Late‐night salivary cortisol cut‐offs for diagnosis of Cushing syndrome using second‐generation electrochemiluminescence immunoassay kits
Authors' conclusion
LNSC measured using second-generation ECLIA demonstrated high diagnostic accuracy for CS. Based on this study, we propose a LNSC cutoff ≥6.73 nmol/L to diagnose CS.
Study context
- Population
- Adults with endogenous Cushing syndrome (CS) and controls aged 18–60 years, South-Asian population; overweight/obese controls had dexamethasone suppression test to exclude CS
- Participants
- 92 vs 155
- Comparison
- Late-night salivary cortisol (LNSC) by second-generation electrochemiluminescence immunoassay (ECLIA) in CS cases vs controls
- Casesn = 92
- Controlsn = 155reference
- Outcome
- LNSC cut-offs for diagnosis of CS using second-generation ECLIA
Methodological detailsprospective recruitment of controls, retrospective review of cases
- Prospective recruitment of controls
- Retrospective review of cases
Performance
As reported in the abstract
Diagnostic performance of LNSC for CS
| Test or model | AUC | Cut-off | Sensitivity | Specificity |
|---|---|---|---|---|
| Cases vs all controls | 0.994 | ≥6.73 nmol/L | 97.8% | 94.8% |
| Cases vs overweight/obese controls | 0.993 | ≥7.26 nmol/L | 97.8% | 95.1% |
AUC
Cases vs all controls0.994
Cases vs overweight/obese controls0.993
Cut-off
Cases vs all controls≥6.73 nmol/L
Cases vs overweight/obese controls≥7.26 nmol/L
Sensitivity
Cases vs all controls97.8%
Cases vs overweight/obese controls97.8%
Specificity
Cases vs all controls94.8%
Cases vs overweight/obese controls95.1%
- 95th percentile LNSC in controls
- 6.76 nmol/L
Further findings
LNSC levels
P < 0.001
Original publication
Late‐night salivary cortisol cut‐offs for diagnosis of Cushing syndrome using second‐generation electrochemiluminescence immunoassay kits. Clin Endocrinol (Oxf). Published 19 April 2023. doi:10.
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