Diagnostic performance of a newly developed salivary cortisol and cortisone measurement using an LC–MS/MS method with simple and rapid sample preparation

K. Mészáros, G. Karvaly, Z. Márta, B. Magda, J. Tőke, N. Szücs, M. Tóth, K. Rácz, A. Patócs

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: 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. Methods: 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. Results: A strong correlation between cortisol results measured using ECLIA and LC–MS/MS (r2 = 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)315-323
Number of pages9
JournalJournal of Endocrinological Investigation
Volume41
Issue number3
DOIs
Publication statusPublished - Mar 1 2018

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Cortisone
Hydrocortisone
Cushing Syndrome
Immunoassay
Saliva
ROC Curve
Mass Spectrometry

Keywords

  • Cortisol
  • Cortisone
  • ECLIA
  • Hypercortisolism
  • Late-night saliva
  • LC–MS/MS

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Diagnostic performance of a newly developed salivary cortisol and cortisone measurement using an LC–MS/MS method with simple and rapid sample preparation. / Mészáros, K.; Karvaly, G.; Márta, Z.; Magda, B.; Tőke, J.; Szücs, N.; Tóth, M.; Rácz, K.; Patócs, A.

In: Journal of Endocrinological Investigation, Vol. 41, No. 3, 01.03.2018, p. 315-323.

Research output: Contribution to journalArticle

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AB - Background: 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. Methods: 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. Results: A strong correlation between cortisol results measured using ECLIA and LC–MS/MS (r2 = 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. Conclusions: 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.

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