Determination of cortisol and cortisone in human saliva by a liquid chromatography-tandem mass spectrometry method

Vieira, José Gilberto H.; Nakamura, Odete H.; Carvalho, Valdemir Melechco

doi:10.1590/0004-2730000003347

Cited by 26 publications

(18 citation statements)

References 31 publications

(37 reference statements)

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“…This is in agreement with our previous results, where we compared serum cortisol concentrations using LC-MS/MS and a radioimmunoassay (RIA) (Dušková et al, 2015). The study of Vieira et al (2014) compared salivary cortisol measured by LC-MS/MS and an in-house RIA method and also found a high correlation (r=0.82).…”

Section: Discussionsupporting

confidence: 91%

A Comparison of Salivary Steroid Levels during Diagnostic Tests for Adrenal Insufficiency

et al. 2016

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Numerous diagnostic tests are used to evaluate the hypothalamic-pituitary-adrenal axis (HPA axis). The gold standard is still considered the insulin tolerance test (ITT), but this test has many limitations. Current guidelines therefore recommend the Synacthen test first when an HPA axis insufficiency is suspected. However, the dose of Synacthen that is diagnostically most accurate and sensitive is still a matter of debate. We investigated 15 healthy men with mean/median age 27.4/26 (SD±4.8) years, and mean/median BMI (body mass index) 25.38/24.82 (SD±3.2) kg/m2. All subjects underwent 4 dynamic tests of the HPA axis, specifically 1 μg, 10 μg, and 250 μg Synacthen (ACTH) tests and an ITT. Salivary cortisol, cortisone, pregnenolone, and DHEA (dehydroepiandrosterone) were analysed using liquid chromatography-tandem mass spectrometry. During the ITT maximum salivary cortisol levels over 12.5 nmol/l were found at 60 minutes. Maximum cortisol levels in all of the Synacthen tests were higher than this; however, demonstrating that sufficient stimulation of the adrenal glands was achieved. Cortisone reacted similarly as cortisol, i.e. we did not find any change in the ratio of cortisol to cortisone. Pregnenolone and DHEA were higher during the ITT, and their peaks preceded the cortisol peak. There was no increase of pregnenolone or DHEA in any of the Synacthen tests. We demonstrate that the 10 μg Synacthen dose is sufficient stimulus for testing the HPA axis and is also a safe and cost-effective alternative. This dose also largely eliminates both false negative and false positive results.

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Section: Discussionsupporting

confidence: 91%

A Comparison of Salivary Steroid Levels during Diagnostic Tests for Adrenal Insufficiency

et al. 2016

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“…Although the cross-reactivity of cortisol with cortisone is reported to be limited to 0.3 % at 74.5 nmol/l, using the Elecsys (Roche) analyser [24], this may be an underestimate, potentially explaining the incongruous results between our initial and current studies. Although a significant correlation between cortisol values obtained using a radio-immunoassay and high-performance LC-MS/MS was reported [25], we were unable to replicate this correlation, using data from our initial study obtained by an immunoassay and LC-MS/MS. It is unlikely that the difference in ethnic composition of the patient and control groups could have influenced cortisol production, as it has been shown that evaluation of the hypothalamic-pituitary-adrenal axis (HPA) in black and white women does not differ when using the 24-h urinary excretion of cortisol and dexamethasone suppressability, matched for age, weight, BMI and body surface area [26].…”

Section: Endocrine Carementioning

confidence: 78%

Salivary Cortisol and Cortisone do not Appear to be Useful Biomarkers for Monitoring Hydrocortisone Replacement in Addison’s Disease

