Usefulness of salivary cortisol in the diagnosis of hypercortisolism: comparison with serum and urinary cortisol
ObjectiveSeveral tests have been proposed to diagnose patients with Cushing's syndrome (CS). The aims of the study were: i) to evaluate the performance of salivary cortisol (SC) in hypercortisolism and ii) to compare SC with serum cortisol (SeC) and urinary cortisol.Design and patientsThis was...
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| Veröffentlicht in: | European journal of endocrinology 2013-03, Vol.168 (3), p.315-321 |
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| creator | Manetti, Luca Rossi, Giuseppe Grasso, Lucia Raffaelli, Valentina Scattina, Ilaria Del Sarto, Simone Cosottini, Mirco Iannelli, Aldo Gasperi, Maurizio Bogazzi, Fausto Martino, Enio |
| description | ObjectiveSeveral tests have been proposed to diagnose patients with Cushing's syndrome (CS). The aims of the study were: i) to evaluate the performance of salivary cortisol (SC) in hypercortisolism and ii) to compare SC with serum cortisol (SeC) and urinary cortisol.Design and patientsThis was a diagnostic study. Twenty-seven patients with untreated Cushing's disease (CD untr), 21 women consuming oral contraceptive pill (OCP), 18 pregnant women, and 89 healthy subjects (controls) were enrolled.MethodsSC and SeC at baseline and after the low-dose dexamethasone suppression test (LDDST) and urinary free cortisol (UFC) were measured.ResultsMidnight SC had a sensitivity of 100% in the CD untr group and a specificity of 97.7% in the controls. Specificity remained high (95.2%) in women taking OCP, while in pregnant women, it decreased to 83.3%. SC after the LDDST showed a sensitivity of 96.3% in the CD untr group; specificity was 97.7% in the controls and 90.5% in OCP women. Midnight SeC had a sensitivity of 100% in the CD untr group. SeC after the LDDST had a sensitivity of 100% in the CD untr group while specificity was 97.7% in the controls and 61.9% in women taking OCP. For UFC, sensitivity was 92.6% in the CD untr group while specificity was 97.7% in the controls and 100% in the OCP group.ConclusionsSC is a reliable parameter for the diagnosis of severe hypercortisolism, with high sensitivity and specificity. In women during pregnancy or taking OCP, the measurement of SC, identifying the free fraction, could be helpful to exclude CS. |
| doi_str_mv | 10.1530/EJE-12-0685 |
| format | Article |
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The aims of the study were: i) to evaluate the performance of salivary cortisol (SC) in hypercortisolism and ii) to compare SC with serum cortisol (SeC) and urinary cortisol.Design and patientsThis was a diagnostic study. Twenty-seven patients with untreated Cushing's disease (CD untr), 21 women consuming oral contraceptive pill (OCP), 18 pregnant women, and 89 healthy subjects (controls) were enrolled.MethodsSC and SeC at baseline and after the low-dose dexamethasone suppression test (LDDST) and urinary free cortisol (UFC) were measured.ResultsMidnight SC had a sensitivity of 100% in the CD untr group and a specificity of 97.7% in the controls. Specificity remained high (95.2%) in women taking OCP, while in pregnant women, it decreased to 83.3%. SC after the LDDST showed a sensitivity of 96.3% in the CD untr group; specificity was 97.7% in the controls and 90.5% in OCP women. Midnight SeC had a sensitivity of 100% in the CD untr group. SeC after the LDDST had a sensitivity of 100% in the CD untr group while specificity was 97.7% in the controls and 61.9% in women taking OCP. For UFC, sensitivity was 92.6% in the CD untr group while specificity was 97.7% in the controls and 100% in the OCP group.ConclusionsSC is a reliable parameter for the diagnosis of severe hypercortisolism, with high sensitivity and specificity. In women during pregnancy or taking OCP, the measurement of SC, identifying the free fraction, could be helpful to exclude CS.