Document Detail


Evaluation of plasma, salivary, and urinary cortisol levels for diagnosis of Cushing's syndrome.
MedLine Citation:
PMID:  20139634     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
As a screening test for Cushing's syndrome, the evaluation of late-night cortisol levels is indispensable. We evaluated the usefulness and accuracy of plasma, urinary, and salivary cortisol levels measured late at night for the diagnosis of Cushing's syndrome. High cortisol levels (> 5 microg/dL) during the night are indicative of Cushing's syndrome, although night plasma cortisol levels are not readily reproducible because of the stressful situation. There was no correlation between plasma and urinary cortisol levels late at night, and late-night urinary cortisol levels provided weak information for the diagnosis of Cushing's syndrome. By contrast, late-night plasma and salivary cortisol levels showed a positive correlation, and salivary cortisol sampling was found to be useful for the diagnosis of Cushing's syndrome, because more than 0.4 microg/dL of late-night salivary cortisol levels gave a sensitivity of 86% and a specificity of 100% in our hospital. This method is also useful for the diagnosis of early or mild stage Cushing's syndrome, so-called subclinical Cushing's syndrome. Inherent differences between assays make it difficult to define optimal diagnostic criteria. However, the relative levels of salivary cortisol ratio, which is presented as a relative level, compared with the mean levels of healthy subjects in each institute, is useful for the screening of Cushing's syndrome as the cut-off level of 1.5 shows both high sensitivity and specificity in subclinical and overt Cushing's syndrome. Late-night salivary cortisol measurement is therefore a primary method of choice in the screening of patients suspected of having Cushing's syndrome.
Authors:
Satoru Sakihara; Kazunori Kageyama; Yutaka Oki; Masaru Doi; Yasumasa Iwasaki; Shinobu Takayasu; Takako Moriyama; Ken Terui; Takeshi Nigawara; Yukio Hirata; Kozo Hashimoto; Toshihiro Suda
Related Documents :
21214164 - Usher syndrome associated with a variant of dandy-walker malformation.
22524904 - Massive spontaneous diaphragmatic rupture in ehlers-danlos syndrome.
3715534 - Splenic salvage techniques in the management of pseudocysts of the spleen.
12138214 - Recovery of language after left hemispherectomy in a sixteen-year-old girl with late-on...
3678574 - Morphometric analysis of collagen fibrils in idiopathic carpal tunnel syndrome: part 2.
15200834 - Hemolytic uremic syndrome incidence in new york.
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-07
Journal Detail:
Title:  Endocrine journal     Volume:  57     ISSN:  1348-4540     ISO Abbreviation:  Endocr. J.     Publication Date:  2010  
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9313485     Medline TA:  Endocr J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  331-7     Citation Subset:  IM    
Affiliation:
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Aomori, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Circadian Rhythm
Cushing Syndrome / blood,  diagnosis*,  urine
Humans
Hydrocortisone / analysis*,  blood,  urine
Reproducibility of Results
Saliva / chemistry*
Sensitivity and Specificity
Chemical
Reg. No./Substance:
50-23-7/Hydrocortisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Short-term Intermittent PTH 1-34 Administration Enhances Bone Formation in SCID/Beige Mice.
Next Document:  Hormonal Regulation of Acetyl-CoA Carboxylase Isoenzyme Gene Transcription.