An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations

Autores
Cardoso, Estela M.del Lujan; Arregger, Alejandro Luis; Monardes, Gloria; Contreras, Liliana Noemi
Año de publicación
2013
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: The prevalence of Cushing’s syndrome (CS) in at-risk populations in developing countries remains uncertain. Evening urinary cortisol (UFC22–23) and salivary cortisol after treatment with 1-mg DST (SAFdex) have seldom been used as diagnostic tools in these populations. Objectives: (1) To establish the prevalence of CS in adults with cortisol-related morbidities using UFC22–23 and SAFdex as markers along with all first-line diagnostic tests recommended for CS; and (2) to assess the performance of each test and define a non-invasive diagnostic approach for CS in at-risk outpatient subjects. Methods: A total of 128 outpatients were evaluated, including type 1 and 2 diabetic patients with poor metabolic control (DM1 and DM2), hypertensive subjects with central obesity (HBP) and premenopausal women with osteoporosis (OS). Controls included 100 healthy volunteers and 23 patients with CS. Total urinary cortisol (UFC), UFC22–23, late-night salivary cortisol (SAF23) and suppression of cortisol levels in saliva (SAFdex) and serum (Fdex) after treatment with 1-mg DST were assessed. Results: CS was diagnosed in one DM2 and one HBP patient; both women exhibited central obesity. Among CS patients, UFC showed more within-person variability than UFC22–23 or SAF23. UFC22–23 and SAF23 were positively and significantly correlated in all groups (r ⩾ 0.70; p ⩽ 0.0001). UFC22–23 > 44.0 ng/mg creatinine or SAF23 > 3.8 nM were 100% sensitive (S) and specific (E) for CS. Furthermore, SAFdex > 2.0 nM or Fdex > 50.0 nM were 100% S and 97.3% E for CS. Conclusion: CS was diagnosed in 1.5% of at-risk patients. The combination of UFC22–23 or SAF23 with SAFdex offers a non-invasive diagnostic tool to assess cortisol nadir and feed-back status in outpatients.
Fil: Cardoso, Estela M.del Lujan. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Investigaciones Medicas; Argentina. Universidad de Buenos Aires. Facultad de Odontología; Argentina
Fil: Arregger, Alejandro Luis. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Monardes, Gloria. Universidad de Buenos Aires. Facultad de Odontología; Argentina
Fil: Contreras, Liliana Noemi. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Investigaciones Medicas; Argentina. Universidad de Buenos Aires. Facultad de Odontología; Argentina
Materia
Urinary Cortisol
Salivary Cortisol
Dexamethasone Suppression Test
Cushing'S Syndrome
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/15015
Acceder
id CONICETDig_c28c78b2c542b45aea2e064016a07da9
oai_identifier_str oai:ri.conicet.gov.ar:11336/15015
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populationsCardoso, Estela M.del LujanArregger, Alejandro LuisMonardes, GloriaContreras, Liliana NoemiUrinary CortisolSalivary CortisolDexamethasone Suppression TestCushing'S Syndromehttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background: The prevalence of Cushing’s syndrome (CS) in at-risk populations in developing countries remains uncertain. Evening urinary cortisol (UFC22–23) and salivary cortisol after treatment with 1-mg DST (SAFdex) have seldom been used as diagnostic tools in these populations. Objectives: (1) To establish the prevalence of CS in adults with cortisol-related morbidities using UFC22–23 and SAFdex as markers along with all first-line diagnostic tests recommended for CS; and (2) to assess the performance of each test and define a non-invasive diagnostic approach for CS in at-risk outpatient subjects. Methods: A total of 128 outpatients were evaluated, including type 1 and 2 diabetic patients with poor metabolic control (DM1 and DM2), hypertensive subjects with central obesity (HBP) and premenopausal women with osteoporosis (OS). Controls included 100 healthy volunteers and 23 patients with CS. Total urinary cortisol (UFC), UFC22–23, late-night salivary cortisol (SAF23) and suppression of cortisol levels in saliva (SAFdex) and serum (Fdex) after treatment with 1-mg DST were assessed. Results: CS was diagnosed in one DM2 and one HBP patient; both women exhibited central obesity. Among CS patients, UFC showed more within-person variability than UFC22–23 or SAF23. UFC22–23 and SAF23 were positively and significantly correlated in all groups (r ⩾ 0.70; p ⩽ 0.0001). UFC22–23 > 44.0 ng/mg creatinine or SAF23 > 3.8 nM were 100% sensitive (S) and specific (E) for CS. Furthermore, SAFdex > 2.0 nM or Fdex > 50.0 nM were 100% S and 97.3% E for CS. Conclusion: CS was diagnosed in 1.5% of at-risk patients. The combination of UFC22–23 or SAF23 with SAFdex offers a non-invasive diagnostic tool to assess cortisol nadir and feed-back status in outpatients.Fil: Cardoso, Estela M.del Lujan. