{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:37:42Z","timestamp":1771591062652,"version":"3.50.1"},"reference-count":26,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100031039","name":"Seth GS Medical College Multidisciplinary Research Unit","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100031039","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009104","name":"Department of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009104","id-type":"DOI","asserted-by":"publisher"}]}],"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>The overnight dexamethasone suppression test (ODST) is precise and highly sensitive; however, its specificity ranges from 80% to 90%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess whether late-afternoon overnight dexamethasone suppression (ODS) cortisol and morning\/late-afternoon ODS ACTH measurements improve ODST accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective, single-center study included healthy adults (n = 60), combined oral contraceptive pill (COCP) users (n = 29), chronic kidney disease (CKD, n = 29), treatment-na\u00efve ACTH-dependent Cushing syndrome (A-CS, n = 33), posttreatment Cushing disease in remission (CD-R, n = 23) or persistence (CD-P, n = 31). Participants underwent the standard 1-mg dexamethasone suppression test; blood samples were collected at 8 to 9 Am for cortisol, ACTH, dexamethasone and at 3 to 4 Pm for cortisol and ACTH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ODS 4 Pm cortisol was significantly lower than 8 Am in healthy adults (P = .003), COCP (P &amp;lt; .001), CKD (P &amp;lt; .001), and CD-R (P = .001), whereas this difference was not significant in treatment-na\u00efve A-CS and CD-P. ODS 8 Am and 4 Pm cortisol (cutoff: 1.8 \u03bcg\/dL) showed high specificity in healthy adults (95% and 100%), but its specificity was low in COCP (55% and 79%) and CKD (17% and 52%). ODS 8 Am and 4 Pm ACTH (cutoff: 10\u2005pg\/mL) showed high specificity in healthy adults (95%, 100%), COCP (100%, 100%), and CKD (96.6%, 100%), with 100% sensitivity for diagnosing A-CS. The diagnostic accuracy of ODS 4 Pm cortisol, ODS 8 Am ACTH, and ODS 4 Pm ACTH in differentiating CD-R from CD-P was 98.1%, 81.5% and 81.5%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Late-afternoon cortisol measurement is a novel modification that enhances ODST specificity. ACTH measurement was particularly useful in COCP and CKD. Before widespread integration in clinical practice, further validation is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf513","type":"journal-article","created":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T11:44:22Z","timestamp":1757763862000},"page":"e758-e765","source":"Crossref","is-referenced-by-count":1,"title":["Overnight Dexamethasone Suppression Test: Enhanced Accuracy With Late-afternoon Cortisol and Morning\/Late-afternoon ACTH"],"prefix":"10.1210","volume":"111","author":[{"given":"Anuj","family":"Ban","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College , Mumbai, Maharashtra 400012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5199-6299","authenticated-orcid":false,"given":"Saba Samad","family":"Memon","sequence":"additional","affiliation":[{"name":"Department of 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