</description><identifier>ISSN: 0804-4643</identifier><identifier>EISSN: 1479-683X</identifier><identifier>DOI: 10.1530/EJE-12-0685</identifier><identifier>PMID: 23211575</identifier><language>eng</language><publisher>Bristol: BioScientifica</publisher><subject>Adolescent ; Adrenals. Adrenal axis. Renin-angiotensin system (diseases) ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Circadian Rhythm ; Clinical Study ; Contraceptives, Oral - pharmacology ; Cushing Syndrome - diagnosis ; Cushing Syndrome - metabolism ; Cushing Syndrome - physiopathology ; Cushing Syndrome - urine ; Dexamethasone ; Endocrinopathies ; Female ; Fundamental and applied biological sciences. Psychology ; Glucocorticoids ; Humans ; Hydrocortisone - blood ; Hydrocortisone - metabolism ; Hydrocortisone - secretion ; Hydrocortisone - urine ; Male ; Medical sciences ; Middle Aged ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Pregnancy ; Pregnancy Complications - diagnosis ; Pregnancy Complications - metabolism ; Pregnancy Complications - physiopathology ; Pregnancy Complications - urine ; Saliva - metabolism ; Sensitivity and Specificity ; Severity of Illness Index ; Vertebrates: endocrinology ; Young Adult</subject><ispartof>European journal of endocrinology, 2013-03, Vol.168 (3), p.315-321</ispartof><rights>2013 European Society of Endocrinology</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b440t-fb4874c784c0492b8de103625403e8477b695f3ba72dc41dd615278ffd8427a73</citedby><cites>FETCH-LOGICAL-b440t-fb4874c784c0492b8de103625403e8477b695f3ba72dc41dd615278ffd8427a73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27158705$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23211575$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manetti, Luca</creatorcontrib><creatorcontrib>Rossi, Giuseppe</creatorcontrib><creatorcontrib>Grasso, Lucia</creatorcontrib><creatorcontrib>Raffaelli, Valentina</creatorcontrib><creatorcontrib>Scattina, Ilaria</creatorcontrib><creatorcontrib>Del Sarto, Simone</creatorcontrib><creatorcontrib>Cosottini, Mirco</creatorcontrib><creatorcontrib>Iannelli, Aldo</creatorcontrib><creatorcontrib>Gasperi, Maurizio</creatorcontrib><creatorcontrib>Bogazzi, Fausto</creatorcontrib><creatorcontrib>Martino, Enio</creatorcontrib><title>Usefulness of salivary cortisol in the diagnosis of hypercortisolism: comparison with serum and urinary cortisol</title><title>European journal of endocrinology</title><addtitle>Eur J Endocrinol</addtitle><description>ObjectiveSeveral tests have been proposed to diagnose patients with Cushing's syndrome (CS). The aims of the study were: i) to evaluate the performance of salivary cortisol (SC) in hypercortisolism and ii) to compare SC with serum cortisol (SeC) and urinary cortisol.Design and patientsThis was a diagnostic study. Twenty-seven patients with untreated Cushing's disease (CD untr), 21 women consuming oral contraceptive pill (OCP), 18 pregnant women, and 89 healthy subjects (controls) were enrolled.MethodsSC and SeC at baseline and after the low-dose dexamethasone suppression test (LDDST) and urinary free cortisol (UFC) were measured.ResultsMidnight SC had a sensitivity of 100% in the CD untr group and a specificity of 97.7% in the controls. Specificity remained high (95.2%) in women taking OCP, while in pregnant women, it decreased to 83.3%. SC after the LDDST showed a sensitivity of 96.3% in the CD untr group; specificity was 97.7% in the controls and 90.5% in OCP women. Midnight SeC had a sensitivity of 100% in the CD untr group. SeC after the LDDST had a sensitivity of 100% in the CD untr group while specificity was 97.7% in the controls and 61.9% in women taking OCP. For UFC, sensitivity was 92.6% in the CD untr group while specificity was 97.7% in the controls and 100% in the OCP group.ConclusionsSC is a reliable parameter for the diagnosis of severe hypercortisolism, with high sensitivity and specificity. In women during pregnancy or taking OCP, the measurement of SC, identifying the free fraction, could be helpful to exclude CS.