Advantage of salivary cortisol measurements in the diagnosis of glucocorticoid related disorders

Restituto, Patricia; Galofré, Juan Carlos; Gil, M.J. Viñolo; Mugueta, Carmen; Santos, Silvana Maria Elói; Monreal, J Ignacio; Varo, Nerea

doi:10.1016/j.clinbiochem.2008.01.015

Cited by 73 publications

(60 citation statements)

References 25 publications

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“…To decrease the effects of macromolecules or pH on cortisol levels in humans, patients are not allowed to eat 1 hour before saliva collection and the mouth is cleaned and rinsed with cold water immediately before obtaining saliva. 4 In our study, these measures were not followed except for removal of food 1 hour before the collection. Thus, food particles may have had an effect on the composition and pH of the saliva.…”

Section: Discussionmentioning

confidence: 96%

“…1 Determination of ''late-night'' and ''morning'' salivary cortisol concentrations are established screening tests for the diagnosis of hypercortisolism (HC) and hypocortisolism in people. [2][3][4] Because cortisol in saliva is unbound, its concentration is approximately 12% of that of plasma; determination of salivary cortisol therefore requires either more sensitive or adapted laboratory methods than the ones used for plasma cortisol. [5][6][7] The concentration of free cortisol in saliva and plasma establishes an equilibrium within 5 minutes.…”

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confidence: 99%

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Salivary Cortisol Concentrations in Healthy Dogs and Dogs with Hypercortisolism

Wenger-Riggenbach

Boretti

Quante

et al. 2010

Journal of Veterinary Internal Medicine

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Background: Measurement of salivary cortisol is a useful diagnostic test for hypercortisolism (HC) in humans. Objectives: To determine whether measurement of salivary cortisol concentration is a practical alternative to plasma cortisol to diagnose HC, to validate the use of salivary cortisol, and to examine the effect of time of day and sampling location on salivary cortisol.Animals: Thirty healthy dogs and 6 dogs with HC. Methods: Prospective, observational clinical trial including healthy volunteer dogs and dogs newly diagnosed with HC. Salivary and plasma cortisol concentrations were measured with an immunoassay analyzer. Intra-and interassay variability, linearity, and correlation between salivary and plasma cortisol concentrations were determined.Results: The required 300 mL of saliva could not be obtained in 88/326 samples from healthy dogs and in 15/30 samples from dogs with HC. The intra-assay variability for measurement of salivary cortisol was 5-17.7%, the interassay variability 8.5 and 17.3%, and the observed to expected ratio 89-125%. The correlation (r) between salivary and plasma cortisol was 0.98. The time of day and location of collection did not affect salivary cortisol concentrations. Dogs with HC had significantly higher salivary cortisol values than healthy dogs (10.2 AE 7.3 nmol/L versus 1.54 AE 0.97 nmol/L; P o .001).Conclusions and Clinical Importance: The ROCHE Elecsys immunoassay analyzer correctly measured salivary cortisol in dogs. However, a broad clinical application of the method seems limited, because of the large sample volume required.

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Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 99%

Salivary Cortisol Concentrations in Healthy Dogs and Dogs with Hypercortisolism

Wenger-Riggenbach

Boretti

Quante

et al. 2010

Journal of Veterinary Internal Medicine

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“…The lack of a circadian rhythm is a peculiar marker of CS (4), so the LNSC test seems to be the best choice to screen for CS because of its noninvasive, stress-free, easy collection in outpatients (1). There is a marked variation between studies in the performance of the LNSC test, reflecting differences in laboratory assays, sample collection, severity of CS, and control groups (2,5,6,7,8,9,10,11,12,13,14). It is also important to have reference data not only for healthy volunteers but also for a control group of obese, hypertensive, diabetic, and depressed subjects or other clinical features of CS that are common in the general population (3,15).…”

Section: Introductionmentioning

confidence: 99%

“…Healthy people show physiologically high levels of salivary cortisol when they wake up, and some authors have reported that low salivary cortisol levels may thus be a marker of adrenal insufficiency (2,6,19). None of these studies have looked for differences between primary and secondary adrenal insufficiency; in the latter, some residual HPA axis activity may be confounding.…”

Section: Introductionmentioning

confidence: 99%

Performance of salivary cortisol in the diagnosis of Cushing's syndrome, adrenal incidentaloma, and adrenal insufficiency

Ceccato

Barbot

Zilio

et al. 2013

European Journal of Endocrinology

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Objective: Salivary cortisol has recently been suggested for studies on the hypothalamic-pituitaryadrenal (HPA) axis. The lack of circadian rhythm is a marker of Cushing's syndrome (CS), and some authors have reported that low salivary cortisol levels may be a marker of adrenal insufficiency. The aim of our study was to define the role of salivary cortisol in specific diagnostic settings of HPA axis disease. Subjects and methods: We analyzed morning salivary cortisol (MSC) and late-night salivary cortisol (LNSC) levels in 406 subjects: 52 patients with Cushing's disease (CD), 13 with ectopic CS, 17 with adrenal CS, 27 with CD in remission (a mean follow-up of 66G39 months), 45 with adrenal incidentaloma, 73 assessed as having CS and then ruled out for endogenous hypercortisolism, 75 with adrenal insufficiency, and 104 healthy subjects. Results: A LNSC value above 5.24 ng/ml differentiated CS patients from controls with high sensitivity (96.3%) and specificity (97.1%); we found higher LNSC levels in ectopic CS patients than in CD patients. We found no difference in MSC and LNSC levels between patients with CD in remission and healthy subjects. Both MSC and LNSC levels were higher in patients with adrenal incidentaloma than in healthy controls. A MSC value below 2.65 ng/ml distinguished patients with adrenal insufficiency from controls with high sensitivity (97.1%) and specificity (93.3%). Conclusions: Salivary cortisol is a useful tool to assess endogenous cortisol excess or adrenal insufficiency and to evaluate stable CD in remission.

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“…Evaluation of salivary free cortisol has been found to be a good indicator of unbound concentrations of cortisol in serum or plasma (15)(16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Simultaneous quantitative analysis of salivary cortisol and cortisone in Korean adults using LC-MS/MS

Lee¹,

Kwon²,

Shin³

et al. 2010

BMB Reports

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The levels of salivary cortisol and cortisone in Korean adults were measured for the first time using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The salivary cortisol and cortisone were separated within 10 min. The regression coefficients (r) of the calibration curves were greater than 0.999 for the two steroids. The limits of quantitation (LOQ) were 0.2 ng/ml for cortisol and 1 ng/ml for cortisone. The intra-day precisions of the assay were ＜3.9% and 8.6% for cortisol and cortisone respectively, and the inter-day precisions were ＜1.9% and 4.3% for cortisol and cortisone, respectively. The salivary cortisone concentrations were approximately 4-9 times higher than those of salivary cortisol during the daytime. Diurnal rhythms, during which the cortisol and cortisone concentrations were higher in the morning than in the afternoon, were also observed. The present assay may be useful for the diagnosis of several adrenal dysfunctions in clinical biochemistry. [BMB reports 2010; 43(7): 506-511]

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Advantage of salivary cortisol measurements in the diagnosis of glucocorticoid related disorders

Cited by 73 publications

References 25 publications

Salivary Cortisol Concentrations in Healthy Dogs and Dogs with Hypercortisolism

Salivary Cortisol Concentrations in Healthy Dogs and Dogs with Hypercortisolism

Performance of salivary cortisol in the diagnosis of Cushing's syndrome, adrenal incidentaloma, and adrenal insufficiency

Simultaneous quantitative analysis of salivary cortisol and cortisone in Korean adults using LC-MS/MS

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