Please use this identifier to cite or link to this item:
https://hdl.handle.net/10316/106778
DC Field | Value | Language |
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dc.contributor.author | Lages, Adriana Sousa | - |
dc.contributor.author | Frade, João Gonçalo | - |
dc.contributor.author | Oliveira, Diana | - |
dc.contributor.author | Paiva, Isabel | - |
dc.contributor.author | Oliveira, Patrícia | - |
dc.contributor.author | Rebelo-Marques, Alexandre | - |
dc.contributor.author | Carrilho, Francisco | - |
dc.date.accessioned | 2023-04-21T10:28:36Z | - |
dc.date.available | 2023-04-21T10:28:36Z | - |
dc.date.issued | 2019-05-31 | - |
dc.identifier.issn | 1646-0758 | pt |
dc.identifier.issn | 0870-399X | pt |
dc.identifier.uri | https://hdl.handle.net/10316/106778 | - |
dc.description.abstract | Introduction: Diagnosis of Cushing’s syndrome remains a challenge in clinical endocrinology. Even though late-night salivary cortisol is used as screening tool, individualized cut-off levels for each population must be defined. Material and Methods: Three groups of subjects were studied: normal subjects, suspected and proven Cushing’s syndrome. Salivary cortisol was measured using an automated electrochemiluminescence assay. The functional sensitivity of the assay is 0.018 μg/dL. The diagnostic cut-off level was defined by Receiver Operating Characteristic curve and Youden’s J index. Results: We studied 127 subjects: 57 healthy volunteers, 39 patients with suspected and 31 with proven Cushing’s syndrome. 2.5th - 97.5th percentile of the late-night salivary cortisol concentrations in normal subjects was 0.054 to 0.1827 μg/dL. Receiver Operating Characteristic curve analysis showed an area under the curve of 0.9881 (p < 0.0001). A cut-off point of 0.1 μg/dL provided a sensitivity of 96.77% (95% CI 83.3 - 99.92%) and specificity of 91.23% (95% CI 80.7 - 97.09%). There was a significant correlation between latenight salivary cortisol and late-night serum cortisol (R = 0.6977; p < 0.0001) and urinary free cortisol (R = 0.5404; p = 0.0025) in proven Cushing’s syndrome group. Discussion: The mean ± SD late-night salivary cortisol concentration in patients with proven Cushing’s syndrome (0.6798 ± 0.52 μg/ dL) was significantly higher (p < 0.0001). In our population, the late-night salivary cortisol cut-off was 0.1 μg/dL with high sensitivity and specificity. Conclusion: Late-night salivary cortisol has excellent diagnostic accuracy, making it a highly reliable, noninvasive, screening tool for outpatient assessment. Given its convenience and diagnostic accuracy, late-night salivary cortisol may be added to other traditional screening tests on hypercortisolism. | pt |
dc.description.abstract | Introdução: O diagnóstico de síndrome de Cushing continua a ser um desafio complexo. Apesar do cortisol salivar noturno ser utilizado como teste de rastreio, a definição de um valor diagnóstico deverá ser individualizada. Material e Métodos: Foram estudados 3 grupos: voluntários saudáveis, com suspeita clínica e com diagnóstico estabelecido de Síndrome de Cushing. O doseamento de cortisol salivar foi realizado por eletroquimioluminescência automatizado. A definição do ponto-de-corte foi obtida pela curva Receiver Operating Characteristic e índice J de Youden. Resultados: Entre os 127 indivíduos, 57 pertenciam ao grupo de voluntários saudáveis, 39 com suspeita clínica e 31 com diagnóstico estabelecido. O percentil 2,5 – 97,5 de cortisol salivar noturno no grupo de voluntários saudáveis