</description><subject>Adolescent</subject><subject>Adrenals. Adrenal axis. Renin-angiotensin system (diseases)</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Circadian Rhythm</subject><subject>Clinical Study</subject><subject>Contraceptives, Oral - pharmacology</subject><subject>Cushing Syndrome - diagnosis</subject><subject>Cushing Syndrome - metabolism</subject><subject>Cushing Syndrome - physiopathology</subject><subject>Cushing Syndrome - urine</subject><subject>Dexamethasone</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Glucocorticoids</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>Hydrocortisone - metabolism</subject><subject>Hydrocortisone - secretion</subject><subject>Hydrocortisone - urine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - diagnosis</subject><subject>Pregnancy Complications - metabolism</subject><subject>Pregnancy Complications - physiopathology</subject><subject>Pregnancy Complications - urine</subject><subject>Saliva - metabolism</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><subject>Vertebrates: endocrinology</subject><subject>Young Adult</subject><issn>0804-4643</issn><issn>1479-683X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90MFr2zAUBnAxVpq062n3octgUNxKsmTJvZWQbiuBXhbozciytGjYsqtnb-S_r9Ika089SYKfvvf4EPpMyRUVOble3i8zyjJSKPEBzSmXZVao_PEjmhNFeMYLns_QGcAfQmi6k1M0YzmjVEgxR8MarJvaYAFw7zDo1v_VcYtNH0cPfYt9wOPG4sbr36EH_6I228HGo_DQ3STeDTqmZ8D__LjBYOPUYR0aPEUf3gZ-QidOt2AvDuc5Wt8tfy1-ZKuH7z8Xt6us5pyMmau5ktxIxQ3hJatVYynJCyY4ya3iUtZFKVxea8kaw2nTFFQwqZxrFGdSy_wcfdvnDrF_miyMVefB2LbVwfYTVJQpVZYiDUv0ck9N7AGiddUQfZeWriipdhVXqeL0odpVnPSXQ_BUd7b5b4-dJvD1ADQY3bqog_Hw6iQVSpKdo3tX-x6Mt2H0zhv97vBnXKqVRw</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Manetti, Luca</creator><creator>Rossi, Giuseppe</creator><creator>Grasso, Lucia</creator><creator>Raffaelli, Valentina</creator><creator>Scattina, Ilaria</creator><creator>Del Sarto, Simone</creator><creator>Cosottini, Mirco</creator><creator>Iannelli, Aldo</creator><creator>Gasperi, Maurizio</creator><creator>Bogazzi, Fausto</creator><creator>Martino, Enio</creator><general>BioScientifica</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130301</creationdate><title>Usefulness of salivary cortisol in the diagnosis of hypercortisolism: comparison with serum and urinary cortisol</title><author>Manetti, Luca ; Rossi, Giuseppe ; Grasso, Lucia ; Raffaelli, Valentina ; Scattina, Ilaria ; Del Sarto, Simone ; Cosottini, Mirco ; Iannelli, Aldo ; Gasperi, Maurizio ; Bogazzi, Fausto ; Martino, Enio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b440t-fb4874c784c0492b8de103625403e8477b695f3ba72dc41dd615278ffd8427a73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adrenals. Adrenal axis. Renin-angiotensin system (diseases)</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Circadian Rhythm</topic><topic>Clinical Study</topic><topic>Contraceptives, Oral - pharmacology</topic><topic>Cushing Syndrome - diagnosis</topic><topic>Cushing Syndrome - metabolism</topic><topic>Cushing Syndrome - physiopathology</topic><topic>Cushing Syndrome - urine</topic><topic>Dexamethasone</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Glucocorticoids</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Hydrocortisone - metabolism</topic><topic>Hydrocortisone - secretion</topic><topic>Hydrocortisone - urine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - diagnosis</topic><topic>Pregnancy Complications - metabolism</topic><topic>Pregnancy Complications - physiopathology</topic><topic>Pregnancy Complications - urine</topic><topic>Saliva - metabolism</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><topic>Vertebrates: endocrinology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manetti, Luca</creatorcontrib><creatorcontrib>Rossi, Giuseppe</creatorcontrib><creatorcontrib>Grasso, Lucia</creatorcontrib><creatorcontrib>Raffaelli, Valentina</creatorcontrib><creatorcontrib>Scattina, Ilaria</creatorcontrib><creatorcontrib>Del