Clinical Utility of Salivary Steroid Profiling for the Differential Diagnosis of Adrenal Diseases
Authors' conclusion
Salivary steroid profiling holds promise as a noninvasive tool for the diagnosis of adrenal diseases.
Study context
- Population
- Patients with adrenal diseases (NF, primary aldosteronism (PA), Cushing syndrome (CS), mild autonomous cortisol secretion (MACS)); morning and night salivary samples, LC-MS profiling of cortisol, cortisone, tetrahydrocortisone (THE), 20α-DHF, 18-OHF and dehydroepiandrosterone sulfate (DHEA-S)
- Participants
- 313 patients
- Comparison
- Morning vs night salivary steroid profiles across NF, PA, CS and MACS
- Outcome
- Diagnostic performance of morning and night salivary steroids
Methodological detailsprospective, multicenter
- Prospective
- Multicenter
Performance
As reported in the abstract
Diagnostic performance of salivary steroids (ROC)
- Morning salivary 18-OHF moderately specific for PA
- Night salivary 20α-DHF and cortisone: robust diagnostic accuracy for CS
- Combined night salivary steroids vs Combined morning salivary steroids: P = 0.007
Further findings
| Outcome | P value |
|---|---|
| Night salivary cortisone and 20α-DHF: MACS vs NFMACS vs NF · night cortisone elevated in MACS | P = 0.040 |
| Night salivary cortisone and 20α-DHF: MACS vs NFMACS vs NF · night 20α-DHF elevated in MACS | P = 0.029 |
Salivary 18-OHF, morning and night: higher in PA vs other groups
- Higher in PA vs other groups
- all P < .05
Salivary cortisone, THE and 20α-DHF, morning and night: elevated in CS vs other groups
- Significantly elevated in CS vs other groups
- all P < .05
Night salivary cortisone and 20α-DHF: MACS vs NF
- Only night-time levels elevated in MACS vs NF
Original publication
Clinical Utility of Salivary Steroid Profiling for the Differential Diagnosis of Adrenal Diseases. J Clin Endocrinol Metab. Published 5 September 2025. doi:10.
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