Urinary cortisol-to-creatinine ratio using a chemiluminescent assay has limited diagnostic accuracy for canine hypercortisolism.

IF 1.4 3区农林科学 Q2 VETERINARY SCIENCES

American journal of veterinary research Pub Date : 2025-04-14 Print Date: 2025-07-01 DOI:10.2460/ajvr.25.01.0020

Francesca Del Baldo, Alessandro Tirolo, Francesco Dondi, Ada Sapignoli, Matteo Galeotti, Antonio Maria Tardo, Stefania Golinelli, Federico Fracassi

{"title":"Urinary cortisol-to-creatinine ratio using a chemiluminescent assay has limited diagnostic accuracy for canine hypercortisolism.","authors":"Francesca Del Baldo, Alessandro Tirolo, Francesco Dondi, Ada Sapignoli, Matteo Galeotti, Antonio Maria Tardo, Stefania Golinelli, Federico Fracassi","doi":"10.2460/ajvr.25.01.0020","DOIUrl":null,"url":null,"abstract":"Objective: To establish the de novo reference interval (RI) for urinary cortisol-to-creatinine ratio (UCCR) in healthy dogs (HDs) using the currently available chemiluminescent enzyme immunoassay antibody (Veterinary Cortisol; IMMULITE 2000 XPi; Siemens Healthineers) and to evaluate UCCR diagnostic performance in dogs with hypercortisolism (HC).Methods: This was a retrospective, single-center, observational study. Stored urine samples from dogs with HC or diseases mimicking HC (DMHC) at the time of diagnosis were selected from July 2019 through November 2022. Healthy dogs were prospectively included. The diagnostic performance of the UCCR was assessed based on receiver operating characteristic curves.Results: One hundred seventy-two dogs were included: 97 with HC, 35 with DMHC, and 40 HDs. The de novo RI for UCCR in HDs was between 3 X 10-6 (90% CI, 2.3 X 10-6 to 3.8 X 10-6) and 26 X 10-6 (90% CI, 29.7 X 10-6 to 35.0 X 10-6). The median UCCR was significantly higher in dogs with HC (70.9 X 10-6; 6.8 X 10-6 to 882.2 X 10-6) as compared to dogs with DMHC (15 X 10-6; 2.63 X 10-6 to 137.8 X 10-6) and HDs (9.1 X 10-6; 3.9 X 10-6 to 36.3 X 10-6). The area under the receiver operating characteristic curve for UCCR to differentiate HC dogs from dogs with DMHC was 0.85 (95% CI, 0.78 to 0.92). Using the upper limit of the de novo RI as the cutoff value (UCCR > 26 X 10-6), the sensitivity and the specificity for the UCCR in diagnosing HC were 80.4% (95% CI, 71.1% to 87.8%) and 71.4% (95% CI, 53.7% to 85.4%), respectively.Conclusions: Using the upper limit of the de novo RI, UCCR showed modest performances not only due to low specificity but also due to a sensitivity of only 80.4%.Clinical relevance: UCCR should not be used alone to rule out HC in dogs, and, when the clinical suspicion for HC is present, other endocrine tests should be pursued.","PeriodicalId":7754,"journal":{"name":"American journal of veterinary research","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of veterinary research","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.2460/ajvr.25.01.0020","RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"Print","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: To establish the de novo reference interval (RI) for urinary cortisol-to-creatinine ratio (UCCR) in healthy dogs (HDs) using the currently available chemiluminescent enzyme immunoassay antibody (Veterinary Cortisol; IMMULITE 2000 XPi; Siemens Healthineers) and to evaluate UCCR diagnostic performance in dogs with hypercortisolism (HC).

Methods: This was a retrospective, single-center, observational study. Stored urine samples from dogs with HC or diseases mimicking HC (DMHC) at the time of diagnosis were selected from July 2019 through November 2022. Healthy dogs were prospectively included. The diagnostic performance of the UCCR was assessed based on receiver operating characteristic curves.

