Morning Salivary Cortisone Versus Serum Cortisol in the Overnight Dexamethasone Suppression Test (ODNST): Evaluation in a Clinical Setting
Authors' conclusion
We have provided further evidence that ONDST salivary cortisone has potential to be the first-line test for suspected Cushing's syndrome, not requiring venepuncture or attendance at hospital, with 100% sensitivity and reasonable specificity. Application of the salivary cortisone test has the potential for significant savings of money and time in this and other contexts.
Study context
- Population
- Individuals undergoing an overnight dexamethasone suppression test (ONDST); 21% men (mean age 49.4 years), 79% women (mean age 56.7 years)analysed
- Participants
- 34 individuals
- Comparison
- Post-dexamethasone 0900 salivary cortisone vs serum cortisol in the 1 mg ONDST
- Outcome
- Diagnostic performance of salivary cortisone for potential Cushing's syndrome (serum cortisol as standard)
Performance
As reported in the abstract
| Test or model | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|
| Salivary cortisone | 100% | 84.6% | 90.5% | 100% |
Salivary cortisone
Sensitivity100%
Specificity84.6%
PPV90.5%
NPV100%
- Agreement with serum cortisol
- 94.1%, kappa 0.87, p < 0.0001
- Correlation of 0900 salivary cortisone and serum cortisol
- r2 = 0.65, p = 0.009
- Serum cortisol did not suppress
- 22/34
- Salivary cortisone did not suppress where cortisol did suppress
- 2
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Morning Salivary Cortisone Versus Serum Cortisol in the Overnight Dexamethasone Suppression Test (ODNST): Evaluation in a Clinical Setting. Clin Endocrinol (Oxf). Published 21 March 2025. doi:10.
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