Value of different assessment criteria of midnight serum cortisol in the diagnosis of Cushing′s syndrome
10.3969/j.issn.1009-0754.2015.01.009
- VernacularTitle:不同判别标准评价午夜血清皮质醇水平在库欣综合征诊断中的价值
- Author:
Wei ZHANG
1
;
Zheng ZHANG
;
Erli XU
Author Information
1. 解放军第四一一医院内分泌科
- Keywords:
Cushing′s syndrome;
Midnight serum cortisol;
Sensitivity;
Specificity
- From:
Journal of Navy Medicine
2015;(1):20-23
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of different assessment criteria of midnight serum cortisol in the diagnosis of Cushing′s syndrome (CS).Methods Seventy-four patients were diagnosed to have CS in No .411 hospital, CPLA, from 2007-2012. Serum cortisol levels at 08:00 and 24:00, urinary free cortisol level ( UFC) at 24 h and the levels of adrenocorticotropic hormore (ACTH) and potassium at 08:00 were detected in the said 74 cases of Cushing′s syndrome.Then, the obtained results were compared with those of the 75 overweight/obesity cases without CS and 84 non-overweight cases ( control group ) .Blood samples were collected at midnight for the detection of serum cortisol in the sleeping mode and awake status .Results (1) In the patients with CS, the levels of serum cotisol and urinary free cortisol detected at 8:00 and 24:00 in sleeping mode were higher than those overweight /obesity cases and the control group .In these same patients , the levels of serum cotisol and urinary free cortisol detected at 8:00 and 24:00 in the awake mode were also higher than those overweight/obesity cases and the control group .Serum cortisol level detected at 24:00 in the patients of the overweight/obesity group was higher than that of the control group .(2) When serum cotisol levels detected in the sleeping mode at 24:00 were respectively 50, 138, 207, 229 and 331 nmol/L, the detection sensitivity to CS was 100.0%, 97.1%, 85.7%, 77.1%and 68.6%, while the detection specificity was 24.1%, 75.9%, 86.1%, 92.4%and 98.7%.On the other hand, the de-tection sensitivity to CS in the awake status , was respectively 100.0%, 97.4%, 92.3%, 84.6%and 71.8%;and the detection specific-
ity was 11.3%, 67.5%, 82.5%, 87.5% and 96.3%.Conclusion The serum cortisol level of 207 nmol/L detected at 24:00 in the sleeping mode and the level of 207 nmol/L or 229 nmol/L detected in the awake status displayed better sensitivity and higher specificity .
