Department of Laboratory Medicine, MTA-SE Lendulet Research Group, Hungarian Academy of Sciences, Semmelweis University, 46. Szentkiralyi str, Budapest, 1088, Hungary.
"Lendület" Hereditary Endocrine Tumours Research Group, HAS-SE, Budapest, Hungary.
J Endocrinol Invest. 2018 Mar;41(3):315-323. doi: 10.1007/s40618-017-0743-6. Epub 2017 Aug 16.
Late-night salivary cortisol level is one of the first-line tests recommended by the Endocrine Society for the diagnosis of endogenous hypercortisolism. Most routine laboratories measure cortisol levels using immunoassay tests which fail to determine low cortisol levels accurately due to the numerous interfering substances. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method with simple and rapid sample preparation was developed for the simultaneous measurement of cortisol and cortisone and its performance in the diagnosis of endogenous hypercortisolism was evaluated.
324 late-night saliva samples were analyzed from which 272 samples were derived from patients with a suspected diagnosis of endogenous hypercortisolism. Salivary cortisol levels were assayed using an electrochemiluminescent immunoassay (ECLIA, Cortisol II, Roche), and simultaneous measurement of cortisol and cortisone was performed using an LC-MS/MS method.
A strong correlation between cortisol results measured using ECLIA and LC-MS/MS (r = 0.892) was demonstrated. Receiver operating characteristics (ROC) analysis showed good diagnostic performance of cortisol and cortisone levels assayed using LC-MS/MS method and for cortisol measured using ECLIA.
Late-night salivary cortisol and cortisone are useful parameters for the diagnosis of hypercortisolism. Using samples obtained from patients where the diagnosis of hypercortisolism is extremely challenging cut-off values for midnight salivary cortisol and cortisone measured by LC-MS/MS method were established.
深夜唾液皮质醇水平是内分泌学会推荐的内源性皮质醇增多症诊断的一线检测方法之一。大多数常规实验室使用免疫测定法测量皮质醇水平，但由于存在许多干扰物质，无法准确确定低皮质醇水平。本研究开发了一种使用简单快速的样品制备的液相色谱-串联质谱（LC-MS/MS）方法，用于同时测量皮质醇和可的松，并评估其在内源性皮质醇增多症诊断中的性能。
分析了 324 份深夜唾液样本，其中 272 份来自疑似内源性皮质醇增多症患者。使用电化学发光免疫分析法（ECLIA，Cortisol II，罗氏）测定唾液皮质醇水平，并使用 LC-MS/MS 方法同时测定皮质醇和可的松。
证明了 ECLIA 和 LC-MS/MS 测定的皮质醇之间具有很强的相关性（r = 0.892）。接收者操作特征（ROC）分析表明，LC-MS/MS 方法测定的皮质醇和可的松水平以及 ECLIA 测定的皮质醇具有良好的诊断性能。
深夜唾液皮质醇和可的松是诊断皮质醇增多症的有用参数。使用来自诊断极度困难的皮质醇增多症患者的样本，建立了 LC-MS/MS 方法测定午夜唾液皮质醇和可的松的截断值。
