Radioimmunoassay and Tandem Mass Spectrometry Measurement of Bedtime Salivary Cortisol Levels: A Comparison of Assays to Establish Hypercortisolism

Baid, Smita; Sinaii, Ninet; Wade, M E; Rubino, Domenica; Nieman, Lynnette K.

doi:10.1210/jc.2006-2861

Cited by 126 publications

(102 citation statements)

References 15 publications

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“…The study by Beko et al revealed better performance of LSC using ECLIA (sensitivity 100% and specificity 88%) compared to RIA (sensitivity 100% and specificity 71%) [23]. Another study demonstrated an important rate of abnormal LSC results in volunteers without evidence of Cushing's syndrome when measured using two different commercial assays and evaluated with laboratory provided normative ranges [24]. Assays of RIA and ELISA can be affected by cross-reactivity with cortisol metabolites and synthetic glucocorticoids.…”

Section: Discussionmentioning

confidence: 99%

Diagnostics of hypercortisolism — comparison between the clinical usefulness of salivary and serum cortisol measurements

Żukowski

Myśliwiec²,

Górska³

2013

Endokrynologia Polska

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Introduction: The aim of this study was the comparison of 24h urine free cortisol (UFC), serum cortisol at 11pm (SCM) and late-night salivary cortisol (LSC) in patients suspected for hypercortisolism, and an assessment of the usefulness of these measurements in diagnosing overt Cushing's (OCS) syndrome, pseudo Cushing's state (PCS) and subclinical Cushing's syndrome (SCS). Material and methods:The study group consisted of 82 patients, of whom four patients had SCS, three OCS and eight PCS. For measurements of LSC, the ELISA method was used, and for UFC and SCM determination, chemiluminescent microparticle immunoassay was used.

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Section: Discussionmentioning

confidence: 99%

Diagnostics of hypercortisolism — comparison between the clinical usefulness of salivary and serum cortisol measurements

Żukowski

Myśliwiec²,

Górska³

2013

Endokrynologia Polska

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“…Unfortunately, reported cut-off values differ considerably. Depending on the relative cross-reactivity of cortisol antibodies towards cortisone, there could be quite variable values for salivary cortisol measured by different immunoassays (Baid et al, 2007). Measurement by LC-MS/MS can overcome this problem.…”

Section: Lc-ms/ms Enables the Simultaneous Determination Of Cortisol mentioning

confidence: 99%

Steroid measurement with LC–MS/MS in pediatric endocrinology

Rauh

2009

Molecular and Cellular Endocrinology

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Please cite this article as: Rauh, M., Steroid measurement with LC-MS/MS in pediatric endocrinology, Molecular and Cellular Endocrinology (2008), doi:10.1016/j.mce.2008 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…More recently, liquid chromatography-tandem mass spectrometry (LC-MS/MS) measurement of salivary cortisol has been also available commercially (49,50). RIA and LC-MS/MS measurement of salivary cortisol and their accuracy of reference ranges were compared, in a cross-sectional prospective study of outpatients, in healthy volunteers and obese subjects with cushingoid features (49).…”

Section: Late-night Salivary Cortisolmentioning

confidence: 99%

“…RIA and LC-MS/MS measurement of salivary cortisol and their accuracy of reference ranges were compared, in a cross-sectional prospective study of outpatients, in healthy volunteers and obese subjects with cushingoid features (49). This study demonstrated an important rate of abnormal bedtime salivary cortisol, measured in two different commercial assays and evaluated with laboratory provided normative ranges.…”

Section: Late-night Salivary Cortisolmentioning

confidence: 99%

“…Overview of studies conducted in control subjects and Cushing's syndrome patients using late-night (2300 h) salivary cortisol. (49,50). Because salivary cortisol measurement is increasing in popularity, it is important to be aware of the different results generated by the commercially available methods and to interpret the published reference intervals appropriately.…”

Section: Late-night Salivary Cortisolmentioning

confidence: 99%

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Screening and diagnosis of Cushing's syndrome

Castro

Moreira

2007

Arq Bras Endocrinol Metab

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Cushing's syndrome (CS) results from sustained pathologic hypercortisolism. The clinical features are variable and the most specific features for CS include abnormal fat distribution, particularly in the supraclavicular and temporal fossae, proximal muscle weakness, wide purple striae, and decreased linear growth with continued weight gain in a child. Clinical presentation of CS can be florid and in this case the diagnosis is usually straightforward. However, the diagnosis can be difficult particularly in states of mild or cyclical or periodical hypercortisolism. Several tests based on the understanding of the physiologic characteristics of the hypothalamic-pituitary-adrenal axis have been used extensively to confirm the diagnosis of Cushing's syndrome, but none has proven fully capable of distinguishing all cases of CS from normal and/or pseudo-Cushing individuals. Three first-line diagnostic tests are currently used to screen for CS: measurement of free cortisol in 24-hour urine (UFC), cortisol suppressibility by low doses of dexamethasone (DST), and assessment of cortisol circadian rhythm using late-night serum and/or salivary cortisol. This paper discusses the effectiveness regarding best cut-off values, the sensitivity and the specificity of these tests to screen for CS. Late-night salivary cortisol appears to be the most useful screening test. UFC and DST should be performed to provide further confirmation of the diagnosis. RESUMO Rastreamento e Diagnóstico da Síndrome de Cushing.A síndrome de Cushing (SC) resulta de um hipercortisolismo patológico mantido. As manifestações clínicas são variáveis e os achados mais específicos para a SC incluem distribuição anormal de gordura, particularmente nas fossas supraclaviculares e temporais, fraqueza muscular proximal, estrias purpúreas largas e interrupção do crescimento linear com ganho contínuo de peso na criança. A apresentação clínica da SC pode ser florida e, neste caso, o diagnósti-co é usualmente direto. Entretanto, o diagnóstico pode ser dificultado particularmente em estados de hipercortisolismo leve ou cíclico/periódico. Vários testes baseados na compreensão das características fisiológicas do eixo hipotálamo-hipófise-adrenal têm sido usados extensivamente para confirmar o diagnóstico da SC, mas nenhum deles mostrou-se totalmente capaz de distinguir todos os casos de SC dos indivíduos normais e/ou portadores de pseudo-Cushing. Três testes diagnósticos de primeira linha são atualmente empregados para rastrear SC: a medida do cortisol livre em urina de 24-horas (CLU), a supressão do cortisol por doses baixas de dexametasona (TSD) e a avaliação do ritmo circadiano do cortisol usando a dosagem do cortisol sérico ou salivar às 23-24 hs. Este artigo discute a efetividade com relação aos melhores valores de corte e a sensibilidade e especificidade destes testes no rastreamento da SC. O cortisol salivar às 23-24 hs parece ser o teste mais útil de rastreamento. O CLU e o TSD devem ser realizados na tentativa de fornecer confirmação adicional ao diagnósti...

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Radioimmunoassay and Tandem Mass Spectrometry Measurement of Bedtime Salivary Cortisol Levels: A Comparison of Assays to Establish Hypercortisolism

Abstract: Salivary cortisol levels should not be used as the sole test to diagnose Cushing's syndrome if laboratory-provided reference ranges are used for diagnostic interpretation.

Cited by 126 publications

References 15 publications

Diagnostics of hypercortisolism — comparison between the clinical usefulness of salivary and serum cortisol measurements

Diagnostics of hypercortisolism — comparison between the clinical usefulness of salivary and serum cortisol measurements

Steroid measurement with LC–MS/MS in pediatric endocrinology

Screening and diagnosis of Cushing's syndrome

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