foi 0,054 – 0,1827 μg/dL. A análise da curva Receiver Operating Characteristic revelou uma área abaixo da curva de 0,9881 (p < 0,0001) e o ponto-de-corte de 0,1 μg/ dL com sensibilidade de 96,77% e especificidade de 91,23%. Verificou-se uma correlação significativa entre cortisol salivar noturno e o cortisol sérico noturno (R = 0,6977; p < 0,0001), bem como, com cortisol livre urinário (R = 0,5404; p = 0,0025) no grupo com diagnóstico estabelecido. Discussão: A concentração média ± DP cortisol salivar noturno no grupo com diagnóstico estabelecido (0,6798 ± 0,52 μg/dL) foi significativamente superior aos restantes grupos. Na nossa população, o valor de ponto-de-corte foi de 0,1 μg/dL com elevada sensibilidade e especificidade. Conclusão: Os resultados demonstram uma excelente acurácia do cortisol salivar noturno. Dada a sua conveniência e elevada exatidão, o doseamento de cortisol salivar noturno poderá ser adicionado aos testes de rastreio tradicionais para estudo de hipercortisolismo. | pt |
dc.language.iso | eng | pt |
dc.publisher | Ordem dos Médicos | pt |
dc.rights | openAccess | pt |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | pt |
dc.subject | Circadian Rhythm | pt |
dc.subject | Cushing Syndrome/diagnosis | pt |
dc.subject | Diagnostic Techniques, Endocrine | pt |
dc.subject | Hydrocortisone | pt |
dc.subject | Saliva | pt |
dc.subject | Hydrocortisona | pt |
dc.subject | Ritmo Circadiano | pt |
dc.subject | Saliva | pt |
dc.subject | Síndrome de Cushing/diagnóstico | pt |
dc.subject | Técnicas de Diagnóstico Endócrino | pt |
dc.subject.mesh | Adult | pt |
dc.subject.mesh | Aged | pt |
dc.subject.mesh | Area Under Curve | pt |
dc.subject.mesh | Biomarkers | pt |
dc.subject.mesh | Cushing Syndrome | pt |
dc.subject.mesh | Female | pt |
dc.subject.mesh | Healthy Volunteers | pt |
dc.subject.mesh | Humans | pt |
dc.subject.mesh | Hydrocortisone | pt |
dc.subject.mesh | Luminescent Measurements | pt |
dc.subject.mesh | Male | pt |
dc.subject.mesh | Middle Aged | pt |
dc.subject.mesh | ROC Curve | pt |
dc.subject.mesh | Reference Values | pt |
dc.subject.mesh | Saliva | pt |
dc.subject.mesh | Sensitivity and Specificity | pt |
dc.subject.mesh | Time Factors | pt |
dc.title | Late-Night Salivary Cortisol: Cut-Off Definition and Diagnostic Accuracy for Cushing's Syndrome in a Portuguese Population | pt |
dc.title.alternative | Cortisol Salivar Noturno: Definição de Ponto de Corte e Valor Diagnóstico na Síndrome de Cushing numa População Portuguesa | pt |
dc.type | article | - |
degois.publication.firstPage | 381 | pt |
degois.publication.lastPage | 387 | pt |
degois.publication.issue | 5 | pt |
degois.publication.title | Acta Medica Portuguesa | pt |
dc.peerreviewed | yes | pt |
dc.identifier.doi | 10.20344/amp.11265 | pt |
degois.publication.volume | 32 | pt |
dc.date.embargo | 2019-05-31 | * |
uc.date.periodoEmbargo | 0 | pt |
item.grantfulltext | open | - |
item.cerifentitytype | Publications | - |
item.languageiso639-1 | en | - |
item.openairetype | article | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.fulltext | Com Texto completo | - |
crisitem.author.orcid | 0000-0001-7739-8887 | - |
Appears in Collections: | FMUC Medicina - Artigos em Revistas Nacionais |
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Latenight-salivary-cortisol-Cutoff-definition-and-diagnostic-accuracy-for-cushings-syndrome-in-a-Portuguese-populationActa-Medica-Portuguesa.pdf | 409.09 kB | Adobe PDF | View/Open |
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