Luana Lionetto, Donatella De Bernardini, Giuseppe Costanzi, Roberta Maggio, Maria Elena Aloini, Guido Roberto, Francesca Ricci, Irene Biondo, Pina Lardo, Gerardo Salerno, Maurizio Simmaco, Antonio Stigliano
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引用次数: 0
Abstract
Background: The diagnosis of Cushing syndrome is challenging and often fraught with many pitfalls depending on several factors. We compare the diagnostic performance of AM serum cortisol; 24-hour urinary free cortisol; and 0800 h, 1400 h, and 2400 h salivary cortisol curve (SCC) in 1 mg dexamethasone suppression test positive and negative patients.
Methods: Eighty-three subjects performed measurements of SCC by the liquid chromatography tandem mass spectrometry method, exploiting the circadian rhythm of cortisol.
Results: The reproducibility and specificity of the test identify patients with hypercortisolism in 95% of cases at midnight. Interestingly, when considering 2 specific points (1400 h and 2400 h) on the SCC, the success rate rises to 100%.
Conclusion: The evaluation of the 1400 h and 2400 h assays led to detection of the total number of patients with Cushing syndrome. Salivary cortisol curve analysis is a non-invasive diagnostic strategy associated with elevated positive predictive value for hypercortisolism capable of enabling diagnosis. In addition, it can be considered for management of patient outcomes and monitoring of Cushing syndrome pharmacological treatment.
期刊介绍:
The American Journal of Medicine - "The Green Journal" - publishes original clinical research of interest to physicians in internal medicine, both in academia and community-based practice. AJM is the official journal of the Alliance for Academic Internal Medicine, a prestigious group comprising internal medicine department chairs at more than 125 medical schools across the U.S. Each issue carries useful reviews as well as seminal articles of immediate interest to the practicing physician, including peer-reviewed, original scientific studies that have direct clinical significance and position papers on health care issues, medical education, and public policy.