{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:47:50Z","timestamp":1787021270412,"version":"build-2736575974"},"reference-count":23,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Korea Health Technology R&D Project"},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare of the Republic of Korea","doi-asserted-by":"publisher","award":["HI21C0032"],"award-info":[{"award-number":["HI21C0032"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Patient-Centered Clinical Research Coordinating Center"},{"name":"Ministry of Health & Welfare, Republic of Korea","award":["RS-2024-00397426"],"award-info":[{"award-number":["RS-2024-00397426"]}]},{"DOI":"10.13039\/501100003693","name":"Korea Institute of Science and Technology Institutional Program","doi-asserted-by":"publisher","award":["2E31156"],"award-info":[{"award-number":["2E31156"]}],"id":[{"id":"10.13039\/501100003693","id-type":"DOI","asserted-by":"publisher"}]},{"name":"EnM research award"},{"name":"Korean Endocrinology Society in 2017"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Although salivary steroid sampling offers several advantages, the diagnostic potential of salivary steroid metabolites remains largely unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This work aimed to evaluate the diagnostic utility of salivary steroid profiling in patients with adrenal diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, multicenter study comprised 313 patients with nonfunctioning adrenal adenoma (NF), primary aldosteronism (PA), Cushing syndrome (CS), and mild autonomous cortisol secretion (MACS). Salivary samples for morning and night steroids were collected using standardized protocols. The liquid chromatography\u2013mass spectrometry\u2013based steroid profiling was applied to quantify cortisol, cortisone, tetrahydrocortisone (THE), 20\u03b1-dihydrocortisol (20\u03b1-DHF), 18-hydroxycortisol (18-OHF), and dehydroepiandrosterone sulfate (DHEA-S). The primary outcome was the diagnostic performance of morning and night salivary steroids<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the PA group, morning and night salivary levels of 18-OHF were higher compared to the other groups (all P &amp;lt; .05). Morning and night salivary levels of cortisone, THE, and 20\u03b1-DHF were significantly elevated in the CS group compared to other groups (all P &amp;lt; .05). Only night-time salivary levels of cortisone (P = .040) and 20\u03b1-DHF (P = .029) were elevated in the MACS group compared to the NF group. Receiver operating characteristic analyses indicated that morning salivary 18-OHF was moderately specific for PA, whereas night salivary 20\u03b1-DHF and cortisone provided robust diagnostic accuracy for CS. Combined night salivary steroids exhibited superior diagnostic performance compared to morning salivary steroids in the CS group (area under the curve, 0.903 vs 0.754; P = .007).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Salivary steroid profiling holds promise as a noninvasive tool for the diagnosis of adrenal diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf499","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T11:50:32Z","timestamp":1756986632000},"page":"e827-e836","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Utility of Salivary Steroid Profiling for the Differential Diagnosis of Adrenal Diseases"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4029-6312","authenticated-orcid":false,"given":"Kyoung Yeun","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University , Seoul 01830 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soyeon","family":"Park","sequence":"additional","affiliation":[{"name":"Center for Advanced Molecular Recognition, Korea Institute of Science and Technology , Seoul 02792 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaelin","family":"Lee","sequence":"additional","affiliation":[{"name":"Center for Advanced Molecular Recognition, Korea Institute of Science and Technology , Seoul 02792 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eu Jeong","family":"Ku","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul National University College of Medicine , Seoul 06236 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sihoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gachon University College of Medicine , Incheon 21936 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoung-Ah","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dongguk University College of Medicine , Seoul 04620 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Wan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center , Seoul 07061 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4227-5638","authenticated-orcid":false,"given":"Yumie","family":"Rhee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yonsei University College of Medicine , Seoul 03722 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Soo","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yonsei University Wonju College of Medicine , Wonju 26493 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choon Hee","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yonsei University Wonju College of Medicine , Wonju 26493 ,","place":["Korea"]},{"name":"Department of Internal Medicine, Research Institute of Metabolism and Inflammation , Wonju 26493 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Wan","family":"Chun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine , Cheonan 31151 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soon-Jib","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Bucheon 14647 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ohk-Hyun","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine , Chuncheon 18445 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hochan","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Keimyung University School of Medicine , Daegu 42601 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A Ram","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chonnam National University Medical School , Kwangju 61469 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo-Jeong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University , Seoul 01830 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1017-1156","authenticated-orcid":false,"given":"Man Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"Center for Advanced Molecular Recognition, Korea Institute of Science and Technology , Seoul 02792 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1932-0234","authenticated-orcid":false,"given":"Jung Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine , Seoul 03080 ,","place":["Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"issue":"1","key":"2026021918523337600_dgaf499-B1","doi-asserted-by":"crossref","first-page":"92","DOI":"10.3109\/00365513.2014.985252","article-title":"The effect of storage conditions on salivary cortisol concentrations using an enzyme immunoassay","volume":"75","author":"Nalla","year":"2015","journal-title":"Scand J Clin Lab Invest"},{"issue":"3","key":"2026021918523337600_dgaf499-B2","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/MED.0000000000000328","article-title":"Salivary cortisol and cortisone in the clinical setting","volume":"24","author":"Blair","year":"2017","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"issue":"6","key":"2026021918523337600_dgaf499-B3","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1038\/ncpendmet0837","article-title":"Late-night salivary cortisol measurement in the diagnosis of Cushing's syndrome","volume":"4","author":"Carroll","year":"2008","journal-title":"Nat Clin Pract Endocrinol Metab"},{"issue":"5","key":"2026021918523337600_dgaf499-B4","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1210\/jc.2008-0125","article-title":"The diagnosis of Cushing's syndrome: an endocrine society clinical practice guideline","volume":"93","author":"Nieman","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026021918523337600_dgaf499-B5","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1210\/jc.2015-3694","article-title":"Salivary cortisone reflects cortisol exposure under physiological conditions and after hydrocortisone","volume":"101","author":"Debono","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026021918523337600_dgaf499-B6","doi-asserted-by":"crossref","first-page":"599","DOI":"10.3803\/EnM.2022.1549","article-title":"Clinical and technical aspects in free cortisol measurement","volume":"37","author":"Choi","year":"2022","journal-title":"Endocrinol Metab (Seoul)"},{"key":"2026021918523337600_dgaf499-B7","doi-asserted-by":"crossref","first-page":"105856","DOI":"10.1016\/j.jsbmb.2021.105856","article-title":"Metabolic changes in serum steroids for diagnosing and subtyping Cushing's syndrome","volume":"210","author":"Ahn","year":"2021","journal-title":"J Steroid Biochem Mol Biol"},{"issue":"3","key":"2026021918523337600_dgaf499-B8","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1210\/jc.2011-2384","article-title":"18-hydroxycorticosterone, 18-hydroxycortisol, and 18-oxocortisol in the diagnosis of primary aldosteronism and its subtypes","volume":"97","author":"Mulatero","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2026021918523337600_dgaf499-B9","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.3803\/EnM.2021.1149","article-title":"Metabolic subtyping of adrenal tumors: prospective multi-center cohort study in Korea","volume":"36","author":"Ku","year":"2021","journal-title":"Endocrinol Metab (Seoul)"},{"key":"2026021918523337600_dgaf499-B10","doi-asserted-by":"crossref","first-page":"117797","DOI":"10.1016\/j.cca.2024.117797","article-title":"Evolution