{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:21:06Z","timestamp":1789698066509,"version":"4.0.1"},"reference-count":5,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T00:00:00Z","timestamp":1565740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the evaluation for hypercortisolism (Cushing\u2019s syndrome), the 1\u2009mg overnight dexamethasone suppression test has an important role, but false-positive results can occur due to low serum dexamethasone. Given the high intraindividual reproducibility of post-dexamethasone suppression test serum cortisol concentrations, we investigated the chance of success of repeating a non-suppressed dexamethasone suppression test if serum dexamethasone is low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed the results of 1901 consecutive dexamethasone suppression tests performed in our laboratory from February 2011 to November 2018. Serum dexamethasone and cortisol were measured by LC-MS\/MS, and both were reported. The 2.5 and 5th percentiles of serum dexamethasone in suppressed dexamethasone suppression tests were investigated as cut-off value. Then, we retrospectively determined the success rate of repeating an initial, non-suppressed dexamethasone suppression test in 131 patients, stratified by initial serum dexamethasone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At serum dexamethasone concentrations between the 2.5 and 5th percentiles (3.2\u20133.9\u2009nmol\/L), significantly more non-suppressed dexamethasone suppression tests were observed (27\/67) than in the control group of 1357 tests having serum dexamethasone \u2a7e6\u2009nmol\/L (40% vs. 30%, P\u2009=\u20090.047), indicating that 3.9\u2009nmol\/L is the better cut-off. Overall, 40% of non-suppressed dexamethasone suppression tests were repeated, but repeat testing was performed more often when serum dexamethasone was low. In patients who had initial serum dexamethasone below the cut-off of 3.9\u2009nmol\/L, a significantly higher chance of having a suppressed repeat dexamethasone suppression test was observed compared to the control group: 57% (31\/54) vs. 26% (15\/57), P\u2009=\u20090.001.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Measuring and reporting serum dexamethasone in dexamethasone suppression tests have added value for the selection of patients who might benefit from a repeat dexamethasone suppression test. We suggest a cut-off for serum dexamethasone of \u2a7e3.9\u2009nmol\/L.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0004563219870834","type":"journal-article","created":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T21:10:30Z","timestamp":1564693830000},"page":"708-710","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Retrospective analysis of repeated dexamethasone suppression tests \u2013 the added value of measuring dexamethasone"],"prefix":"10.1177","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5451-3010","authenticated-orcid":false,"given":"Albert J","family":"de Graaf","sequence":"first","affiliation":[{"name":"Department of Clinical Chemistry, Medisch Spectrum Twente, Enschede, The Netherlands"},{"name":"Medlon B.V., Enschede, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AH Leontine","family":"Mulder","sequence":"additional","affiliation":[{"name":"Medlon B.V., Enschede, The Netherlands"},{"name":"Department of Clinical Chemistry, Ziekenhuisgroep Twente, Almelo, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes G","family":"Krabbe","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Medisch Spectrum Twente, Enschede, The Netherlands"},{"name":"Medlon B.V., Enschede, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,8,14]]},"reference":[{"key":"bibr1-0004563219870834","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0125"},{"key":"bibr2-0004563219870834","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1982.tb00733.x"},{"key":"bibr3-0004563219870834","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-17-0078"},{"key":"bibr4-0004563219870834","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2011.011004"},{"key":"bibr5-0004563219870834","doi-asserted-by":"publisher","DOI":"10.1177\/0004563218766566"}],"container-title":["Annals of Clinical Biochemistry: International Journal of Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0004563219870834","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0004563219870834","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0004563219870834","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:23:58Z","timestamp":1777379038000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0004563219870834"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,14]]},"references-count":5,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1177\/0004563219870834"],"URL":"https:\/\/doi.org\/10.1177\/0004563219870834","relation":{},"ISSN":["0004-5632","1758-1001"],"issn-type":[{"value":"0004-5632","type":"print"},{"value":"1758-1001","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,14]]}}}