Midnight Salivary Cortisol and Other Effective Factors in the Graduation of Clinical Suspect of Cushing Syndrome: Is There Any Reasonable Clinical Score?

作     者：Meral Mert Refik Tanakol Hande Karpuzoglu Semra Abbasoglu Sema Yarman Harika Boztepe Faruk Alagol 

作者机构：Istanbul University Istanbul Medical Faculty Department of Biochemistry Istanbul Turkey Istanbul University Istanbul Medical Faculty Department of Internal Medicine Division of Endocrinology and Metabolism Istanbul Turkey 

出 版 物：《Open Journal of Endocrine and Metabolic Diseases》 (内分泌与新陈代谢疾病期刊（英文）)

年 卷 期：2013年第3卷第1期

页      面：52-54页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Salivary Cortsiol Clinical Suspect Clinical Score Cushing’s Syndrome 

摘      要：Background: Diagnosis of Cushing’s Syndrome (CS) at the right time and with the right method is getting more important for the patients and clinicians due to high mortality rate. The most appropriate laboratory test will provide great benefits in terms of cost-effectiveness in the well-chosen group of patients. Selection of the high risk group is of crucial importance for the true diagnosis and treatment on time. Aim: The aim of this study was to evaluate the worth of the midnight salivary cortisol and to establish other effective factors in the graduation of clinical suspect of CS. Material and Methods: 115 patients were evaluated in weight, height, body mass index (BMI), waist/hip ratio, systolic, diastolic blood pressures, hirsutism, weight gain, purple-stria, plethore, buffalo-hump, supraclavicular fullness, temporal fat cushion, acnea, moonface, proximal muscle weakness, lower limb edema, ecchymosis, loss of libido, depression, diabetes mellitus, hypertension, allopecia of all patients were noted in the evaluation forms (23 findings). Patients were grouped according to clinical scores, low (16). Results: When we compare the groups in terms of midnight salivary cortisol, morning salivary cortisol after overnight dexamethasone suppression test, we found statistically significant relationship between the low and high clinical score groups, as well as between medium and high score groups (p: 0.0001). Urinary free cortisol was statistically significant only between low and high clinical score groups (p: 0.0001). Conclusion: This clinical scoring system which includes clinical signs and laboratory findings both, can be used for selection of the high risk group.