Results: One hundred seventy-two dogs were included: 97 with HC, 35 with DMHC, and 40 HDs. The de novo RI for UCCR in HDs was between 3 X 10-6 (90% CI, 2.3 X 10-6 to 3.8 X 10-6) and 26 X 10-6 (90% CI, 29.7 X 10-6 to 35.0 X 10-6). The median UCCR was significantly higher in dogs with HC (70.9 X 10-6; 6.8 X 10-6 to 882.2 X 10-6) as compared to dogs with DMHC (15 X 10-6; 2.63 X 10-6 to 137.8 X 10-6) and HDs (9.1 X 10-6; 3.9 X 10-6 to 36.3 X 10-6). The area under the receiver operating characteristic curve for UCCR to differentiate HC dogs from dogs with DMHC was 0.85 (95% CI, 0.78 to 0.92). Using the upper limit of the de novo RI as the cutoff value (UCCR > 26 X 10-6), the sensitivity and the specificity for the UCCR in diagnosing HC were 80.4% (95% CI, 71.1% to 87.8%) and 71.4% (95% CI, 53.7% to 85.4%), respectively.

Conclusions: Using the upper limit of the de novo RI, UCCR showed modest performances not only due to low specificity but also due to a sensitivity of only 80.4%.

Clinical relevance: UCCR should not be used alone to rule out HC in dogs, and, when the clinical suspicion for HC is present, other endocrine tests should be pursued.

查看原文本刊更多论文

尿皮质醇与肌酐比值使用化学发光法诊断犬高皮质醇血症的准确性有限。

目的：利用现有的化学发光酶免疫测定抗体(Veterinary Cortisol；IMMULITE 2000 XPi；并评估UCCR对高皮质醇血症（HC）犬的诊断效果。方法：回顾性、单中心、观察性研究。在2019年7月至2022年11月期间，选择了诊断时患有HC或类似HC （DMHC）疾病的狗的尿液样本。健康犬被纳入前瞻性研究。根据受试者工作特征曲线评估UCCR的诊断性能。结果：共纳入172只犬：HC型97只，DMHC型35只，hd型40只。hd患者UCCR的新发RI介于3 × 10-6 （90% CI， 2.3 × 10-6至3.8 × 10-6）和26 × 10-6 （90% CI， 29.7 × 10-6至35.0 × 10-6）之间。HC犬的中位UCCR明显更高(70.9 X 10-6；6.8 X 10-6至882.2 X 10-6)与DMHC相比(15 X 10-6；2.63 X 10-6至137.8 X 10-6)和硬盘(9.1 X 10-6；3.9 X 10-6至36.3 X 10-6)。UCCR区分HC犬与DMHC犬的受试者工作特征曲线下面积为0.85 （95% CI, 0.78 ~ 0.92）。以新发mri上限为临界值（UCCR bbb26 × 10-6）， UCCR诊断HC的敏感性为80.4% (95% CI, 71.1% ~ 87.8%)，特异性为71.4% （95% CI, 53.7% ~ 85.4%）。结论：使用新发mri的上限，UCCR表现不佳，不仅特异性低，而且敏感性仅为80.4%。临床相关性：UCCR不应单独用于排除犬HC，当临床怀疑存在HC时，应进行其他内分泌检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American journal of veterinary research 农林科学-兽医学

CiteScore

1.70

自引率

10.00%

发文量

186

审稿时长

3 months

期刊介绍： The American Journal of Veterinary Research supports the collaborative exchange of information between researchers and clinicians by publishing novel research findings that bridge the gulf between basic research and clinical practice or that help to translate laboratory research and preclinical studies to the development of clinical trials and clinical practice. The journal welcomes submission of high-quality original studies and review articles in a wide range of scientific fields, including anatomy, anesthesiology, animal welfare, behavior, epidemiology, genetics, heredity, infectious disease, molecular biology, oncology, pharmacology, pathogenic mechanisms, physiology, surgery, theriogenology, toxicology, and vaccinology. Species of interest include production animals, companion animals, equids, exotic animals, birds, reptiles, and wild and marine animals. Reports of laboratory animal studies and studies involving the use of animals as experimental models of human diseases are considered only when the study results are of demonstrable benefit to the species used in the research or to another species of veterinary interest. Other fields of interest or animals species are not necessarily excluded from consideration, but such reports must focus on novel research findings. Submitted papers must make an original and substantial contribution to the veterinary medicine knowledge base; preliminary studies are not appropriate.