ReviewAnnals of laboratory medicine2020
Cortisol Measurements in Cushing's Syndrome: Immunoassay or Mass Spectrometry?
Review in Annals of laboratory medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.
- Association of primary allostatic load mediators and metabolic syndrome (MetS): A systematic review.Frontiers in endocrinology · 2022Pooled it
- Biases of large language models in diagnosing Cushing's syndrome.World journal of methodology · 2026Review
- Morning cortisol and central adrenal insufficiency: new thresholds from low-dose ACTH test and second-generation assay.Journal of endocrinological investigation · 2026Article
- Old and new pituitary biomarkers: evidence for sex-specificity.Pituitary · 2026Review
- Consensus on the diagnosis of Cushing's disease: a collaborative statement from the Korean Endocrine Society and Japan Endocrine Society.Endocrine journal · 2026Article
- Salivary Cortisol versus Serum Cortisol Levels in Asthmatic Children Treated with Inhaled Corticosteroid Alone or in Combination with Montelukast.Journal of asthma and allergy · 2026Article
- Clinical utility of salivary cortisol for diagnosis and therapeutic monitoring in adrenal insufficiency.Endocrine · 2025Article
- Lowering the dexamethasone suppression test cut-off: is it time yet?Journal of endocrinological investigation · 2025Review
- Cortisol Detection Methods and the Hormone's Role in Evaluating Circadian Rhythm Disruption.International journal of molecular sciences · 2025Review
- Validation of an LC-MS/MS Method for Urinary Cortisol in Dogs and Reference Interval, with an Exploratory Comparison to Immunoassay.Animals : an open access journal from MDPI · 2025Article
- Management of Osilodrostat Therapy in Patients With Cushing's Syndrome: A Modified Delphi Consensus Panel.Journal of the Endocrine Society · 2025Article
- A Dual Biomarker Approach to Stress: Hair and Salivary Cortisol Measurement in Students via LC-MS/MS.Analytical science advances · 2025Article
- Ultrasound-Assisted Microcontinuous Process Facilitates the Selective Deuteration of Steroid Hormones.Journal of labelled compounds & radiopharmaceuticals · 2025Article
- Cushing syndrome in paediatric population: who and how to screen.Journal of endocrinological investigation · 2025Review
- Resolution of paradoxical bilateral aldosterone suppression with mass spectrometry.European journal of endocrinology · 2025Article
- Nocturnal Salivary Cortisol Is an Accurate Non-Invasive Test to Assess Endogenous Hypercortisolism in Children with Obesity and a Clinical Phenotype Suspicious for Cushing's Syndrome.Hormone research in paediatrics · 2025Article
- Current Challenges and Future Directions in the Assessment of Glucocorticoid Status.Endocrine reviews · 2024Review
- Mindfulness-Based Interventions and the Hypothalamic-Pituitary-Adrenal Axis: A Systematic Review.Neurology international · 2024Review
- Cortisol and cortisone determination by disposable pipette extraction (DPX) and ultra-efficient liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) in urine and saliva samples from patients with Parkinson's disease.Analytical and bioanalytical chemistry · 2024Article
- Neurobiological Implications of Chronic Stress and Metabolic Dysregulation in Inflammatory Bowel Diseases.Diseases (Basel, Switzerland) · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Determination of cortisol levels in the urine (24 hours urine free cortisol), saliva (late-night), or serum (total cortisol after dexamethasone suppression) is recommended to screen for Cushing's syndrome (CS). This review focuses on the differences between the frequently used cortisol-antibody immunoassay-based methods and the highly specific mass-spectrometry-based methods that are progressively being employed in clinical laboratories for CS screening. The particular characteristics of cortisol metabolism and the lack of specificity of the immunoassays cause marked differences between both methods that are in turn highly dependent on the biological matrix, in which the cortisol is measured. Understanding the origin of these differences is essential for the interpretation of these results. Although cross-reactivity with endogenous steroids leads to grossly inaccurate results of immunoassay measurements of cortisol in the saliva and urine, preliminary evidence suggests that the clinical sensitivity of CS screening using immunoassays may be similar to CS screening using mass spectrometry. However, mass spectrometry offers more accurate results and considerably reduced variation across laboratories, while avoiding false-positive results. Moreover, mass spectrometry can overcome some common diagnostic challenges, such as identification of exogenous corticosteroids or simultaneous assessment of appropriate dexamethasone levels in suppression tests. Further, comprehensive mass spectrometry-based profiling of several steroid metabolites may be useful for discriminating among different subtypes of CS. Finally, this review discusses the main preanalytical factors that could cause variations in cortisol measurements and their influence on the reliability of the results.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.