夜间两不同时间点唾液皮质醇检测结果分析

Deteotion of salivary cortisol at two different time points at night

目的比较分析夜间23：00与24：00唾液皮质醇检测结果，以判断能否将午夜唾液皮质醇提前至23：00采集，用于临床库欣综合征的筛查诊断。方法对健康人群组（NS组）108例，库欣综合征（CS）高危人群组（NCS组）50例，库欣综合征患者（cs组）7例，分别于夜间23：00与24：00采集唾液，用酶联免疫吸附分析法（ELISA）检测唾液皮质醇。结果三组受试者夜间23：00与24：00唾液皮质醇检测结果分别为：Ns组：（2．01±O．91）ng/m1，（1．96±0．85）ng／ml；NCS组：（3．55±1．73）ng／ml，（3．81±1．49）ng／ml；CS组：（12．63±6．14）ng／ml，（10．98±3．98）ng／ml；三组组内两时间唾液皮质醇检测结果差异均无统计学意义（P均〉0．05），呈良好的直线相关（r=0．924，P〈0．001）；三组组间两时间唾液皮质醇检测结果差异均有统计学意义（P均〈0．001），cs组明显高于NS组和NCS组，NCS组高于NS组；23：00和24：00唾液皮质醇ROC曲线下面积分别为：0．995、0．996，对cs的诊断准确性较高。结论夜间唾液皮质醇浓度是筛查、诊断cs的一个方便、敏感指标；23：00唾液皮质醇浓度与24：00的接近，在23：00采集唾液可以满足临床库欣综合征的筛查诊断要求。

Objective To compare the detection results of salivary cortisol（SL） at 23：00 and 24：00 to estimate whether the collection of saliva can be taken in advance at 23：00 for the screening and diagnosis of Cushing＇s syndrome（CS）. Methods Saliva samples were collected by a cotton-based sampling approaches Salivettes at 23：00 and 24：00 from 108 normal subjects （NS group）, 50 patients （NCS group） with type 2 diabetes, primary hypertension or non-functional adrenal adenoma and 7 patients with Cushing＇ s syndrome（CS group）. Then the samples were assayed by ELISA. Retmlts The levels of SC at 23：00 （SC23） and 24：00 （SC24） in different groups were ： 2.01 ± 0.91 ng/ml, 1.96 ± 0.85 ng/ml in NS group, 3.55 ± 1.17 ng/ml, 3.81 ± 1.49 ng/ml in NCS group, and 12.63± 6.14 ng/ml, 10.98 ±3.98 ng/ml in CS group （ all P〉0.05）. Using Pearson correlation analysis, SC23 and SC24 showed a very good linear correlation （r = 0.924, P〈 0.001）. SC23 or SC24 in CS group were obviously higher than NS and NCS group. The areas under the ROC curves of SC23 and SC24 were 0.995 and 0.996 respectively, which displayed good accuracy to diagnosis of CS. Conelusions Midnight salivary cortisol is a convenient and sensitive indicator for the screening and diagnosis of CS. The concentrations of salivary cortisol at 23：00 and 24：00 are close,so collecting saliva at 23：00 is feasible for the clinical screening and diagnosis of CS.