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https://hdl.handle.net/2440/63219
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Type: | Journal article |
Title: | Screening for subclinical Cushing's Syndrome in Type 2 Diabetes Mellitus: Low false-positive rates with nocturnal salivary cortisol |
Author: | Gagliardi, L. Chapman, I. O'Loughlin, P. Torpy, D. |
Citation: | Hormone and Metabolic Research, 2010; 42(4):280-284 |
Publisher: | Georg Thieme Verlag KG |
Issue Date: | 2010 |
ISSN: | 0018-5043 1439-4286 |
Statement of Responsibility: | L. Gagliardi, I. M. Chapman, P. O'Loughlin, D. J. Torpy |
Abstract: | The diagnosis of subclinical Cushing's syndrome (SCS) is important, but its relative rarity amongst patients with common metabolic disorders requires a simple test with a low false-positive rate. Using nocturnal salivary cortisol (NSC), which we first validated in patients with suspected and proven Cushing's syndrome, we screened 106 overweight patients with type 2 diabetes mellitus, a group at high risk of SCS and nontumoral hypothalamic-pituitary-adrenal axis perturbations. Our hypothesis was that a lower false-positive rate with NSC was likely, compared with that reported with the dexamethasone suppression test (DST) (10-20%), currently the foundation of diagnosis of SCS. No participant had clinically apparent Cushing's syndrome. Three participants had an elevated NSC but further testing excluded SCS. In this study, NSC had a lower false-positive rate (3%) than previously reported for the DST. Given the reported excellent performance of NSC in detection of hypercortisolism, the low false-positive rate in SCS suggests NSC may be superior to the DST for SCS screening. The NSC and DST should be compared directly in metabolic disorder patients; although our data suggest the patient group will need to be substantially larger to definitively determine the optimal screening test. |
Keywords: | adrenal hypercortisolism metabolic syndrome |
Rights: | © Georg Thieme Verlag KG Stuttgart · New York |
DOI: | 10.1055/s-0029-1246191 |
Published version: | http://dx.doi.org/10.1055/s-0029-1246191 |
Appears in Collections: | Aurora harvest Medicine publications |
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