ECEESPE2025 ePoster Presentations Adrenal and Cardiovascular Endocrinology (170 abstracts)
The combination of afternoon and midnight salivary cortisol improves the diagnosis of cushing’s syndrome
Luana Lionetto 1 , Maria Elena Aloini 2 , Donatella De Bernardini 1 , Giuseppe Costanzi 1 , Roberta Maggio 2 , Guido Roberto 2 , Francesca Ricci 2 , Irene Biondo 2 , Pina Lardo 2 , Gerardo Salerno 2 , Maurizio Simmaco 2 & Antonio Stigliano 2
1Sant’Andrea University Hospital, Rome, Italy; 2Sapienza University of Rome, Rome, Italy
JOINT1452
The diagnosis of Cushing’s syndrome is based on the inhibition test with 1 mg dexamethasone (1 mg DST), 24-h urine free cortisol, and serum and salivary cortisol measurements at midnight. Nevertheless, the diagnosis is challenging and often fraught with many pitfalls depending on several factors, such as taking drugs that interfere with the hypothalamic-pituitary-adrenal axis (HPA axis), the presence of molecules active on CYP3A4 enzyme and many other factors such as age, sex, and body mass index. In addition, some diseases such as renal and liver failure, or psychiatric disorders, reduce the diagnostic power of the tests commonly used in the diagnosis of hypercortisolism. We propose a new diagnostic strategy, simple to perform, easy to reproduce and with a high diagnostic performance. It consists of measurements of salivary cortisol by LC-MS/MS method, at three different times of the day: the first in the morning (0800 h), the second around 1400 h and the third between 2300 h and 2400 h. The reproducibility and specificity of the test identify patients with hypercortisolism in 95% of cases at midnight. Interestingly, when considering two specific points on the salivary cortisol curve, the success rate rises to 100%. Furthermore, the method allows diagnosis even in patients who cannot perform the commonly used diagnostic tests.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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