title: Central adrenal insufficiency could not be confirmed by measurement of basal serum DHEAS levels in pubertal children.
abstract: BACKGROUND
  Central adrenal insufficiency (CAI) is due to a decrease of CRH and/or ACTH secretion. ACTH-dependent dehydroepiandrosterone sulphate (DHEAS) has been postulated as a possible marker of adrenal function in adult patients.
  
  
  OBJECTIVE
  To evaluate the usefulness of basal serum DHEAS determination to diagnose CAI in pubertal patients with a suspected diagnosis of CAI.
  
  
  METHODS
  Ninety-four pubertal patients suspected of having CAI were divided into two groups according to sufficient (group 1) or insufficient (group 2) low-dose ACTH test serum cortisol response. Concordance with low (<2.5th percentile) or normal (≥2.5th percentile) basal serum DHEAS levels for age and sex, respectively, was analysed.
  
  
  RESULTS
  Fifty patients (53.2%) in group 1 and 44 (46.8%) in group 2 were included. The median value of serum DHEAS levels in group 2 (0.7 µmol/l, interquartile range 0.44-1.49) was significantly lower than in group 1 (2.13 µmol/l, interquartile range 0.87-3.5; p < 0.03). Nevertheless, serum basal DHEAS levels as a diagnostic marker of CAI showed 39% sensitivity and 80% specificity.
  
  
  CONCLUSIONS
  In pubertal patients, basal serum DHEAS levels do not seem to be a useful tool to diagnose either sufficiency or insufficiency of secondary adrenal function.
authors.affiliation: Endocrine Service, Hospital de Pediatría Garrahan, Buenos Aires, Argentina.
authors.forename: Elisa
authors.initials: E
authors.lastname: Vaiani
authors.forename: Mercedes
authors.initials: M
authors.lastname: Maceiras
authors.forename: Eduardo
authors.initials: E
authors.lastname: Chaler
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Lazzati
authors.forename: Monica
authors.initials: M
authors.lastname: Chiavero
authors.forename: Claudia
authors.initials: C
authors.lastname: Novelle
authors.forename: Marco
authors.initials: M
authors.lastname: Rivarola
authors.forename: Alicia
authors.initials: A
authors.lastname: Belgorosky
mesh_terms: D000293:Adolescent; D000309:Adrenal Insufficiency / Q000097:blood*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002648:Child; D003687:Dehydroepiandrosterone / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D011627:Puberty / Q000097:blood*
chemical_list: D015415:Biomarkers; D003687:Dehydroepiandrosterone; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone