Eur J Endocrinol
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European Journal of Endocrinology, Vol 134, Issue 1, 93-96
Copyright © 1996 by European Society of Endocrinology
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Articles

Overnight dexamethasone suppression test: comparison of plasma and salivary cortisol measurement for the screening of Cushing's syndrome

Z Barrou, D Guiban, A Maroufi, C Fournier, MA Dugue, JP Luton, and P Thomopoulos

Clinique des maladies endocriniennes et metaboliques, Pr Luton, Hopital Cochin, Paris, France.

The overnight 1-mg dexamethasone suppression test is a very good screening test for subjects suspected of having Cushing's syndrome. To simplify the procedure, we evaluated the 1-mg dexamethasone suppression test with measurement of salivary cortisol. We performed this test with plasma and salivary cortisol measurements in 27 patients with Cushing's syndrome and 64 normal controls. The sensitivity and specificity of plasma cortisol measurements were 100% and 87%, respectively, for a cut-off point of 100 nmol/l, in accordance with previous studies. The results of salivary cortisol showed the absence of overlap between the two groups, with a sensitivity and specificity of 100% for a cut-off point of 2.8 nmol/l. On a larger series, however, one might occasionally miss the diagnosis of a patient with Cushing's syndrome. Therefore, we favor a cut-off point of 1.9 nmol/l, the sensitivity remaining at 100% and the specificity being 94%. In conclusion we recommend the overnight dexamethasone suppression test with measurement of salivary cortisol as a screening test for Cushing's syndrome.


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J. W. Findling, H. Raff, and D. C. Aron
The Low-Dose Dexamethasone Suppression Test: A Reevaluation in Patients with Cushing's Syndrome
J. Clin. Endocrinol. Metab., March 1, 2004; 89(3): 1222 - 1226.
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D. A. Papanicolaou, N. Mullen, I. Kyrou, and L. K. Nieman
Nighttime Salivary Cortisol: A Useful Test for the Diagnosis of Cushing's Syndrome
J. Clin. Endocrinol. Metab., October 1, 2002; 87(10): 4515 - 4521.
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 J. Clin. Endocrinol. Metab.Home page
H. Raff, J. L. Raff, and J. W. Findling
Late-Night Salivary Cortisol as a Screening Test for Cushing's Syndrome
J. Clin. Endocrinol. Metab., August 1, 1998; 83(8): 2681 - 2686.
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