Salivary cortisol as a tool for physiological studies and diagnostic strategies

Abstract

Salivary cortisol is an index of plasma free cortisol and is obtained by a noninvasive procedure. We have been using salivary cortisol as a tool for physiological and diagnostic studies, among them the emergence of circadian rhythm in preterm and term infants. The salivary cortisol circadian rhythm in term and premature infants was established between 8 and 12 postnatal weeks. In the preterm infants the emergence of circadian rhythm was parallel to the onset of sleep rhythm. We also studied the use of salivary cortisol for screening for Cushings syndrome (CS) in control and obese outpatients based on circadian rhythm and the overnight 1 mg dexamethasone (DEX) suppression test. Salivary cortisol was suppressed to less than 100 ng/ dl after 1 mg DEX in control and obese patients. A single salivary cortisol measurement at 23:00 h and again after 1 mg DEX above the 90th percentile of the obese group values had sensitivity and specificity of 93 and 93% (23:00 h), and 91 and 94% (after DEX), respectively. The sensitivity improved to 100% when we combined both parameters. We also studied 11 CS children and 21 age-matched primary obese children for whom salivary cortisol sensitivity and specificity were 100/95% (23:00 h), and 100/95% (1 mg DEX), respectively. Similar to adults, sensitivity and specificity of 100% were obtained by combining 23:00 h and 1 mg DEX. The measurement of salivary cortisol is a useful tool for physiological studies and for the diagnosis of CS in children and adults on an outpatient basis. Correspondence

Baseline ‘state anxiety’ influences HPA-axis sensitivity to one sham-controlled HF-rTMS session applied to the right dorsolateral prefrontal cortex

“…As the AUCg analysis showed, the general cortisol output was not affected by the HF-rTMS experiment, indicating that in line with animal studies stress-responses did not interfere with our data (Hedges et al, 2002). Furthermore, to reduce possible stressrelated responses, we used of salivettes as this has certain advantages over blood samples: sampling is noninvasive, it can frequently be repeated, and it avoids stress induction (painless) (Castro et al, 2000).…”

Salivary Cortisol Can Replace Free Serum Cortisol Measurements in Patients With Septic Shock

“…The correlation between free serum cortisol and salivary cortisol levels varies from patients with excess cortisol concentration, such as Cushing disease and psychiatric patients. 15 Most studies available on salivary cortisol are in healthy volunteers or noncritically ill subjects with excess production of cortisol, and in these patients the correlation between salivary cortisol and free serum cortisol levels is 80% to 90%. 19 Sample size was calculated using single correlations.…”

“…12 Studies in healthy volunteers and for the evaluation of patients with hypothalamus-pituitary-adrenal axis disease have showed an excellent correlation between free or unbound serum and salivary cortisol levels, although the relationship is nonlinear and correlation is more closely related at lower levels (when total serum concentration is , 16.3 m g/dL). [13][14][15] We evaluated the correlation between salivary cortisol and total serum cortisol with free serum cortisol levels in adult medical intensive care patients with septic shock.…”

Análise de esteróides na saliva: uma ferramenta não-invasiva para pesquisa em pediatria e clínica médica

“…6 A negative correlation of morning salivary cortisol concentrations and total cortisol concentration with body mass index was found in children with recurrent abdominal pain of psychosomatic origin in another study. 2 These authors also found in their cohort of 159 healthy girls and 147 boys that salivary cortisol concentration was dependent on the time of sampling, age and menarche.…”