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  • Bäcklund, NilsUmeå University,Umeå universitet,Avdelningen för medicin,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden,Umeå Univ, Dept Publ Hlth & Clin Med, Umeå, Sweden (author)

Reference intervals of salivary cortisol and cortisone and their diagnostic accuracy in Cushing's syndrome

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • Bioscientifica,2020

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/296151
  • https://gup.ub.gu.se/publication/296151URI
  • https://doi.org/10.1530/EJE-19-0872DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-180275URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-174306URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-441103URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:146151326URI
  • https://lup.lub.lu.se/record/bbee6383-6f24-4ded-b244-64435614964dURI

Supplementary language notes

  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • This study was supported by a donation to Umeå University for research on pituitary disease.
  • Objective: The challenge of diagnosing Cushing's syndrome (CS) calls for high precision biochemical screening. This study aimed to establish robust reference intervals for, and compare the diagnostic accuracy of, salivary cortisol and cortisone in late-night samples and after a low-dose (1 mg) dexamethasone suppression test (DST). Design and methods: Saliva samples were collected at 08:00 and 23:00 h, and at 08:00 h, after a DST, from 22 patients with CS and from 155 adult reference subjects. We also collected samples at 20:00 and 22:00 h from 78 of the reference subjects. Salivary cortisol and cortisone were analysed with liquid chromatography-tandem mass spectrometry. The reference intervals were calculated as the 2.5th and 97.5th percentiles of the reference population measurements. Diagnostic accuracies of different tests were compared, based on areas under the receiver-operating characteristic curves. Results: The upper reference limits of salivary cortisol and cortisone at 23:00 h were 3.6 nmol/L and 13.5 nmol/L, respectively. Using these reference limits, CS was detected with a sensitivity (95% CI) of 90% (70-99%) and specificity of 96% (91-98%) for cortisol, and a 100% (84-100%) sensitivity and 95% (90-98%) specificity for cortisone. After DST, cortisol and cortisone upper reference limits were 0.79 nmol/L and 3.5 nmol/L, respectively. CS was detected with 95% (75-100%) sensitivity and 96% (92-99%) specificity with cortisol, and 100% (83-100%) sensitivity and 94% (89-97%) specificity with cortisone. No differences in salivary cortisol or cortisone levels were found between samples collected at 22:00 and 23:00 h. Conclusion: Salivary cortisol and cortisone in late-night samples and after DST showed high accuracy for diagnosing CS, salivary cortisone being slightly, but significantly better. © 2020 European Society of Endocrinology Printed in Great Britain.

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  • Brattsand, GöranUmeå University,Umeå universitet,Klinisk kemi,Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden,Umeå Univ, Dept Med Biosci, Clin Chem, Umeå, Sweden(Swepub:umu)gobr0001 (author)
  • Israelsson, MarlenUmeå University,Umeå universitet,Klinisk kemi,Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden,Umeå Univ, Dept Med Biosci, Clin Chem, Umeå, Sweden(Swepub:umu)mais0016 (author)
  • Ragnarsson, Oskar,1971Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Inst Med, Dept Internal Med & Clin Nutr, Sahlgrenska Acad, Gothenburg, Sweden; Sahlgrens Univ Hosp, Dept Endocrinol, Gothenburg, Sweden(Swepub:gu)xragos (author)
  • Burman, PiaLund University,Lunds universitet,Translationell muskelforskning,Forskargrupper vid Lunds universitet,Translational Muscle Research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-bap (author)
  • Edén Engström, BrittUppsala University,Uppsala universitet,Endokrinologi och mineralmetabolism(Swepub:uu)brittee (author)
  • Høybye, C.Karolinska Institutet,Karolinska University Hospital (author)
  • Berinder, K.Karolinska Institutet,Karolinska University Hospital (author)
  • Wahlberg, Jeanette,1969-Linköping University,Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Endokrinmedicinska kliniken,Linköping Univ, Dept Med & Hlth Sci, Dept Endocrinol, Linköping, Sweden(Swepub:liu)jeawa98 (author)
  • Olsson, TommyUmeå University,Umeå universitet,Avdelningen för medicin,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden,Umeå Univ, Dept Publ Hlth & Clin Med, Umeå, Sweden(Swepub:umu)tool0003 (author)
  • Dahlqvist, PerUmeå University,Umeå universitet,Avdelningen för medicin,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden,Umeå Univ, Dept Publ Hlth & Clin Med, Umeå, Sweden(Swepub:umu)perdat96 (author)
  • Umeå universitetAvdelningen för medicin (creator_code:org_t)

Related titles

  • In:European Journal of Endocrinology: Bioscientifica182:6, s. 569-5820804-46431479-683X

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