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Investigaciones Medicas; Argentina. Universidad de Buenos Aires. Facultad de Odontología; ArgentinaFil: Arregger, Alejandro Luis. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Monardes, Gloria. Universidad de Buenos Aires. Facultad de Odontología; ArgentinaFil: Contreras, Liliana Noemi. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Investigaciones Medicas; Argentina. Universidad de Buenos Aires. Facultad de Odontología; ArgentinaElsevier Inc2013-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/15015Cardoso, Estela M.del Lujan; Arregger, Alejandro Luis; Monardes, Gloria; Contreras, Liliana Noemi; An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations; Elsevier Inc; Steroids; 78; 5; 5-2013; 476-4820039-128Xenginfo:eu-repo/semantics/altIdentifier/url/http://www.sciencedirect.com/science/article/pii/S0039128X13000391info:eu-repo/semantics/altIdentifier/doi/10.1016/j.steroids.2013.02.005info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-nd/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T10:09:41Zoai:ri.conicet.gov.ar:11336/15015instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 10:09:41.861CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations
title An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations
spellingShingle An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations
Cardoso, Estela M.del Lujan
Urinary Cortisol
Salivary Cortisol
Dexamethasone Suppression Test
Cushing'S Syndrome
title_short An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations
title_full An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations
title_fullStr An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations
title_full_unstemmed An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations
title_sort An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations
dc.creator.none.fl_str_mv Cardoso, Estela M.del Lujan
Arregger, Alejandro Luis
Monardes, Gloria
Contreras, Liliana Noemi
author Cardoso, Estela M.del Lujan
author_facet Cardoso, Estela M.del Lujan
Arregger, Alejandro Luis
Monardes, Gloria
Contreras, Liliana Noemi
author_role author
author2 Arregger, Alejandro Luis
Monardes, Gloria
Contreras, Liliana Noemi
author2_role author
author
author
dc.subject.none.fl_str_mv Urinary Cortisol
Salivary Cortisol
Dexamethasone Suppression Test
Cushing'S Syndrome
topic Urinary Cortisol
Salivary Cortisol
Dexamethasone Suppression Test
Cushing'S Syndrome
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: The prevalence of Cushing’s syndrome (CS) in at-risk populations in developing countries remains uncertain. Evening urinary cortisol (UFC22–23) and salivary cortisol after treatment with 1-mg DST (SAFdex) have seldom been used as diagnostic tools in these populations. Objectives: (1) To establish the prevalence of CS in adults with cortisol-related morbidities using UFC22–23 and SAFdex as markers along with all first-line diagnostic tests recommended for CS; and (2) to assess the performance of each test and define a non-invasive diagnostic approach for CS in at-risk outpatient subjects. Methods: A total of 128 outpatients were evaluated, including type 1 and 2 diabetic patients with poor metabolic control (DM1 and DM2), hypertensive subjects with central obesity (HBP) and premenopausal women with osteoporosis (OS). Controls included 100 healthy volunteers and 23 patients with CS. Total urinary cortisol (UFC), UFC22–23, late-night salivary cortisol (SAF23) and suppression of cortisol levels in saliva (SAFdex) and serum (Fdex) after treatment with 1-mg DST were assessed. Results: CS was diagnosed in one DM2 and one HBP patient; both women exhibited central obesity. Among CS patients, UFC showed more within-person variability than UFC22–23 or SAF23. UFC22–23 and SAF23 were positively and significantly correlated in all groups (r ⩾ 0.70; p ⩽ 0.0001). UFC22–23 > 44.0 ng/mg creatinine or SAF23 > 3.8 nM were 100% sensitive (S) and specific (E) for CS. Furthermore, SAFdex > 2.0 nM or Fdex > 50.0 nM were 100% S and 97.3% E for CS. Conclusion: CS was diagnosed in 1.5% of at-risk patients. The combination of UFC22–23 or SAF23 with SAFdex offers a non-invasive diagnostic tool to assess cortisol nadir and feed-back status in outpatients.
