S showed a significant linear correlation with the plasma ACTH level, but not with the 24-h urine free cortisol or dexamethasone suppression test results. All steroids, except allo-tetrahydrocortisol and tetrahydrocortisone, decreased significantly at 3 months post-treatment with similar patterns in both adrenal and pituitary Cushing's syndrome. Serum steroid profiling using a single morning serum sample provides valuable information for diagnosing and subtyping Cushing's syndrome. English PERGAMON-ELSEVIER SCIENCE LTD MASS-SPECTROMETRY INDUCTION Metabolic changes in serum steroids for diagnosing and subtyping Cushing's syndrome Article 10.1016/j.jsbmb.2021.105856 1 JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY, v.210 JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY 210 scie scopus 000652020500010 2-s2.0-85101916197 Biochemistry & Molecular Biology Endocrinology & Metabolism Biochemistry & Molecular Biology Endocrinology & Metabolism Article MASS-SPECTROMETRY INDUCTION Steroid profiling Cushing&apos s syndrome LC-MS Serum biomarker