Imperial College London
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Professor Niamh Martin

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Endocrinology
 
 
 
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Contact

 

n.martin

 
 
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Location

 

6N5Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Mohamed:2022:10.1530/ec-22-0050,
author = {Mohamed, RS and Abuelgasim, B and Barker, S and Prabhudev, H and Martin, NM and Meeran, K and Walker, E and Darch, S and Matthew, W and Tan, T and Wernig, F},
doi = {10.1530/ec-22-0050},
journal = {Endocrine Connections},
title = {Late night salivary cortisol and cortisone should be the initial screening test for Cushing’s syndrome},
url = {http://dx.doi.org/10.1530/ec-22-0050},
volume = {11},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Endogenous Cushing’s syndrome (CS) poses considerable diagnostic challenges. Although late night salivary  cortisol  (LNSC)  is  recommended  as  a  first  line  screening  investigation,  it  remains  the  least widely  used  test  in  many  countries.  The  combined  measurement  of  LNSC  and  late-night  salivary cortisone  (LNS  cortisone)  has  shown  to  further  improve  diagnostic  accuracy1.  We  present  a retrospective   study   in   a   tertiary   referral   centre   comparing   LNSC,   LNS   cortisone,   overnight dexamethasone  suppression  test,  low  dose  dexamethasone  suppression  test  and  24-hour  urinary  free cortisol  results  of  patients  investigated  for  CS.  Patients  were  categorised  into  those  who  had  CS  (21 patients) and those who did not (33 patients).LNSC had a sensitivity of 95% and a specificity of 91%. LNS  cortisone  had  a  specificity  of  100%  and  a  sensitivity  of  86%.  With  an  optimal  cut-off  for  LNS cortisone of >14.5 nmol/l the sensitivity was 95.2%, and the specificity was 100% with an area under the curve of 0.997, for diagnosing CS. Saliva collection is non-invasive and can be carried out at home.We  therefore  advocate  simultaneous  measurement  of  LNSC  and  LNS  cortisone  as  the  first-line screening test to evaluate patients with suspected CS.
AU  - Mohamed,RS
AU  - Abuelgasim,B
AU  - Barker,S
AU  - Prabhudev,H
AU  - Martin,NM
AU  - Meeran,K
AU  - Walker,E
AU  - Darch,S
AU  - Matthew,W
AU  - Tan,T
AU  - Wernig,F
DO  - 10.1530/ec-22-0050
PY  - 2022///
SN  - 2049-3614
TI  - Late night salivary cortisol and cortisone should be the initial screening test for Cushing’s syndrome
T2  - Endocrine Connections
UR  - http://dx.doi.org/10.1530/ec-22-0050
UR  - https://ec.bioscientifica.com/view/journals/ec/aop/ec-22-0050/ec-22-0050.xml
UR  - http://hdl.handle.net/10044/1/97270
VL  - 11
ER  -
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