| Evaluation of plasma, salivary, and urinary cortisol levels for diagnosis of Cushing's syndrome. | |
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MedLine Citation:
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PMID: 20139634 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Satoru Sakihara; Kazunori Kageyama; Yutaka Oki; Masaru Doi; Yasumasa Iwasaki; Shinobu Takayasu; Takako Moriyama; Ken Terui; Takeshi Nigawara; Yukio Hirata; Kozo Hashimoto; Toshihiro Suda |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-02-07 |
Journal Detail:
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Title: Endocrine journal Volume: 57 ISSN: 1348-4540 ISO Abbreviation: Endocr. J. Publication Date: 2010 |
Date Detail:
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Created Date: 2010-05-07 Completed Date: 2010-08-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9313485 Medline TA: Endocr J Country: Japan |
Other Details:
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Languages: eng Pagination: 331-7 Citation Subset: IM |
Affiliation:
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Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Aomori, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Circadian Rhythm Cushing Syndrome / blood, diagnosis*, urine Humans Hydrocortisone / analysis*, blood, urine Reproducibility of Results Saliva / chemistry* Sensitivity and Specificity |
| Chemical | |
Reg. No./Substance:
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50-23-7/Hydrocortisone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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