Zhang Qian, Dou Jingtao, Gu Weijun, Yang Guoqing, Lu Juming
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
J Int Med Res. 2013 Oct;41(5):1387-94. doi: 10.1177/0300060513498017. Epub 2013 Sep 24.
The cortisol concentration in saliva is 10-fold lower than total serum cortisol and accurately reflects the serum concentration, both levels being lowest around midnight. The salivary cortisol assay measures free cortisol and is unaffected by confounding factors. This study analysed published data on the sensitivity and specificity of salivary cortisol levels in the diagnosis of Cushing syndrome.
Data from studies on the use of different salivary cortisol assay techniques in the diagnosis of Cushing syndrome, published between 1998 and 2012 and retrieved using Ovid MEDLINE®, were analysed for variance and correlation.
For the 11 studies analysed, mean sensitivity and specificity of the salivary cortisol assay were both >90%. Repeated measurements were easily made with this assay, enabling improved diagnostic accuracy in comparison with total serum cortisol measurements.
This analysis confirms the reliability of the saliva cortisol assay as pragmatic tool for the accurate diagnosis of Cushing syndrome. With many countries reporting a rising prevalence of metabolic syndrome, diabetes and obesity--in which there is often a high circulating cortisol level--salivary cortisol measurement will help distinguish these states from Cushing syndrome.
唾液中的皮质醇浓度比血清总皮质醇低10倍，且能准确反映血清浓度，两者在午夜左右均处于最低水平。唾液皮质醇检测可测量游离皮质醇，不受混杂因素影响。本研究分析了已发表的关于唾液皮质醇水平在库欣综合征诊断中的敏感性和特异性的数据。
分析了1998年至2012年间发表的、使用不同唾液皮质醇检测技术诊断库欣综合征的研究数据，这些数据通过Ovid MEDLINE®检索获得，并进行方差和相关性分析。
对于所分析的11项研究，唾液皮质醇检测的平均敏感性和特异性均>90%。该检测方法易于进行重复测量，与血清总皮质醇测量相比，可提高诊断准确性。
本分析证实了唾液皮质醇检测作为准确诊断库欣综合征的实用工具的可靠性。许多国家报告代谢综合征、糖尿病和肥胖的患病率不断上升，这些疾病中循环皮质醇水平通常较高，唾液皮质醇测量将有助于将这些状态与库欣综合征区分开来。
