AI Article Synopsis
- Late-night salivary cortisol (SAF(23)) shows high reproducibility in diagnosing Cushing's syndrome (CS) with a sensitivity of 100% and specificity of 97.5% when levels exceed 3.8 nM.
- In the study, SAF(23) was found to correlate well with 24-hour urine cortisol levels and results from the dexamethasone suppression test (DST).
- The findings suggest that both SAF(23) and the saliva sample after DST (SAF(dex)) are effective noninvasive screening tools for monitoring patients with CS, especially after treatment.
Article Abstract
Objective: The diagnosis of Cushing's syndrome (CS) remains a challenge in clinical endocrinology. The aim of this study was to determine the reproducibility and diagnostic value of late-night salivary cortisol (SAF(23)) for CS and its utility along the follow-up of treated patients. In addition, using the same radioimmunoassay reactives, the cut-off values for saliva and serum cortisol, assessed synchronically after the overnight 1 mg dexamethasone suppression test (DST), were defined.
Design: Twenty-one patients with confirmed CS and 121 volunteers were studied. All the subjects collected 24-h urine for cortisol (UFC). On the same day whole saliva was obtained from the subjects at 23 h for SAF(23). The intraclass coefficient of correlation (ICC) of SAF(23) was estimated in 47 subjects (21 CS and 26 C). At 8 h, after DST, simultaneous saliva and serum samples for cortisol (SAF(dex) and F(dex), respectively) were obtained in 51 subjects (17 CS and 34 C). After specific therapy, 18 patients with CS were followed with SAF(23) measurements. SAF and F were expressed as nM.
Results: The intraclass coefficient of correlation of SAF(23) was 0.89 in CS and 0.83 in C. SAF(23) > 3.8 nM showed a sensitivity and specificity of 100% and 97.5%, respectively, for diagnosing CS. SAF(23) correlated positively with UFC (r = 0.685; P = 0.0001). After DST, SAF(dex) significantly correlated with F(dex) (r = 0.61, P < 0.0001). A cut-off value of SAF(dex) > 2.0 nM and F(dex) > 50.0 nM detected CS with 100% sensitivity and specificity. After successful surgical therapy, 13 patients with CS had SAF(23) levels < 3.8 nM (1.4 +/- 0.8 nM).
Conclusions: SAF(23) and SAF(dex) seem to be good screening tools based on their noninvasive nature, remarkable reproducibility and diagnostic performances.
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| http://dx.doi.org/10.1111/j.1365-2265.2008.03381.x | DOI Listing |
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Article Synopsis
- Late-night salivary cortisol (SAF(23)) shows high reproducibility in diagnosing Cushing's syndrome (CS) with a sensitivity of 100% and specificity of 97.5% when levels exceed 3.8 nM.
- In the study, SAF(23) was found to correlate well with 24-hour urine cortisol levels and results from the dexamethasone suppression test (DST).
- The findings suggest that both SAF(23) and the saliva sample after DST (SAF(dex)) are effective noninvasive screening tools for monitoring patients with CS, especially after treatment.
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