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新生性皮质高皮质醇症:深夜唾液皮质醇和皮质醇的截止值

Karlijn Koops¹, Peter H Bisschop², Annemieke C Heijboer³

¹Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Laboratory Medicine, Endocrine Laboratory, Boelelaan 1117, Amsterdam, The Netherlands; Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands; Amsterdam UMC location University of Amsterdam, Department of Laboratory Medicine, Endocrine Laboratory, Meibergdreef 9, Amsterdam, The Netherlands.

Clinica chimica acta; international journal of clinical chemistry

|April 18, 2025

概括

夜晚的唾液皮质醇 (Cortisone_LNSa) 是一种比夜晚的唾液皮质醇 (Cortisol_LNSa) 更准确的瘤性高皮质醇症的诊断标志物. 这项研究确立了新的切断值,推Cortisone_LNSa,以提高诊断准确度.

科学领域:

内分泌学在内分泌学.
临床化学临床化学
诊断生物标志物诊断生物标志物

背景情况:

新生性高皮质醇症的诊断通常依赖于深夜的唾液皮质醇 (皮质醇_LNSa).
对于皮质醇_LNSa和深夜唾液皮质素 (皮质素_LNSa) 的现有切断值显示出显著的变化.
标准化和验证的诊断标记对于准确的高皮质醇症评估至关重要.

研究的目的:

通过液体染色学-并联质谱法来确定皮质醇_LNSa和皮质素_LNSa的精确切割值.
为了比较皮质醇_LNSa和皮质素_LNSa的诊断性能,以区分瘤性高皮质醇症.
为了确定优越的唾液生物标志物来诊断瘤性高皮质醇症.

主要方法:

在阿姆斯特丹UMC (2015-2022) 对455名被查内源性高皮质醇症的受试者的回顾性分析.
包括25名确诊瘤性高皮质醇症患者和430名对照患者.
在深夜的唾液样本 (22:00-23:59小时) 中通过LC-MS/MS测量皮质醇_LNSa和皮质素_LNSa.

主要成果:

与对照组相比,在患有瘤性高皮质醇症的患者中,皮质醇_LNSa (7.8 与 0.8 nmol/L) 和皮质醇_LNSa (35.5 与 5.3 nmol/L) 的中位数度显著更高 (p < 0.001).
确定了最佳切断值:对皮质醇_LNSa2.25nmol/L (92%的灵敏度,89%的特异性) 和对皮质素_LNSa15.5nmol/L (93.8%的灵敏度,94.5%的特异性).
与皮质醇_LNSa相比,皮质醇_LNSa显示出更高的诊断准确性,具有更高的正预测值 (46.9%) 和负预测值 (99.7%).

结论:

确定了晚上唾液皮质醇和皮质醇在瘤性皮质醇过高症诊断中的可靠切断值.
夜晚的唾液皮质醇 (Cortisone_LNSa) 的诊断准确度高于夜晚的唾液皮质醇 (Cortisol_LNSa).
建议使用皮质醇_LNSa作为诊断瘤性皮质醇过高症的首选唾液生物标志物.

关键词:

皮质醇是一种皮质醇.皮质激素的皮质激素库辛综合征是什么意思库辛综合征是什么意思过高皮质醇主义 (hypercortisolism) 是一种超高皮质醇主义.这是LC-MS/MS.在深夜的唾液.

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