news & views Endocrine Research Laboratory, Aurora St Luke’s Medical Center, 2801 West Kinnickinnic River Parkway, Suite 245, Milwaukee, WI 53215, USA (H. Raff). Endocrinology Center and Clinics, Department of Medicine, Medical College of Wisconsin, W129 N7055 Northfield Drive, Suite A‑203, Menomonee Falls, Milwaukee, WI 53051, USA (J. W. Findling). Correspondence to: J. W. Findling
[email protected] doi:10.1038/nrendo.2010.192 competing interests The authors declare no competing interests. 1.
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Carroll, T., Raff, H. & Findling, J. w. Late-night salivary cortisol for the diagnosis of Cushing’s syndrome: a meta-analysis. Endocr. Pract. 15, 335–342 (2009). elamin, M. B. et al. Accuracy of diagnostic tests for Cushing’s syndrome: a systematic review and metaanalyses. J. Clin. Endocrinol. Metab. 93, 1553–1562 (2008). nieman, L. K. et al. The diagnosis of Cushing’s syndrome: an endocrine society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 93, 1526–1540 (2008).
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Perogamvros, i., Keevil, B. G., Ray, D. w. & Trainer, P. J. salivary cortisone is a potential biomarker for serum free cortisol. J. Clin. Endocrinol. Metab. doi:10:1210/jc/ 2010–1215. 5. Raff, H. Brock, s. & Findling, J. w. Cosyntropinstimulated salivary cortisol in hospitalized patients with hypoproteinemia. Endocrine 34, 68–74 (2008). 6. Arafah, B. M., nishiyama, F. J., Tlaygeh, H. & Hejal, R. Measurement of salivary cortisol concentration in the assessment of adrenal function in critically ill subjects: a surrogate marker of the circulating free cortisol. J. Clin. Endocrinol. Metab. 92, 2965–2971 (2007). 7. Raff, H. Utility of salivary cortisol measurements in Cushing’s syndrome and adrenal insufficiency. J. Clin. Endocrinol. Metab. 94, 3647–3655 (2009). 8. Findling, J. w. & Raff, H. Cushing’s syndrome: important issues in diagnosis and management. J. Clin. Endocrinol. Metab. 91, 3746–3753 (2006). 9. Carroll, T., Raff, H. & Findling, J. w. Late-night salivary cortisol measurement in the diagnosis of Cushing’s syndrome. Nat. Clin. Pract. Endocrinol. Metab. 6, 344–350 (2008). 10. Zerikly, R. K. et al. Diagnostic characteristics of late-night salivary cortisol using liquid chromatography-tandem mass spectrometry. J. Clin. Endocrinol. Metab. doi:10.1210/ jc.2009-2458.
nonAlcoholic fAtty liver diseAse
Liver disease: an overlooked complication of diabetes mellitus Marco Arrese
A recent study has shown that the diagnosis of new-onset type 2 diabetes mellitus is associated with a substantial risk of developing chronic liver disease. should screening for liver disorders be part of the routine evaluation of patients with type 2 diabetes mellitus? the association between type 2 diabetes mellitus and chronic liver disease is frequently encountered in clinical practice.1 although cirrhosis is known to contribute to the development of type 2 diabetes mellitus by several mechanisms, the possibility that diabetes mellitus can itself directly lead to cirrhosis, potentially as a result of the progression of nonalcoholic fatty liver disease (naFlD), has only recently been recognized.2 in line with this concept, a new study conducted in Canada by Porepa et al.3 provides good evidence that adults newly diagnosed as having type 2 diabetes mellitus are indeed at a higher risk of developing advanced chronic liver disease than the general population. naFlD is a term used to describe a clinicopathological entity hallmarked by
triglyceride accumulation in the liver in the absence of excessive alcohol intake (arbitrarily defined as
