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Cited by 70Pituitary Gland Disorders and TreatmentsAdrenal Hormones and DisordersAdrenal and Paraganglionic Tumors

Determination of nighttime salivary cortisol during pregnancy: comparison with values in non-pregnancy and Cushing’s disease

Lopes, Ludmilla Malveira Lima, Francisco, Rossana Pulcineli Vieira, Galletta, Marco Aurélio Knippel, Bronstein, Marcello Delano·2016·Pituitary
DOI 10.1007/s11102-015-0680-3
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Abstract

Purpose Nighttime salivary cortisol (NSC) has been proposed for the diagnosis of Cushing's syndrome during pregnancy. However, reference values for NCS in pregnant women have not been adequately determined. The aim of this study was to determine the reference values of NSC in the three gestational trimesters in order to help distinguish physiological from pathological hypercortisolism during pregnancy. Methods This prospective and retrospective study evaluated 85 pregnant women in whom samples were collected in the first, second and/or third gestational trimester (pregnancy group), 33 non-pregnant women (control group), and 25 non-pregnant women with Cushing's disease (CD group). NSC was measured by enzyme-linked immunosorbent assay. Results NSC increased progressively during pregnancy, reaching maximum levels on the third trimester (median 2.1-fold increase compared with controls, p < 0.001). Reference values for NSC were determined and the upper limits on each gestational trimester were: first trimester 0.25 µg/dL (6.9 nmol/L), second trimester 0.26 µg/dL (7.2 nmol/L), and third trimester 0.33 µg/dL (9.1 nmol/L). Cutoff values that separated the CD group from the three trimesters in the pregnancy groups were, respectively, 0.255 µg/dL (7.0 nmol/L), 0.260 µg/dL (7.2 nmol/L), and 0.285 µg/dL (7.9 nmol/L). Comparison of NSC cutoff values in pregnant women with CD patients showed high sensitivity and specificity in all three trimesters. Conclusions We established cutoff values for determination of NSC which can be useful for pregnant women with a diagnostic suspicion of CD.

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  • In the study of Lopes et al, the reference range for LNSC in each gestational trimester were 0.03 to 0.25 μg/dL in the first trimester, 0.04 to 0.26 μg/dL in the second trimester, and 0.07 to 0.33 μg/dL in the third trimester.

    “In the study of Lopes et al (95), the reference range for the LNSC in each gestational trimester were 0.03 to 0.25 µg/dL (0.8-6.9 nmol/L) in the first trimester, 0.04 to 0.26 µg/dL (1.1-7.2 nmol/L) in the second trimester, and 0.07 to 0.33 µg/dL (1.7-9.1 nmol/L) in the third trimester.”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [95]

  • In the study of Lopes et al, the cutoff values for the diagnosis of Cushing disease were 0.255 μg/dL for the first trimester, 0.260 μg/dL for the second trimester, and 0.285 μg/dL for the third trimester.

    “The cutoff values for the diagnosis of Cushing disease in the study were 0.255 µg/dL (7.0 nmol/L) for the first trimester, 0.260 µg/dL (7.2 nmol/L) for the second trimester, and 0.285 µg/dL (7.9 nmol/L) for the third trimester (90, 95).”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [95]

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Authors
Lopes, L. M. L., Francisco, R. P. V., Galletta, M. A. K., & Bronstein, M. D.
Affiliations
Universidade de São Paulo (BR)
Corresponding author
Lopes, Ludmilla Malveira Lima
ORCID
Venue
Pituitary
Publisher
Springer Science and Business Media LLC
Published
2015-09-07
Volume
19
Issue
1
Pages
30-38
ISSN
  • 1386-341X (ISSN-L)
  • 1573-7403
DOI
10.1007/s11102-015-0680-3
OpenAlex
W1514123902
Cited by
70
References
0
Citations by year
2026: 6 · 2025: 3 · 2024: 5 · 2023: 6 · 2022: 13 · 2021: 9 · 2020: 5 · 2019: 11 · 2018: 7 · 2017: 4 · 2016: 1
FWCI
3.48
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Pituitary (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Science Council
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
Keywords
pregnancy, Cushing's disease, Cushing's syndrome, reference values, pregnancy trimesters, hypercortisolism, diagnostic thresholds, salivary biomarkers
MeSH terms
Circadian Rhythm, Female, Humans, Hydrocortisone, Pregnancy, Prospective Studies, Retrospective Studies, Saliva, Pituitary ACTH Hypersecretion

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