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27.09.2017 | Original Article

Daily salivary cortisol and cortisone rhythm in patients with adrenal incidentaloma

verfasst von: Filippo Ceccato, Mattia Barbot, Nora Albiger, Giorgia Antonelli, Marialuisa Zilio, Marco Todeschini, Daniela Regazzo, Mario Plebani, Carmelo Lacognata, Maurizio Iacobone, Franco Mantero, Marco Boscaro, Carla Scaroni

Erschienen in: Endocrine | Ausgabe 3/2018

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Abstract

Background and aim

Impaired cortisol rhythm is a characteristic feature of Cushing’s Syndrome, nevertheless late night salivary cortisol (LNSC) is not suitable to detect subclinical hypercortisolism in patients with adrenal incidentaloma (AI). We studied daily salivary cortisol (F) and cortisone (E) rhythm in patients with AI.

Materials and methods

Six saliva samples were collected from awakening to night in 106 patients with AI and 40 controls. F and E were measured with LC-MS/MS and daily F exposure was calculated with the area under the curve (AUC).

Results

Patients with serum cortisol after dexamethasone suppression test (DST) > 50 nmol/L showed higher morning F (15.5 ± 14.5 vs. 8.6 ± 5.5 nmol/L, p = 0.001), suppressed corticotropin levels (76 vs. 35%, p < 0.001) and increased daily F exposure (3795 ± 1716 vs. 2898 ± 1478, p = 0.012), especially in the morning (2035 ± 1267 vs. 1365 ± 777, p = 0.003), otherwise LNSC levels were similar. Salivary E and AUC levels were higher in patients with DST > 50 nmol/L. AUC was not correlated with urinary cortisol levels or adenoma size. F and E levels were similar among patients with unilateral or bilateral adenoma, or considering the presence of hypertension, dyslipidemia, diabetes, or cardiovascular events.

Conclusion

Daily cortisol exposure, evaluated with AUC from multiple saliva collections, is increased in AI patients with serum cortisol > 50 nmol/L after DST, especially in the morning, leading to reduced corticotropin levels. Cortisol rhythm is preserved in patients with AI, remarking that LNSC is not a screening test for subclinical hypercortisolism.

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Titel: Daily salivary cortisol and cortisone rhythm in patients with adrenal incidentaloma
verfasst von: Filippo Ceccato
Mattia Barbot
Nora Albiger
Giorgia Antonelli
Marialuisa Zilio
Marco Todeschini
Daniela Regazzo
Mario Plebani
Carmelo Lacognata
Maurizio Iacobone
Franco Mantero
Marco Boscaro
Carla Scaroni
Publikationsdatum: 27.09.2017
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 3/2018
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-017-1421-3

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Daily salivary cortisol and cortisone rhythm in patients with adrenal incidentaloma

Abstract

Background and aim

Materials and methods

Results

Conclusion

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Background and aim

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Results

Conclusion

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