The Utility of Salivary Cortisone in the Overnight Dexamethasone Suppression Test in Adrenal Incidentalomas

Issa, Basil George; Hanna, Fahmy W F; Fryer, Anthony A; Ensah, Grace; Ebere, Ikenna; Marshall, David; Keevil, Brian

Abstract

BackgroundGuidelines recommend the assessment of cortisol secretion in patients with adrenal incidentalomas (AI) using the overnight dexamethasone suppression test (ONDST). This requires attendance to a health care facility and venepuncture. Alternatively, the ONDST can be done by measuring salivary cortisol and cortisone which can be collected at home. We aimed to assess the utility of these measurements in patients with AI.Materials and MethodsA retrospective analysis of data from 173 patients with AI who underwent an ONDST and salivary cortisol/cortisone diurnal studies. Serum and salivary cortisol and salivary cortisone were collected at 09:00, late night and at 09:00 post dexamethasone. Dexamethasone levels were measured in the post dexamethasone samples. Serum and salivary samples were analysed with liquid chromatography-tandem mass spectrometry (LC-MS/MS). Stata.

• Journal Article Type: Article
• Acceptance Date: Apr 30, 2023
• Online Publication Date: May 8, 2023
• Publication Date: 2023-10
• Deposit Date: May 25, 2023
• Publicly Available Date: May 9, 2024
• Journal: The Journal of Clinical Endocrinology & Metabolism
• Print ISSN: 0021-972X
• Electronic ISSN: 1945-7197
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 108
• Issue: 10
• Pages: e937-e943
• DOI: https://doi.org/10.1210/clinem/dgad242
• Keywords: Biochemistry (medical), Clinical Biochemistry, Endocrinology, Biochemistry, Endocrinology, Diabetes and Metabolism