{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:58:38Z","timestamp":1781330318013,"version":"3.54.1"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":162,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Endocrinology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n Objective<\/jats:title>\n Although various tests are used for Cushing\u2019s syndrome (CS) screening and diagnosis, none exhibit ideal sensitivity or specificity. This study evaluates the association of the blood urea nitrogen (BUN)\/creatinine ratio with disease status in CS and subclinical Cushing\u2019s syndrome (SCS), and with postoperative changes in patients with CS.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A single\u2010center, observational, cross\u2010sectional study conducted at Endocrinology and Metabolic Diseases Clinic of a tertiary training and research hospital in Istanbul, Turkey (2017\u20132022).<\/jats:p>\n <\/jats:sec>\n \n Patients<\/jats:title>\n \n This study included 229 individuals: 151 CS\/SCS patients and 78 healthy controls. CS cases were classified as adrenocorticotropic hormone (ACTH)\u2013dependent (\n n<\/jats:italic>\n \u2009=\u200952) or ACTH\u2010independent (\n n<\/jats:italic>\n \u2009=\u200934).\n <\/jats:p>\n <\/jats:sec>\n \n Measurements<\/jats:title>\n BUN\/creatinine ratios were compared among CS, SCS, and control groups, as well as between pre\u2010 and posttreatment states in CS patients. Correlations between BUN\/creatinine ratio and standard CS diagnostic tests were analyzed. Receiver operating characteristic (ROC) analysis was performed to evaluate the discriminatory performance of the BUN\/creatinine ratio between CS and control groups.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n BUN\/creatinine ratios were significantly higher in CS, ACTH\u2010independent CS, and SCS groups compared to controls. Cutoff values were >\u200915.34 for CS, >\u200913.67 for ACTH\u2010independent CS, and >\u200919.8 for SCS. The BUN\/creatinine ratio correlated positively with basal plasma cortisol, 1\u2009mg dexamethasone suppression test (DST), and midnight serum cortisol in ACTH\u2010dependent CS (\n p<\/jats:italic>\n = 0.047, 0.038, 0.004). In all CS patients, it correlated with 1\u2010mg DST and midnight serum cortisol (\n p<\/jats:italic>\n = 0.041, 0.049). In ACTH\u2010dependent CS, a positive correlation was found between pituitary adenoma diameter and the preoperative BUN\/creatinine ratio (\n p<\/jats:italic>\n = 0.036).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The BUN\/creatinine ratio may provide supportive information associated with CS status and postoperative changes in patients with CS, particularly when standard tests are unavailable or inconclusive. Larger multicenter studies are needed to confirm its clinical utility.<\/jats:p>\n <\/jats:sec>","DOI":"10.1155\/ije\/2517065","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:40:57Z","timestamp":1781329257000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Blood Urea Nitrogen\/Creatinine Ratio in Cushing\u2019s Syndrome: Associations With Disease Status and Postoperative Changes"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6938-0851","authenticated-orcid":false,"given":"C.","family":"Yarkutay Turkkan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M.","family":"Canat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Erhan Gol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Altuntas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"e_1_2_14_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61375-1"},{"key":"e_1_2_14_2_2","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2008-0125"},{"key":"e_1_2_14_3_2","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/1547358"},{"key":"e_1_2_14_4_2","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.104099"},{"key":"e_1_2_14_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-81265-1_27"},{"key":"e_1_2_14_6_2","first-page":"480","volume-title":"Williams Textbook of Endocrinology","author":"Newell-Price J. D. C.","year":"2020"},{"key":"e_1_2_14_7_2","first-page":"8","article-title":"Subclinical Hypercortisolism: An Important, Unrecognized Dysfunction","volume":"21","author":"Pizzorno L.","year":"2022","journal-title":"Integrative Medicine"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05810-y"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-12-200306170-00010"},{"key":"e_1_2_14_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/08958378.2014.955932"},{"key":"e_1_2_14_11_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-65-6-1287"},{"key":"e_1_2_14_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/S00134-019-05760-5"},{"key":"e_1_2_14_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-22676-1"},{"key":"e_1_2_14_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/JCM1106"}],"container-title":["International Journal of Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ije\/2517065","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/ije\/2517065","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ije\/2517065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:40:59Z","timestamp":1781329259000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/ije\/2517065"}},"subtitle":[],"editor":[{"given":"Suraiya","family":"Saleem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/ije\/2517065"],"URL":"https:\/\/doi.org\/10.1155\/ije\/2517065","archive":["Portico"],"relation":{},"ISSN":["1687-8337","1687-8345"],"issn-type":[{"value":"1687-8337","type":"print"},{"value":"1687-8345","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-07-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"2517065"}}