ArticleJournal of endocrinological investigation2020
Reference ranges of late-night salivary cortisol and cortisone measured by LC-MS/MS and accuracy for the diagnosis of Cushing's syndrome.
Article in Journal of endocrinological investigation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 23 citations in OpenAlex.
- Clinical Implications and Research Progress of Salivary Biomarkers for Endocrine and Metabolic Disorders.Diabetes, obesity & metabolism · 2026Review
- Combination of magnetic bead extraction and LC-MS/MS detection for the detection of saliva cortisol.Analytical and bioanalytical chemistry · 2026Article
- Determination of hydrocortisone and cortisone in artificial saliva by spray assisted fine droplet formation liquid phase microextraction coupled to LC-MS/MS.Scientific reports · 2026Article
- Hypertension and Cushing's syndrome: hunt for the red flag.Journal of endocrinological investigation · 2025Review
- Screening for endogenous hypercortisolism in patients with osteoporosis and fractures: why, when and how.Journal of endocrinological investigation · 2025Review
- Cushing syndrome in paediatric population: who and how to screen.Journal of endocrinological investigation · 2025Review
- Who and how to screen for endogenous hypercortisolism in adrenal and pituitary incidentaloma.Journal of endocrinological investigation · 2025Review
- Development of diagnostic algorithm for Cushing's syndrome: a tertiary centre experience.Journal of endocrinological investigation · 2024Article
- Ionic liquid-caged nucleic acids enable active folding-based molecular recognition with hydrolysis resistance.Nucleic acids research · 2024Article
- Different Types of Glucocorticoids to Evaluate Stress and Welfare in Animals and Humans: General Concepts and Examples of Combined Use.Metabolites · 2023Review
- Confounding effects of liquorice, hydrocortisone, and blood contamination on salivary cortisol but not cortisone.Endocrine connections · 2023Article
- Simultaneous Measurement of Cortisol, Cortisone, Dexamethasone and Additional Exogenous Corticosteroids by Rapid and Sensitive LC-MS/MS Analysis.Molecules (Basel, Switzerland) · 2022Article
- Molecular Derangements and the Diagnosis of ACTH-Dependent Cushing's Syndrome.Endocrine reviews · 2022Review
- The diagnostic value of salivary cortisol and salivary cortisone in patients with suspected hypercortisolism.Frontiers in endocrinology · 2022Article
- A New Clinical Model to Estimate the Pre-Test Probability of Cushing's Syndrome: The Cushing Score.Frontiers in endocrinology · 2021Article
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14 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeInternational guidelines recommend salivary cortisol for the diagnosis of Cushing's syndrome. Despite mass spectrometry-based assays are considered the analytical gold-standard, there is still the need to define reference intervals and diagnostic accuracy of such methodology.
methods100 healthy volunteers and 50 consecutive patients were enrolled to compare LC-MS/MS and electrochemiluminescence assay for the determination of late-night salivary cortisol and cortisone. Moreover, we aimed to determine reference intervals of salivary steroids in a population of healthy individuals and diagnostic accuracy in patients with suspected hypercortisolism and in a population including also healthy individuals.
resultsMethod comparison highlighted a positive bias (51.8%) of immunoassay over LC-MS/MS. Reference intervals of salivary cortisol (0.17-0.97 µg/L), cortisone (0.84-4.85 µg/L) and ratio (0.08-0.30) were obtained. The most accurate thresholds of salivary cortisol for the diagnosis of hypercortisolism were 1.15 µg/L in the population with suspected hypercortisolism (AUC 1) and 1.30 µg/L in the population including also healthy individuals (AUC 1). Cut-off values of salivary cortisone (7.23 µg/L; Se 92.9%, Sp 97.2%, AUC 0.960 and Se 92.9%, Sp 99.1%, AUC 0.985 in suspected hypercortisolism and in overall population, respectively) and cortisol-to-cortisone ratio (0.20; Se 85.7%, Sp 80.6%, AUC 0.820 and Se 85.7%, Sp 85.5%, AUC 0.855 in suspected hypercortisolism and in overall population, respectively) were accurate and similar in both populations.
conclusionLC-MS/MS is the most accurate analytical platform for measuring salivary steroids. Obtained reference intervals are coherent with previously published data and diagnostic accuracy for diagnosis of overt hypercortisolism proved highly satisfactory.
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