| Texto completo | |
| Autor(es): |
Elias, Paula C. L.
[1]
;
Martinez, Edson Z.
[2]
;
Barone, Bruno F. C.
[1]
;
Mermejo, Livia M.
[1]
;
Castro, Margaret
[1]
;
Moreira, Ayrton C.
[1]
Número total de Autores: 6
|
| Afiliação do(s) autor(es): | [1] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Med, Div Endocrinol, BR-14049900 Ribeirao Preto, SP - Brazil
[2] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Social Med, Div Stat, BR-14049900 Ribeirao Preto, SP - Brazil
Número total de Afiliações: 2
|
| Tipo de documento: | Artigo Científico |
| Fonte: | JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM; v. 99, n. 6, p. 2045-2051, JUN 2014. |
| Citações Web of Science: | 39 |
| Resumo | |
Context: The comparison of variability, reproducibility, and diagnostic performance of late-night salivary cortisol (LNSF) and urinary free cortisol (UFC) using concurrent and consecutive samples in Cushing's syndrome (CS) is lacking. Objectives, Patients, and Methods: In a prospective study, we evaluated 3 simultaneous and consecutive samples of LNSF by RIA and UFC by liquid chromatography associated with tandem mass spectrometry in Cushing's disease (CD) patients (n = 43), adrenal CS patients (n = 9), and obese subjects (n = 18) to compare their diagnostic performances. In CS patients, we also performed a modified CS severity index. Results: There was no difference in the coefficient of variation (percentage) between LNSF and UFC among the 3 samples obtained for each patient with Cushing's disease (35 +/- 26 vs 31 +/- 24), adrenal CS (28 +/- 14 vs 22 +/- 14), and obesity (39 +/- 37 vs 48 +/- 20). LNSF confirmed the diagnosis of hypercortisolism even in the presence of normal UFC in 17.3% of CS, whereas the inverse situation was not observed for UFC. The area under the receiver-operating characteristic curves for LNSF was 0.999 (95% credible interval {[}CI] 0.990-1.00) and for UFC was 0.928 (95% CI 0.809-0.987). The ratio between areas under the curve was 0.928 (95% CI 0.810-0.988), indicating better performance of LNSF than UFC in diagnosing CS. There was no association between the CS severity index and the degree of biochemical hypercortisolism. Conclusion: Our data show that despite similar variability between both methods, LNSF has a superior diagnostic performance than UFC and should be used as the primary biochemical diagnostic test for CS diagnosis. (AU) | |
| Processo FAPESP: | 07/58365-3 - Fisiopatologia e etiopatogenia molecular de doencas relacionadas aos eixos corticotrofico, somatotrofico e neurohipofisario. |
| Beneficiário: | Margaret de Castro |
| Modalidade de apoio: | Auxílio à Pesquisa - Temático |
| Processo FAPESP: | 10/03039-7 - Cortisol ao despertar (car) e ritmo circadiano do cortisol em indivíduos normais e na síndrome de cushing |
| Beneficiário: | Silvia Liliana Ruiz Roa |
| Modalidade de apoio: | Bolsas no Brasil - Mestrado |