PMID- 29550934
OWN - NLM
STAT- MEDLINE
DCOM- 20190121
LR  - 20190121
IS  - 1720-8386 (Electronic)
IS  - 0391-4097 (Linking)
VI  - 41
IP  - 11
DP  - 2018 Nov
TI  - Specificity of late-night salivary cortisol measured by automated 
      electrochemiluminescence immunoassay for Cushing's disease in an obese 
      population.
PG  - 1325-1331
LID - 10.1007/s40618-018-0870-8 [doi]
AB  - PURPOSE: Data about the specificity of late-night salivary cortisol (LNSC) in 
      obese subjects are still conflicting. Therefore, with this study, we aimed to 
      evaluate the specificity of LNSC measurement in an obese cohort with or without 
      type 2 diabetes mellitus (T2DM) using an automated electrochemiluminescence 
      immunoassay (ECLIA). METHODS: A total number of 157 patients involving 40 healthy 
      subjects (HS) with BMI < 25 kg/m(2), 83 obese subjects (OS) with 
      BMI >/= 35 kg/m(2), and 34 histopathologically proven Cushing's disease (CD) were 
      included. All patients underwent LNSC testing. Salivary cortisol was measured at 
      11 p.m. for all groups using an ECLIA. Reference range was established using 
      values of LNSCs of HS and ROC curves were used to determine diagnostic cutoffs. 
      RESULTS: In the HS group, mean LNSC was 4.7 nmol/l (SD +/- 3.1), while the OS group 
      had a mean value of 10.9 nmol/l (SD +/- 7.5) and the CD group of 19.9 nmol/l 
      (SD +/- 15.4). All groups differed significantly (p < 0.001). The ROC analysis of 
      CD against HS alone showed a sensitivity of 85.3% and a specificity of 87.5% with 
      a cut-off value of 8.3 nmol/l. The ROC analysis between OS and CD showed a 
      maximum sensitivity of 67.6% and specificity of 78.3% for a cut-off value of 
      12.3 nmol/l. Taken both (HS and OS) groups together against the CD group, ROC 
      analysis showed a maximum sensitivity of 67.6% and specificity of 85.4% for a 
      cut-off value of 12.3 nmol/l. No correlation was found between BMI, T2DM, and 
      LNSC for all groups. CONCLUSIONS: In our obese cohort, we found that LNSC assayed 
      by ECLIA had a low specificity in the diagnosis of CD.
FAU - Aberle, J
AU  - Aberle J
AD  - Department for Endocrinology and Diabetology, University Medical Center 
      Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
FAU - Schulze Zur Wiesch, C
AU  - Schulze Zur Wiesch C
AD  - Department for Endocrinology and Diabetology, University Medical Center 
      Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
FAU - Flitsch, J
AU  - Flitsch J
AD  - Department for Neurosurgery, University Medical Center Hamburg-Eppendorf, 
      Martinistrasse 52, 20246, Hamburg, Germany.
FAU - Veigel, J
AU  - Veigel J
AD  - Department for Endocrinology and Diabetology, University Medical Center 
      Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
FAU - Schon, G
AU  - Schon G
AD  - Institute of Medical Biometry and Epidemiology, University Medical Center 
      Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
FAU - Jung, R
AU  - Jung R
AD  - Institute of Clinical Chemistry, University Medical Center Hamburg-Eppendorf, 
      Martinistrasse 52, 20246, Hamburg, Germany.
FAU - Reining, F
AU  - Reining F
AD  - Department for Endocrinology and Diabetology, University Medical Center 
      Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
FAU - Lautenbach, A
AU  - Lautenbach A
AD  - Department for Endocrinology and Diabetology, University Medical Center 
      Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
FAU - Rotermund, R
AU  - Rotermund R
AD  - Department for Neurosurgery, University Medical Center Hamburg-Eppendorf, 
      Martinistrasse 52, 20246, Hamburg, Germany.
FAU - Riedel, N
AU  - Riedel N
AD  - Department for Endocrinology and Diabetology, University Medical Center 
      Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. ni.sauer@uke.de.
LA  - eng
PT  - Journal Article
DEP - 20180317
PL  - Italy
TA  - J Endocrinol Invest
JT  - Journal of endocrinological investigation
JID - 7806594
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - Adult
MH  - Circadian Rhythm/physiology
MH  - Female
MH  - Humans
MH  - Hydrocortisone/*analysis
MH  - Luminescent Measurements
MH  - Male
MH  - Middle Aged
MH  - Obesity/*complications/metabolism
MH  - Pituitary ACTH Hypersecretion/complications/*diagnosis/metabolism
MH  - Reference Values
MH  - Saliva/*chemistry
MH  - Sensitivity and Specificity
MH  - Young Adult
OTO - NOTNLM
OT  - Bariatric surgery
OT  - Cushing's disease
OT  - Hypercortisolism
OT  - Late-night salivary cortisol
OT  - Obesity
EDAT- 2018/03/20 06:00
MHDA- 2019/01/22 06:00
CRDT- 2018/03/19 06:00
PHST- 2017/11/01 00:00 [received]
PHST- 2018/03/09 00:00 [accepted]
PHST- 2018/03/20 06:00 [pubmed]
PHST- 2019/01/22 06:00 [medline]
PHST- 2018/03/19 06:00 [entrez]
AID - 10.1007/s40618-018-0870-8 [pii]
AID - 10.1007/s40618-018-0870-8 [doi]
PST - ppublish
SO  - J Endocrinol Invest. 2018 Nov;41(11):1325-1331. doi: 10.1007/s40618-018-0870-8. 
      Epub 2018 Mar 17.