Supplementary Material: Diagnostic Tests for Differentiation between Cushing´s Syndrome and Non-Neoplastic Hypercortisolism: A Systematic Review and Meta-analysis

Hinojosa Amaya, José Miguel y González Colmenero, Fernando Díaz y Alvarez Villalobos, Neri Alejandro y Salcido Montenegro, Alejandro y Quintanilla Sánchez, Carolina y Moreno Peña, Pablo José y Manzanares Gallegos, Dulce María y Gutiérrez Dávila, Luis Fernando y Castillo Morales, Patricia Lizeth y García Campa, Mariano y González González, José Gerardo y Varlamov, Elena V. y Rodríguez Gutiérrez, René y Fleseriu, Maria Supplementary Material: Diagnostic Tests for Differentiation between Cushing´s Syndrome and Non-Neoplastic Hypercortisolism: A Systematic Review and Meta-analysis. [Conjunto de datos.] (Sin publicar)

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Context: Differential diagnosis between Cushing’s syndrome (CS) due to neoplastic endogenous hypercortisolism and non-neoplastic hypercortisolism (NNH, pseudo-Cushing’s syndrome) is crucial. Due to worldwide corticotropin-releasing hormone test CRH shortage, accuracy of alternative tests to Dexamethasone (Dex)-CRH is clearly needed. Objective: Asses the diagnostic accuracy of Dex-CRH, desmopressin stimulation test, midnight serum cortisol (MSC), and late-night salivary cortisol (LNSC) levels to distinguish CS from NNH. Methods: Articles through March 2022 were identified from Scopus, Web of Science, MEDLINE, EMBASE, and PubMed. All steps through the systematic review were performed independently and in duplicate and strictly adhered to the updated PRISMA-DTA checklist. Data Synthesis: A total of 26 articles (2059 patients) were included. Dex-CRH had a pooled sensitivity and specificity of 91% (95%CI 87-94%; I2 0%) and 82% (73-88%; I2 50%), desmopressin test 87% (81-91%; I2 34%) and 91% (85-94%; I2 15%), MSC 91% (85-94%; I2 65%) and 80% (70-88%; I2 70%), and LNSC 78% (66-86%; I2 54%) and 88% (83-92%; I2 36%), respectively. SROC areas under the curve were Dex-CRH 0.949, desmopressin test 0.941, MSC 0.939, and LNSC 0.940 without visual or statistical significance. The overall risk of studies bias was moderate. Conclusion: Dex-CRH, the desmopressin stimulation test, and MSC have similar diagnostic accuracy, with Dex-CRH and MSC having slightly higher sensitivity, and the desmopressin test being more specific. LNSC was the least accurate, probably due to high heterogeneity, intrinsic variability, different assays, and lack of consistent reported cutoffs. Our results should increase clinicians’ confidence when deciding which test to perform when facing this challenging differential diagnosis. Key Words: Cushing’s syndrome, neoplastic endogenous hypercortisolism, non-neoplastic hypercortisolism, pseudoCushing’s, dexamethasone CRH test, desmopressin test, salivary cortisol, midnight serum cortisol

Tipo de elemento:

Conjunto de datos.

Materias:

R Medicina > RC Medicina Interna, Psiquiatría, Neurología

Divisiones:

Medicina

Usuario depositante:

Dr. José Miguel Hinojosa Amaya

Creadores:

Creador	Email	ORCID
Hinojosa Amaya, José Miguel	miguel.hinojosa398@uanl.edu.mx	orcid.org/0000-0002-6015-797X
González Colmenero, Fernando Díaz	ferdgc1412@gmail.com	NO ESPECIFICADO
Alvarez Villalobos, Neri Alejandro	villalobos.neri@mayo.edu	NO ESPECIFICADO
Salcido Montenegro, Alejandro	alex.salcido.montenegro@gmail.com	orcid.org/0000-0002-2487-0241
Quintanilla Sánchez, Carolina	carolina.qsg@gmail.com	orcid.org/0000-0002-0595-6162
Moreno Peña, Pablo José	pjmp9926@gmail.com	NO ESPECIFICADO
Manzanares Gallegos, Dulce María	dulcemanzanares20@gmail.com	NO ESPECIFICADO
Gutiérrez Dávila, Luis Fernando	luis.gtz00@gmail.com	NO ESPECIFICADO
Castillo Morales, Patricia Lizeth	s.castillomg@gmail.com	NO ESPECIFICADO
García Campa, Mariano	marianogarciax@gmail.com	NO ESPECIFICADO
González González, José Gerardo	gergonz@hotmail.com	NO ESPECIFICADO
Varlamov, Elena V.	varlamoe@ohsu.com	NO ESPECIFICADO
Rodríguez Gutiérrez, René	rodriguezgutierrez.rene@mayo.edu	orcid.org/0000-0002-3022-5302
Fleseriu, Maria	fleseriu@ohsu.edu	orcid.org/0000-0001-9284-6289