open access

Vol 64, No 4 (2013)
Original papers
Published online: 2013-09-03
Submitted: 2013-09-03
Accepted: 2013-09-03
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Diagnostics of hypercortisolism — comparison between the clinical usefulness of salivary and serum cortisol measurements

Łukasz Żukowski, Janusz Myśliwiec, Maria Górska
DOI: 10.5603/EP.2013.0003
·
Endokrynologia Polska 2013;64(4):263-267.

open access

Vol 64, No 4 (2013)
Original papers
Published online: 2013-09-03
Submitted: 2013-09-03
Accepted: 2013-09-03

Abstract

Introduction: The aim of this study was the comparison of 24h urine free cortisol (UFC), serum cortisol at 11pm (SCM) and late-nightsalivary cortisol (LSC) in patients suspected for hypercortisolism, and an assessment of the usefulness of these measurements in diagnosingovert Cushing’s (OCS) syndrome, pseudo Cushing’s state (PCS) and subclinical Cushing’s syndrome (SCS).

Material and methods: The study group consisted of 82 patients, of whom four patients had SCS, three OCS and eight PCS. For measurementsof LSC, the ELISA method was used, and for UFC and SCM determination, chemiluminescent microparticle immunoassay was used.

Results: The highest correlation coefficient characterised LSC and SCM (r = 0.72). Area under curve (AUC) for SCM and LSC in receiveroperating characteristic (ROC) for OCS was: 0.86 v. 0.74; for PCS: 0.83 v. 0.70; and for SCS: 0.74 v. 0.79.

Conclusions: Our findings suggest that LSC is more useful compared to SCM in diagnosing subclinical Cushing’s syndrome. Moreover,LSC seems to be a valuable diagnostic criterion to distinguish pseudo Cushing’s state. However, to obtain reliable cut-offs for LSC values,a larger group of hypercortisolic patients is needed.

Abstract

Introduction: The aim of this study was the comparison of 24h urine free cortisol (UFC), serum cortisol at 11pm (SCM) and late-nightsalivary cortisol (LSC) in patients suspected for hypercortisolism, and an assessment of the usefulness of these measurements in diagnosingovert Cushing’s (OCS) syndrome, pseudo Cushing’s state (PCS) and subclinical Cushing’s syndrome (SCS).

Material and methods: The study group consisted of 82 patients, of whom four patients had SCS, three OCS and eight PCS. For measurementsof LSC, the ELISA method was used, and for UFC and SCM determination, chemiluminescent microparticle immunoassay was used.

Results: The highest correlation coefficient characterised LSC and SCM (r = 0.72). Area under curve (AUC) for SCM and LSC in receiveroperating characteristic (ROC) for OCS was: 0.86 v. 0.74; for PCS: 0.83 v. 0.70; and for SCS: 0.74 v. 0.79.

Conclusions: Our findings suggest that LSC is more useful compared to SCM in diagnosing subclinical Cushing’s syndrome. Moreover,LSC seems to be a valuable diagnostic criterion to distinguish pseudo Cushing’s state. However, to obtain reliable cut-offs for LSC values,a larger group of hypercortisolic patients is needed.

Get Citation

Keywords

salivary cortisol, serum cortisol, urinary cortisol, overt Cushing’s syndrome, sublinical Cushing’s syndrome, pseudo Cushing’s state

About this article
Title

Diagnostics of hypercortisolism — comparison between the clinical usefulness of salivary and serum cortisol measurements

Journal

Endokrynologia Polska

Issue

Vol 64, No 4 (2013)

Pages

263-267

Published online

2013-09-03

DOI

10.5603/EP.2013.0003

Bibliographic record

Endokrynologia Polska 2013;64(4):263-267.

Keywords

salivary cortisol
serum cortisol
urinary cortisol
overt Cushing’s syndrome
sublinical Cushing’s syndrome
pseudo Cushing’s state

Authors

Łukasz Żukowski
Janusz Myśliwiec
Maria Górska

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