Saliva Cortisol Measurement as a Screening Test for Suspicious Cushings Syndrome in Children.

Study Overview
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Brief Summary
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Cortisol overproduction ( Cushings syndrome) is a condition where the patient have a special fat distribution, with accumulation of fat around the abdomen and in the neck, with thinner limbs and weak musculature. The condition can be difficult to separate from adipositas in general. Screening for hypercortisolism in adults has been easier the last years, because we can measure free cortisol in saliva samples at late night. In children we still dont have reference ranges for saliva cortisol in children, so the screening is still troublesome, based on Collection of 24-hour urine.The meaning of this study is to establish reference ranges for saliva cortisol, and evaluate in a cohort with adipose children if screening with saliva cortisol is sensitive and specific enough to be the New screening test for hypercortisolism in children too.

Detailed Description
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the investigators have collected saliva samples morning and late evening for cortisol measurements in a total of 330 children ( 660 samples) in the age from 4 to 16 years ols. This samples are going to be used to define a reference range for saliva cortisol in children. The investigators are then collecting 24 hour urine and saliva samples ( morning and late evening) from children at the obesity clinic Haukeland University hospital for verification of the reference range , and to estimate if the test is good enough to identify the patients that have Cushings syndrome. Since the diagnose is very seldom in children, we will get help from a 3. line referral center in London to include patients with true Cushings syndrome.

Official Title
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Saliva Cortisol Measurement as a Screening Test for Suspicious Cushings Syndrome in Children.

Conditions
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Cushings Syndrome

Intervention / Treatment
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* Other: Children refered to the obesity clinic


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria:Children aged 4-16 years. Healthy population from selected kindergarten and Schools, and patients refered to the obesity clinic Haukeland University Hospital, for examination and optionally treatment. - Exclusion Criteria:Use of any kind of steroids ( oral, liniments, inhalations etc) -

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Children refered to the obesity clinic.<br>All children refered to the obesity clinic for examination and optionally treatment are invited. | Other: Children refered to the obesity clinic<br>* Compere if urine cortisol is as good as saliva cortisol as a screening for hypercortisolism in children.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with positive saliva cortisol measurement, not having Cushings syndrome. | Number of patients | 2 years | 
| Number of patients With negative saliva cortisol measurement , having Cushings syndrome. | Number of patients | 2 years |