The Utility of Salivary Cortisone in the Overnight Dexamethasone Suppression Test in Adrenal Incidentalomas
Authors' conclusion
In AI patients, after dexamethasone, salivary cortisone correlates very strongly with serum cortisol in the ONDST and could therefore be used as an alternative sampling method which does not require venepuncture or attendance at hospital.
Study context
- Population
- Patients with adrenal incidentalomas (AI) who underwent an overnight dexamethasone suppression test (ONDST) and salivary cortisol/cortisone diurnal studies; samples analysed by liquid chromatography-tandem mass spectrometry
- Participants
- 173 patients
- Comparison
- Salivary cortisone and cortisol vs serum cortisol in the ONDST
- Outcome
- Prediction of an ONDST serum cortisol of ≤50 nmol/L
- Follow-up
- 09:00 the morning after 1 mg dexamethasone
Performance
As reported in the abstract
Prediction of ONDST serum cortisol ≤50 nmol/L
| Test or model | Sensitivity | Specificity | Kappa |
|---|---|---|---|
| Predictive indices (4 parameters) | 88.5% | 91.2% | 0.80 |
| Postdexamethasone salivary cortisone | 85.3% | 91.7% | 0.77 |
Sensitivity
Predictive indices (4 parameters)88.5%
Postdexamethasone salivary cortisone85.3%
Specificity
Predictive indices (4 parameters)91.2%
Postdexamethasone salivary cortisone91.7%
Kappa
Predictive indices (4 parameters)0.80
Postdexamethasone salivary cortisone0.77
- Correlation of salivary cortisone with serum cortisol after 1 mg dexamethasone (r)
- 0.95
Further findings
Independent variables (stepwise multivariate regression)
- Postdexamethasone salivary cortisone, baseline serum cortisol, salivary cortisone suppression and sex were the only significant or near-significant independent variables
- No correlation with any of the other measured parameters
Original publication
The Utility of Salivary Cortisone in the Overnight Dexamethasone Suppression Test in Adrenal Incidentalomas. J Clin Endocrinol Metab. Published 8 May 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →