Show simple item record

dc.contributor.authorUeland, Grethe Åstrøm
dc.contributor.authorKellmann, Ralf
dc.contributor.authorDavidsen, Melissa Jørstad
dc.contributor.authorViste, Kristin
dc.contributor.authorHusebye, Eystein Sverre
dc.contributor.authorAlmås, Bjørg
dc.contributor.authorStorr, Helen L.
dc.contributor.authorSagen, Jørn Vegard
dc.contributor.authorMellgren, Gunnar
dc.contributor.authorJuliusson, Pétur Benedikt
dc.contributor.authorMethlie, Paal
dc.description.abstractBackground Diagnosing Cushing syndrome (CS) can be challenging. The 24-hour urine free cortisol (UFC) measurement is considered gold standard. This is a laborious test, dependent on correct urine collection. Late-night salivary cortisol is easier and is used as a screening test for CS in adults, but has not been validated for use in children. Objective To define liquid chromatography tandem mass spectrometry (LC-MS/MS)-based cutoff values for bedtime and morning salivary cortisol and cortisone in children, and validate the results in children with and without CS. Methods Bedtime and morning salivary samples were collected from 320 healthy children aged 4 to 16 years. Fifty-four patients from the children’s outpatient obesity clinic and 3 children with pituitary CS were used for validation. Steroid hormones were assayed by LC-MS/MS. Cutoff levels for bedtime salivary cortisol and cortisone were defined by the 97.5% percentile in healthy subjects. Results Bedtime cutoff levels for cortisol and cortisone were 2.4 and 12.0 nmol/L, respectively. Applying these cutoff levels on the verification cohort, 1 child from the obesity clinic had bedtime salivary cortisol exceeding the defined cutoff level, but normal salivary cortisone. All 3 children with pituitary CS had salivary cortisol and cortisone far above the defined bedtime cutoff levels. Healthy subjects showed a significant decrease in salivary cortisol from early morning to bedtime. Conclusions We propose that bedtime salivary cortisol measured by LC-MS/MS with a diagnostic threshold above 2.4 nmol/L can be applied as a screening test for CS in children. Age- and gender-specific cutoff levels are not needed.en_US
dc.publisherOxford University Pressen_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internasjonal*
dc.titleBedtime Salivary Cortisol as a Screening Test for Cushing Syndrome in Childrenen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright The Author(s) 2021en_US
dc.source.journalJournal of the Endocrine Society (JES)en_US
dc.identifier.citationJournal of the Endocrine Society. 2021, 5 (5), 1-8.en_US

Files in this item


This item appears in the following Collection(s)

Show simple item record

Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal