Cortisol and cortisone ratio in urine: LC-MS/MS method validation and preliminary clinical application

Antonelli, Giorgia; Artusi, Carlo Alberto; Marinova, Mariela; Brugnolo, Laura; Zaninotto, Martina; Scaroni, Carla; Gatti, Rosalba; Mantero, Franco; Plebani, Mario

doi:10.1515/cclm-2013-0471

Cited by 25 publications

(20 citation statements)

References 21 publications

(17 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The reference range used in our department, determined using the LC-MS/MS method described above, is for UFF 16-170 nmol/24 h, UFE 41-364 nmol/24 h, and UFF:UFE 0.14-1.09 (13); these values are comparable with others obtained using LC-MS/MS methods (5,6,14).…”

Section: Urinary Glucocorticoid Analysissupporting

confidence: 82%

The diagnostic performance of urinary free cortisol is better than the cortisol:cortisone ratio in detecting de novo Cushing's syndrome: the use of a LC–MS/MS method in routine clinical practice

Ceccato

Antonelli

Barbot

et al. 2014

European Journal of Endocrinology

Self Cite

View full text Add to dashboard Cite

Objective: The Endocrine Society Clinical Guidelines recommend measuring 24-h urinary free cortisol (UFF) levels using a highly accurate method as one of the first-line screening tests for the diagnosis of Cushing's Syndrome (CS). We evaluated the performance of UFF, urinary free cortisone (UFE), and the UFF:UFE ratio, measured using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Subjects and methods: The LC-MS/MS was used to analyze UFF and UFE levels in 43 surgically confirmed CS patients: 26 with Cushing's disease (CD, 16 de novo and ten recurrences), 11 with adrenal CS and six with ectopic CS; 22 CD patients in remission; 14 eu-cortisolemic CD patients receiving medical therapy; 60 non-CS patients; and 70 healthy controls. Sensitivity and specificity were determined in the combined groups of non-CS patients, healthy controls, and CD in remission. Results: UFFO170 nmol/24 h showed 98.7% specificity and 100% sensitivity for de novo CS, while sensitivity was 80% for recurrent CD patients, who were characterized by lower UFF levels. The UFF:UFE and UFFCUFE showed lower sensitivity and specificity than UFF. Ectopic CS patients had the highest UFF and UFF:UFE levels, which were normal in the CD remission patients and in those receiving medical therapy. Conclusions: Our data suggest high diagnostic performance of UFF excretion measured using LC-MS/MS, in detecting de novo CS. UFF:UFE and UFFCUFE assessments are not useful in the first step of CS diagnosis, although high levels were found to be indicative of ectopic CS.

show abstract

Section: Urinary Glucocorticoid Analysissupporting

confidence: 82%

The diagnostic performance of urinary free cortisol is better than the cortisol:cortisone ratio in detecting de novo Cushing's syndrome: the use of a LC–MS/MS method in routine clinical practice

Ceccato

Antonelli

Barbot

et al. 2014

European Journal of Endocrinology

Self Cite

View full text Add to dashboard Cite

show abstract

“…LNSC was performed between 11.00 and 12.00 pm using a Salivette® device (Sarstedt, Numbrecht, Germany), with an intra/interassay CV Ͻ 3% and Ͻ 9% respectively, as previously described (12). Patients collected their urine excretions for 24h as instructed in a written form (to ensure that it was done properly); UFC was measured by LC-MS/MS, with calculated intra/interassay CV Ͻ 6% and Ͻ 8%, as previously described in detail elsewhere (10).…”

Section: First-line Screening Testsmentioning

confidence: 99%

“…In fact, the widespread use of immunoassays may give rise to falsely high values due to cross-reactivity with cortisol metabolites (9). In the last years, we measured UFC by LC-MS/MS in routine clinical practice (10,11), and this prompted us to study its diagnostic performance and compare it with that of the other two recommended screening tests (1-mg DST and LNSC) in a large series of patients. We calculated sensitivity, specificity (SP) and negative-positive likelihood ratio (LR) of the three tests, separately and in all their possible combinations, for the purpose of identifying the best diagnostic tool for recognizing endogenous hypercortisolism.…”

mentioning

confidence: 99%

Screening Tests for Cushing's Syndrome: Urinary Free Cortisol Role Measured by LC-MS/MS

Ceccato¹,

Barbot²,

Zilio³

et al. 2015

The Journal of Clinical Endocrinology & Metabolism

Self Cite

View full text Add to dashboard Cite

show abstract

“…their serum cortisol levels after a 1-mg overnight dexamethasone suppression test were <50 nmol/L (the lower cut-off, in order to avoid false negative results) and the mean of two 24-hour urinary free cortisol collections were <170 nmol/24h (our local cut-off for endogenous hypercortisolism. 12 The percentiles of salivary cortisol at each of the 7 time-points and the AUC F0àF14 are outlined in Table 1. We did not observe an increase in cortisol levels after meals.…”

Section: Gender and Age Differencementioning

confidence: 99%

Age and the metabolic syndrome affect salivary cortisol rhythm: data from a community sample

Ceccato¹,

Barbot²,

Zilio³

et al. 2015

Self Cite

View full text Add to dashboard Cite

Objective: Measurement of cortisol levels in saliva is a marker of free hormone. How salivary cortisol rhythm is affected by age, gender, the metabolic syndrome and estrogen-progestin therapy was evaluated in a community sample of adults. SubjectS and MetHOdS: One hundred twenty volunteers recruited from the Hospital staff and family members of the endocrinology unit were instructed to collect 7 salivary samples: the first on awakening ( . according to the Kruskal-Wallis analysis of variance, the most important factor affecting F 14 value was age (p=0.001). auc F0àF14 was not influenced by gender, age, metabolic syndrome or estrogen-progestin therapy. cOncluSiOnS: While it did not affect the daily cortisol rate, late-night salivary cortisol levels were found to be increased in the subjects in the higher age tertile and in those with the metabolic syndrome.

show abstract

Cortisol and cortisone ratio in urine: LC-MS/MS method validation and preliminary clinical application

Cited by 25 publications

References 21 publications

The diagnostic performance of urinary free cortisol is better than the cortisol:cortisone ratio in detecting de novo Cushing's syndrome: the use of a LC–MS/MS method in routine clinical practice

The diagnostic performance of urinary free cortisol is better than the cortisol:cortisone ratio in detecting de novo Cushing's syndrome: the use of a LC–MS/MS method in routine clinical practice

Screening Tests for Cushing's Syndrome: Urinary Free Cortisol Role Measured by LC-MS/MS

Age and the metabolic syndrome affect salivary cortisol rhythm: data from a community sample

Contact Info

Product

Resources

About