of LC-MS\/MS in clinical laboratories","volume":"555","author":"Yu","year":"2024","journal-title":"Clin Chim Acta"},{"issue":"2","key":"2026021918523337600_dgaf499-B11","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1530\/EJE-18-0782","article-title":"Plasma steroid metabolome profiling for the diagnosis of adrenocortical carcinoma","volume":"180","author":"Schweitzer","year":"2019","journal-title":"Eur J Endocrinol"},{"key":"2026021918523337600_dgaf499-B12","doi-asserted-by":"crossref","first-page":"105615","DOI":"10.1016\/j.jsbmb.2020.105615","article-title":"Selective LC-MRM\/SIM-MS based profiling of adrenal steroids reveals metabolic signatures of 17alpha-hydroxylase deficiency","volume":"198","author":"Lee","year":"2020","journal-title":"J Steroid Biochem Mol Biol"},{"issue":"1","key":"2026021918523337600_dgaf499-B13","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1093\/ejendo\/lvad066","article-title":"European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors","volume":"189","author":"Fassnacht","year":"2023","journal-title":"Eur J Endocrinol"},{"issue":"5","key":"2026021918523337600_dgaf499-B14","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1210\/jc.2015-4061","article-title":"The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline","volume":"101","author":"Funder","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026021918523337600_dgaf499-B15","doi-asserted-by":"crossref","first-page":"bvad155","DOI":"10.1210\/jendso\/bvad155","article-title":"Multiplexed serum steroid profiling reveals metabolic signatures of subtypes in congenital adrenal hyperplasia","volume":"8","author":"Shim","year":"2023","journal-title":"J Endocr Soc"},{"key":"2026021918523337600_dgaf499-B16","doi-asserted-by":"crossref","unstructured":"Jung KY, Park S, Lee C, et al \u00a02025. Data from: Supplementary materials for clinical utility of salivary steroid profiling for the differential diagnosis of adrenal Diseases. figshare. doi:10.6084\/m9.figshare.29558720.","DOI":"10.1210\/clinem\/dgaf499"},{"issue":"3 Pt 2","key":"2026021918523337600_dgaf499-B17","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1161\/01.HYP.38.3.688","article-title":"Serum 18-hydroxycortisol in primary aldosteronism, hypertension, and normotensives","volume":"38","author":"Mosso","year":"2001","journal-title":"Hypertension"},{"issue":"1","key":"2026021918523337600_dgaf499-B18","doi-asserted-by":"crossref","first-page":"R1","DOI":"10.1530\/EJE-17-0563","article-title":"DIAGNOSIS OF ENDOCRINE DISEASE: 18-oxocortisol and 18-hydroxycortisol: is there clinical utility of these steroids?","volume":"178","author":"Lenders","year":"2018","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2026021918523337600_dgaf499-B19","first-page":"873","article-title":"The unique steroidogenesis of the aldosteronoma in the differential diagnosis of primary aldosteronism","volume":"76","author":"Ulick","year":"1993","journal-title":"J Clin Endocrinol Metab"},{"issue":"8","key":"2026021918523337600_dgaf499-B20","first-page":"2681","article-title":"Late-night salivary cortisol as a screening test for Cushing's syndrome","volume":"83","author":"Raff","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"issue":"7","key":"2026021918523337600_dgaf499-B21","doi-asserted-by":"crossref","first-page":"e220050","DOI":"10.1530\/EC-22-0050","article-title":"Late-night salivary cortisol and cortisone should be the initial screening test for Cushing's syndrome","volume":"11","author":"Mohamed","year":"2022","journal-title":"Endocr Connect"},{"issue":"11","key":"2026021918523337600_dgaf499-B22","doi-asserted-by":"crossref","first-page":"4951","DOI":"10.1210\/jc.2010-1215","article-title":"Salivary cortisone is a potential biomarker for serum free cortisol","volume":"95","author":"Perogamvros","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026021918523337600_dgaf499-B23","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1373\/clinchem.2017.282582","article-title":"Plasma steroid metabolome profiling for diagnosis and subtyping patients with Cushing syndrome","volume":"64","author":"Eisenhofer","year":"2018","journal-title":"Clin Chem"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaf499\/64213968\/dgaf499.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/3\/e827\/64213968\/dgaf499.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/3\/e827\/64213968\/dgaf499.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T23:52:41Z","timestamp":1771545161000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/111\/3\/e827\/8248363"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9,5]]},"published-print":{"date-parts":[[2026,2,20]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaf499","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2025,9,5]]}}}