et al. 2016

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Salivary cortisol has been used to monitor hydrocortisone replacement in patients with Addison's disease (AD). Since salivary cortisol is metabolised to salivary cortisone, it may be an adjunctive analyte to assess adequacy of hydrocortisone replacement in patients with AD. We aimed to characterise the exposure of salivary cortisol and cortisone in patients and healthy controls. We measured salivary cortisol and cortisone by liquid chromatography-tandem mass spectrometry and constructed a day curve (08:00 until 24:00 h) with 16 time points in 25 AD patients taking their usual hydrocortisone dose and in 26 healthy controls. The median (interquartile range) area under the curve (AUC) for cortisol was not different for patients, compared with controls [55.63 (32.91-151.07) nmol*min*l vs. 37.49 (27.41-52.00) nmol*min*l; p=0.098, respectively], whereas the peak cortisol C was higher in patients [32.61 (5.75-146.19) nmol/l vs. 8.96 (6.96-12.23) nmol/l; p=0.013], compared with controls. The AUC for cortisone [23.65 (6.10-54.76) nmol*min*l vs. 227.73 (200.10-280.52) nmol*min*l; p≤ 0.001, respectively], and peak cortisone C was lower in patients than in controls [11.11 (2.91-35.85) nmol/l vs. 33.12 (25.97-39.95) nmol/l; p=0.002]. The AUC for salivary cortisol and salivary cortisone were not correlated with any measures of hydrocortisone dose. The time-course and AUC of salivary cortisol were similar between Addison's patients and healthy controls. Patients had substantially lower salivary cortisone AUC, compared to healthy controls. Salivary cortisol AUC and pharmacokinetics were not related to hydrocortisone dose and thus are not likely useful markers for the adequacy of hydrocortisone replacement.

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“…Por outro lado, a dosagem do cortisol livre urinário apresenta uma limitação específica que concerne à coleta da urina, procedimento que exige participação ativa do paciente. Métodos mais específicos, como a espectrometria de massa é a que apresenta maior potencial, embora o custo elevado seja a maior barreira [36]. A concentração de cortisol plasmático tem sido muito utilizada para medir dor induzida e estresse em cães após cirurgias [16,23].…”

Section: Discussionunclassified

Cortisol plasmático como indicador de estresse em colopexias laparoscópicas com implante de tela de polipropileno en cães

Zanella

Thomazi²,

Guizzo

et al. 2018

Acta Scientiae. Vet.

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A realização de cirurgias convencionais, mesmo com a utilização recomendada de fármacos analgésicos, geralmente está associada a um período de recuperação longo, além de causar estresse, dor e desconforto nos animais, dependendo do grau de invasão do procedimento. Considerando a crescente busca por métodos que minimizem o estresse cirúrgico em cães, reduzindo o período de recuperação pós-cirúrgico, o presente trabalho foi desenvolvido para avaliar a técnica de colopexia laparoscópica em relação aos níveis de cortisol plasmático, as frequências respiratórias, e as frequências cardíacas nos períodos pré, trans e pós-operatório imediatos. Foram utilizados nove cães, fêmeas adultas, SRD. As coletas sanguíneas para mensuração dos níveis de cortisol, e os parâmetros de frequências respiratórias (FR) e cardíacas (FC) foram efetuadas a partir do préoperatório até o término do procedimento. Após esse período, a tomada de dados foi realizada de três em três horas até completar as primeiras 12 horas pós-operatórias. Os níveis de cortisol foram mensurados com a utilização de Kit ELISA para cortisol. Os resultados foram submetidos à ANOVA e ao teste de Tukey, considerando as diferenças significativas p < 0,05. Aumentos dos níveis de cortisol, FR e FC foram verificados principalmente no período após tricotomia, mantendo-se constantes no transcirúrgico, com um novo aumento no pós-operatório imediato, no período de recuperação anestésica. Tais parâmetros retornaram aos valores basais nove horas após o término da operação. Conclui-se que a colopexia laparoscópica causa estresse ao paciente, contudo os valores de cortisol plasmático apresentaram-se dentro de valores fisiológicos para a espécie em estudo e tenderam ao retorno às condições basais, nove horas após a operação.

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Determination of cortisol and cortisone in human saliva by a liquid chromatography-tandem mass spectrometry method

Abstract: We conclude that the HPLC-MS/MS method compares favorably with the RIA for salivary cortisol measurement, with the additional possibility of concomitant cortisone measurement and the evaluation of 11βHSD2 activity.

Cited by 26 publications

References 31 publications

A Comparison of Salivary Steroid Levels during Diagnostic Tests for Adrenal Insufficiency

A Comparison of Salivary Steroid Levels during Diagnostic Tests for Adrenal Insufficiency

Salivary Cortisol and Cortisone do not Appear to be Useful Biomarkers for Monitoring Hydrocortisone Replacement in Addison’s Disease

Cortisol plasmático como indicador de estresse em colopexias laparoscópicas com implante de tela de polipropileno en cães

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