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Diagnostics of hypercortisolism — comparison between the clinical usefulness of salivary and serum cortisol measurements
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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.
Keywords
salivary cortisol, serum cortisol, urinary cortisol, overt Cushing’s syndrome, sublinical Cushing’s syndrome, pseudo Cushing’s state
About this articleTitle
Diagnostics of hypercortisolism — comparison between the clinical usefulness of salivary and serum cortisol measurements
Journal
Issue
Article type
Original paper
Pages
263-267
Published online
2013-09-03
Page views
1627
Article views/downloads
2954
DOI
10.5603/EP.2013.0003
Bibliographic record
Endokrynol Pol 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
