Diagnostic performance of an automated immunoassay for salivary cortisol - 22/02/24
, Fidéline Bonnet-Serrano a, b, Marie-Clémence Leguy a, Miliça Simeonovic a, d, Catherine Sée a, Corinne Zientek a, Mickael Soussan a, b, Lucas Bouys b, c, e, Jérôme Bertherat b, c, e, Jean Guibourdenche a, b
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Highlights |
• | Saliva sampling is easy, non-invasive, and thus suitable for outpatient settings. |
• | HPLC-MS/MS is the gold standard, measuring cortisol and cortisone simultaneously. |
• | Immunoassays for cortisol may cross-react with cortisone, which is abundant in saliva. |
• | Cut-off values are lacking for salivary cortisol in adrenal dynamic tests. |
• | Automated immunoassays for salivary cortisol can be used in first line. |
Abstract |
Automated immunoanalysis (AI) is an interesting alternative for measuring salivary cortisol, as the gold standard HPLC-MS/MS method is not yet readily available. The aim of this study was to evaluate the diagnostic performance of salivary cortisol immunoassay on the iSYS immunoanalyzer in adrenal dynamic tests. Cortisol was measured on iSYS and on HPLC-MS/MS in saliva samples collected after 1mg-dexamethasone suppression test (DST) in 115 patients suspected of Cushing syndrome, and during Synacthen® stimulation test (SST) in 108 patients suspected of adrenal insufficiency. Concentrations on AI correlated well with HPLC-MS/MS (Spearman r=0.9496; P<0.0001), but with a significant positive bias. ROC analysis of salivary cortisol identified optimal cut-off values on AI and HPLC-MS/MS of respectively 3.5 and 0.77nmol/L for DST and 32.6 and 13.8nmol/L at T60 after SST. Automated immunoassays for salivary cortisol are suitable in daily practice but require determination of specific cut-off and reference values.
Le texte complet de cet article est disponible en PDF.Keywords : Cortisol, Saliva, Synacthen® stimulation test, Dexamethasone suppression test, Immunoanalyzer, Mass spectrometry
Plan
Vol 85 - N° 1
P. 20-26 - février 2024 Retour au numéro
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