Sarto, Simone</creatorcontrib><creatorcontrib>Cosottini, Mirco</creatorcontrib><creatorcontrib>Iannelli, Aldo</creatorcontrib><creatorcontrib>Gasperi, Maurizio</creatorcontrib><creatorcontrib>Bogazzi, Fausto</creatorcontrib><creatorcontrib>Martino, Enio</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of endocrinology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manetti, Luca</au><au>Rossi, Giuseppe</au><au>Grasso, Lucia</au><au>Raffaelli, Valentina</au><au>Scattina, Ilaria</au><au>Del Sarto, Simone</au><au>Cosottini, Mirco</au><au>Iannelli, Aldo</au><au>Gasperi, Maurizio</au><au>Bogazzi, Fausto</au><au>Martino, Enio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Usefulness of salivary cortisol in the diagnosis of hypercortisolism: comparison with serum and urinary cortisol</atitle><jtitle>European journal of endocrinology</jtitle><addtitle>Eur J Endocrinol</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>168</volume><issue>3</issue><spage>315</spage><epage>321</epage><pages>315-321</pages><issn>0804-4643</issn><eissn>1479-683X</eissn><abstract>ObjectiveSeveral tests have been proposed to diagnose patients with Cushing's syndrome (CS). The aims of the study were: i) to evaluate the performance of salivary cortisol (SC) in hypercortisolism and ii) to compare SC with serum cortisol (SeC) and urinary cortisol.Design and patientsThis was a diagnostic study. Twenty-seven patients with untreated Cushing's disease (CD untr), 21 women consuming oral contraceptive pill (OCP), 18 pregnant women, and 89 healthy subjects (controls) were enrolled.MethodsSC and SeC at baseline and after the low-dose dexamethasone suppression test (LDDST) and urinary free cortisol (UFC) were measured.ResultsMidnight SC had a sensitivity of 100% in the CD untr group and a specificity of 97.7% in the controls. Specificity remained high (95.2%) in women taking OCP, while in pregnant women, it decreased to 83.3%. SC after the LDDST showed a sensitivity of 96.3% in the CD untr group; specificity was 97.7% in the controls and 90.5% in OCP women. Midnight SeC had a sensitivity of 100% in the CD untr group. SeC after the LDDST had a sensitivity of 100% in the CD untr group while specificity was 97.7% in the controls and 61.9% in women taking OCP. For UFC, sensitivity was 92.6% in the CD untr group while specificity was 97.7% in the controls and 100% in the OCP group.ConclusionsSC is a reliable parameter for the diagnosis of severe hypercortisolism, with high sensitivity and specificity. In women during pregnancy or taking OCP, the measurement of SC, identifying the free fraction, could be helpful to exclude CS.</abstract><cop>Bristol</cop><pub>BioScientifica</pub><pmid>23211575</pmid><doi>10.1530/EJE-12-0685</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adrenals. Adrenal axis. Renin-angiotensin system (diseases) Adult Aged Aged, 80 and over Biological and medical sciences Circadian Rhythm Clinical Study Contraceptives, Oral - pharmacology Cushing Syndrome - diagnosis Cushing Syndrome - metabolism Cushing Syndrome - physiopathology Cushing Syndrome - urine Dexamethasone Endocrinopathies Female Fundamental and applied biological sciences. Psychology Glucocorticoids Humans Hydrocortisone - blood Hydrocortisone - metabolism Hydrocortisone - secretion Hydrocortisone - urine Male Medical sciences Middle Aged Non tumoral diseases. Target tissue resistance. Benign neoplasms Pregnancy Pregnancy Complications - diagnosis Pregnancy Complications - metabolism Pregnancy Complications - physiopathology Pregnancy Complications - urine Saliva - metabolism Sensitivity and Specificity Severity of Illness Index Vertebrates: endocrinology Young Adult |
| title | Usefulness of salivary cortisol in the diagnosis of hypercortisolism: comparison with serum and urinary cortisol |
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