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Cited by 129Pituitary Gland Disorders and TreatmentsAdrenal and Paraganglionic TumorsAdrenal Hormones and Disorders

The DOI matches its Crossref record; 41 of the 43 references it cites were found in a registry or an index.

Late-Night Salivary Cortisol for Diagnosis of Overt and Subclinical Cushing’s Syndrome in Hospitalized and Ambulatory Patients

Nunes, Marie-Laure, Vattaut, Stéphanie, Corcuff, Jean-Benoît, Rault, Alexandre, Loiseau, Hugues, Gatta, Blandine, Valli, Nathalie, Letenneur, Luc, Tabarin, Antoine·2009·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2008-1542
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Abstract

CONTEXT: Neither precise evaluation of pertinent thresholds nor comparison of the diagnostic performance of late-night salivary cortisol (NSC) between inpatient and outpatient settings has been conducted. The usefulness of NSC for the screening of "subclinical" Cushing's syndrome is still unknown. OBJECTIVES: The aim of the study was to compare the influence of inpatient and outpatient settings on the diagnostic performance of NSC and assess its usefulness as a screening test for subclinical Cushing's syndrome. DESIGN: Consecutive patients were investigated prospectively with two salivary collections, first as inpatients and then as outpatients. PARTICIPANTS: Forty-two obese subjects participated in the study, as well as nine patients cured of Cushing's disease, 13 with overt Cushing's syndrome, 14 showing mild recurrence of Cushing's disease, and 48 with adrenal incidentalomas [23 subclinical cortisol-secreting adenomas (SCSA), 25 nonsecreting adenomas]. MAIN OUTCOME MEASURES: Reproducibility of NSC and diagnostic performance were measured using receiver operating characteristic analysis. RESULTS: NSC in controls was similar between inpatient and outpatient settings. The diagnostic performance of NSC across the different patient groups was similar irrespective of the setting. A threshold of 12 nmol/liter yielded 100% sensitivity and specificity in overt Cushing's syndrome. Optimal performance in subclinical Cushing's syndrome required lower thresholds. NSC showed acceptable performance in diagnosing recurrence of Cushing's disease (90% sensitivity, 91.8% specificity). On the contrary, NSC was similar between patients with SCSA and nonsecreting adenomas. CONCLUSIONS: Our data validate the outpatient bed sampling strategy for NSC with no need for specific outpatient threshold. NSC may be helpful to detect mild recurrence of Cushing's disease after surgery but is of little value in identifying SCSA amongst adrenal incidentalomas.

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Metadata

Authors
Nunes, M.-L., Vattaut, S., Corcuff, J.-B., Rault, A., Loiseau, H., Gatta, B., Valli, N., Letenneur, L., & Tabarin, A.
Affiliations
Inserm (FR)
Corresponding author
Tabarin, Antoine
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2009-02
Volume
94
Issue
2
Pages
456-462
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2008-1542
OpenAlex
W1969322965
Cited by
129
References
43
Citations by year
2026: 2 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 1 · 2021: 4 · 2020: 5 · 2019: 5 · 2018: 8 · 2017: 5 · 2016: 9 · 2015: 6 · 2014: 13 · 2013: 9 · 2012: 11
FWCI
10.40
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
late-night salivary cortisol, subclinical Cushing's syndrome, adrenal incidentaloma, diagnostic thresholds, screening test performance, obesity
MeSH terms
Adrenal Cortex Neoplasms, Ambulatory Care, Circadian Rhythm, Cushing Syndrome, Female, Hospitalization, Humans, Hydrocortisone, Inpatients, Male, Outpatients, Recurrence, Saliva, Sensitivity and Specificity, Time Factors, Case-Control Studies, Adrenocortical Adenoma, Incidental Findings

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