Fil: Cardoso, Estela M.del Lujan. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Investigaciones Medicas; Argentina. Universidad de Buenos Aires. Facultad de Odontología; Argentina
Fil: Arregger, Alejandro Luis. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Monardes, Gloria. Universidad de Buenos Aires. Facultad de Odontología; Argentina
Fil: Contreras, Liliana Noemi. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Oficina de Coordinacion Administrativa Houssay. Instituto de Investigaciones Medicas; Argentina. Universidad de Buenos Aires. Facultad de Odontología; Argentina
description Background: The prevalence of Cushing’s syndrome (CS) in at-risk populations in developing countries remains uncertain. Evening urinary cortisol (UFC22–23) and salivary cortisol after treatment with 1-mg DST (SAFdex) have seldom been used as diagnostic tools in these populations. Objectives: (1) To establish the prevalence of CS in adults with cortisol-related morbidities using UFC22–23 and SAFdex as markers along with all first-line diagnostic tests recommended for CS; and (2) to assess the performance of each test and define a non-invasive diagnostic approach for CS in at-risk outpatient subjects. Methods: A total of 128 outpatients were evaluated, including type 1 and 2 diabetic patients with poor metabolic control (DM1 and DM2), hypertensive subjects with central obesity (HBP) and premenopausal women with osteoporosis (OS). Controls included 100 healthy volunteers and 23 patients with CS. Total urinary cortisol (UFC), UFC22–23, late-night salivary cortisol (SAF23) and suppression of cortisol levels in saliva (SAFdex) and serum (Fdex) after treatment with 1-mg DST were assessed. Results: CS was diagnosed in one DM2 and one HBP patient; both women exhibited central obesity. Among CS patients, UFC showed more within-person variability than UFC22–23 or SAF23. UFC22–23 and SAF23 were positively and significantly correlated in all groups (r ⩾ 0.70; p ⩽ 0.0001). UFC22–23 > 44.0 ng/mg creatinine or SAF23 > 3.8 nM were 100% sensitive (S) and specific (E) for CS. Furthermore, SAFdex > 2.0 nM or Fdex > 50.0 nM were 100% S and 97.3% E for CS. Conclusion: CS was diagnosed in 1.5% of at-risk patients. The combination of UFC22–23 or SAF23 with SAFdex offers a non-invasive diagnostic tool to assess cortisol nadir and feed-back status in outpatients.
publishDate 2013
dc.date.none.fl_str_mv 2013-05
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/15015
Cardoso, Estela M.del Lujan; Arregger, Alejandro Luis; Monardes, Gloria; Contreras, Liliana Noemi; An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations; Elsevier Inc; Steroids; 78; 5; 5-2013; 476-482
0039-128X
url http://hdl.handle.net/11336/15015
identifier_str_mv Cardoso, Estela M.del Lujan; Arregger, Alejandro Luis; Monardes, Gloria; Contreras, Liliana Noemi; An accurate, non-invasive approach to diagnose Cushing’s syndrome in at-risk populations; Elsevier Inc; Steroids; 78; 5; 5-2013; 476-482
0039-128X
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://www.sciencedirect.com/science/article/pii/S0039128X13000391
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.steroids.2013.02.005
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier Inc
publisher.none.fl_str_mv Elsevier Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1842270091535712256
score 13.13397

Publicaciones similares