2013年11月
Significantly high level of late-night free cortisol to creatinine ratio in urine specimen in patients with subclinical Cushing's syndrome
CLINICAL ENDOCRINOLOGY
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- 巻
- 79
- 号
- 5
- 開始ページ
- 617
- 終了ページ
- 622
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1111/cen.12197
- 出版者・発行元
- WILEY-BLACKWELL
ObjectiveAbsence of a late-night cortisol nadir is a consistent biochemical abnormality in patients with cortisol-producing adenoma. We evaluated the abnormality of late-night urinary free cortisol to creatinine ratio (late-night UFCCR) in patients with subclinical Cushing's syndrome (SCS).
MethodsFifty-eight patients with incidentally detected adrenocortical adenomas [SCS: 9; nonfunctioning adenoma (NF): 49] were enrolled as subjects. Values measured in all patients were urinary free cortisol accumulated between 9:00 p.m. and 11:00 p.m. (late-night UFCCR), serum cortisol at 11:00 p.m. (midnight serum cortisol: MSC), serum cortisol after 1-mg overnight dexamethasone suppression test (1mg-DST) and 24-h urinary free cortisol (UFC).
ResultsMedian late-night UFCCR value in SCS was significantly higher than that in NF (P<0001). Significant correlations were observed between late-night UFCCR and each of serum cortisol after 1mg-DST and MSC (r=0537, P<0001 and r=0556, P<0001, respectively). There was no significant correlation between serum cortisol after 1mg-DST and 24-h UFC (r=0211, P=0112). In receiver operating characteristic analysis for diagnosis of SCS, the areas under the curves of late-night UFCCR and 24-h UFC were 0937 (95% confidence interval 0865-1008) and 0726 (0874-0999), respectively. Late-night UFCCR cut-off value of 49nmol/molCre showed a sensitivity of 100% and a specificity of 766%.
ConclusionPatients with SCS showed higher late-night UFCCR values than those with NF. Late-night UFCCR was significantly correlated with autonomous cortisol production findings. Diagnostic performance of late-night UFCCR was superior to 24-h UFC. These results suggest that late-night UFCCR might represent one of the simple and reliable tests for SCS diagnosis.
MethodsFifty-eight patients with incidentally detected adrenocortical adenomas [SCS: 9; nonfunctioning adenoma (NF): 49] were enrolled as subjects. Values measured in all patients were urinary free cortisol accumulated between 9:00 p.m. and 11:00 p.m. (late-night UFCCR), serum cortisol at 11:00 p.m. (midnight serum cortisol: MSC), serum cortisol after 1-mg overnight dexamethasone suppression test (1mg-DST) and 24-h urinary free cortisol (UFC).
ResultsMedian late-night UFCCR value in SCS was significantly higher than that in NF (P<0001). Significant correlations were observed between late-night UFCCR and each of serum cortisol after 1mg-DST and MSC (r=0537, P<0001 and r=0556, P<0001, respectively). There was no significant correlation between serum cortisol after 1mg-DST and 24-h UFC (r=0211, P=0112). In receiver operating characteristic analysis for diagnosis of SCS, the areas under the curves of late-night UFCCR and 24-h UFC were 0937 (95% confidence interval 0865-1008) and 0726 (0874-0999), respectively. Late-night UFCCR cut-off value of 49nmol/molCre showed a sensitivity of 100% and a specificity of 766%.
ConclusionPatients with SCS showed higher late-night UFCCR values than those with NF. Late-night UFCCR was significantly correlated with autonomous cortisol production findings. Diagnostic performance of late-night UFCCR was superior to 24-h UFC. These results suggest that late-night UFCCR might represent one of the simple and reliable tests for SCS diagnosis.
- リンク情報
- ID情報
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- DOI : 10.1111/cen.12197
- ISSN : 0300-0664
- PubMed ID : 23480295
- Web of Science ID : WOS:000325249900004