The relationship of salivary and cord blood cortisol inpreterm infants

Chou, I-Ching; Lien, Han‐Chung; Lin, Hung-Chih; Fu, Jachih J C; Kao, Chia‐Hung; Tsai, Chang‐Hai; Lin, Pao-Hsuan; Tsai, Fuu-Jen

doi:10.1515/jpem.2011.119

Cited by 12 publications

(13 citation statements)

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“…In preterm infant cohorts, mean GA at birth ranged from 25.3 to 34.2 weeks and mean BW from 854 to 2,164 g ( table 2 ). Three [15,17,19] of four [15][16][17]19] identified studies on correlation between plasma and salivary cortisol in preterm infants did not report on exact weight and postmenstrual age of investigated infants at sample recovery. The rate of infants that could not be studied because of inadequate saliva sample size was only reported by Matsukura et al [17] .…”

Section: Patientsmentioning

confidence: 99%

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Relationship of Salivary and Plasma Cortisol Levels in Preterm Infants: Results of a Prospective Observational Study and Systematic Review of the Literature

et al. 2014

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BACKGROUND AND OBJECTIVES: (1) To investigate the relationship of salivary and plasma cortisol levels in preterm infants with a focus on the usability of salivary cortisol in diagnostic work-up of infants at risk of adrenal insufficiency. (2) To perform a systematic review addressing this question. METHODS: Clinical study: We conducted a prospective observational single-center study in preterm infants. We analyzed plasma and saliva cortisol concentrations by enzyme immunoassay. Correlation analysis was used to determine the relation between salivary and plasma cortisol levels and the agreement of the measurement methods was analyzed according to Bland-Altman. Systematic review: A systematic literature search (PubMed and Embase) on the relationship of salivary and plasma cortisol levels in neonates was performed in November 2012. RESULTS: Clinical study: We enrolled 58 preterm infants (median (interquartile range) gestational age at birth was 31.4 (28.1-32.7) weeks, birth weight 1,340 (974-1,745) g, respectively). Correlation analyses revealed a relationship of plasma cortisol and salivary cortisol levels. Rank correlation coefficient was 0.6. Estimating plasma cortisol levels based on measured salivary cortisol levels showed poor agreement of the two methods for determining plasma cortisol levels (direct and via salivary cortisol). Sensitivity and specificity of salivary cortisol for the detection of adrenal insufficiency were 0.66 and 0.62, respectively. Systematic review: Six studies in preterm infants and term neonates depicting the correlation of salivary and plasma cortisol were identified with a range of saliva-plasma correlation coefficients from 0.44 to 0.83. CONCLUSIONS: Substitution of plasma cortisol by salivary cortisol determination cannot be recommended in preterm infants because of unsatisfactory agreement between methods. tionship of plasma cortisol and salivary cortisol levels. Rank correlation coefficient was 0.6. Estimating plasma cortisol levels based on measured salivary cortisol levels showed poor agreement of the two methods for determining plasma cortisol levels (direct and via salivary cortisol). Sensitivity and specificity of salivary cortisol for the detection of adrenal insufficiency were 0.66 and 0.62, respectively. Systematic review: Six studies in preterm infants and term neonates depicting the correlation of salivary and plasma cortisol were identified with a range of saliva-plasma correlation coefficients from 0.44 to 0.83. Conclusions: Substitution of plasma cortisol by salivary cortisol determination cannot be recommended in preterm infants because of unsatisfactory agreement between methods.

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Section: Patientsmentioning

confidence: 99%

“…Table 2. Characteristics and results of identified studies on correlation between plasma and salivary cortisol levels in preterm infants and term neonates Francis et al [14] Kurihara et al [18] Calixto et al [15] Chou et al [16] Matsukura et al [17] Ng et al [19] Own data …”

Section: Relationship Of Salivary and Plasma Cortisol Levelsmentioning

confidence: 99%

Relationship of Salivary and Plasma Cortisol Levels in Preterm Infants: Results of a Prospective Observational Study and Systematic Review of the Literature

et al. 2014

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“…One study by Chou et al [22] reported good correlation between cord blood cortisol and salivary cortisol levels in preterm neonates (r=0.48 and p=0.0003). They obtained cord blood from umbilical cord vessels or placental vessels immediately after clamping the umbilical cord.…”

Section: Discussionmentioning

confidence: 98%

“…The procedure of obtaining saliva is painless and free from stress to the infants [18]. A few studies have reported on the relationship between plasma and salivary cortisol in term [20][21][22] infants.…”

Section: Discussionmentioning

confidence: 99%

“…Maas et al reported the exclusion of 49% of preterm infants (28/58); they obtained mean volume of 53 µL of saliva (range 10-80 µL). Chou et al [22] report the use of Salivette (Sarstedt) with no salivary stimulants, however, they did not report on the quantity of saliva obtained by this method. No salivary stimulants were used in our study and we succeeded in obtaining mean volume of 100 microliters of saliva at each sampling (Range 25-200 µL).…”

Section: Discussionmentioning

confidence: 99%

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Correlation of Plasma and Salivary Cortisol in Extremely Premature Infants

Ng¹,

Drury²,

Upradrasta³

et al. 2017

J Neonatal Biol

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IntroductionAntenatal administration of glucocorticoids to mothers at risk of preterm labour is known to improve production of surfactant in the neonate born prematurely, thus aiding maturation of lungs. Plasma cortisol concentration is expected to increase during significant stress [1,2] and recent studies in neonates by serial blood sampling have shown that cortisol is secreted in short pulses every 80 minutes [3]. These rapid pulsations are called ultradian rhythms and are caused by hypothalamic pituitary signalling. Arnold et al. [4] have shown that these secretory pulses in neonates exposed to antenatal glucocorticoids are shorter compared to neonates who have not been exposed to antenatal glucocorticoids.Plasma cortisol concentrations are affected by intrinsic factors (for example, immaturity of the hypothalamic-pituitary-adrenal (HPA) axis, physiological decline of plasma cortisol during the immediate post-partum period, effect of antenatal steroids on HPA axis) and extrinsic factors (for example, vaginal delivery, poor condition at birth, respiratory distress, mechanical ventilation, hypoglycaemia or infection) [5]. Extremely preterm infants may develop adrenal insufficiency in the early neonatal period requiring cortisol supplementation [6,7]. In these infants, hypotension may occur which is responsive to the administration of hydrocortisone [8]. Assessment of adrenal function in extremely premature infants by the administration of ACTH for a synacthen test is difficult because sequential blood sampling is required for determination of cortisol levels.Measurement of free cortisol is the best indicator of adrenal glucocorticoid secretion [9] because cortisol is more than 80% bound to cortisol binding globulins (CBG) in the circulation and therefore measurements of plasma cortisol can be compromised by conditions that alter CBG levels [10,11]. However, obtaining blood samples by venepuncture is a painful procedure, which might of itself cause high cortisol values [12] and free cortisol may be better tested by taking saliva samples [13] because salivary cortisol levels are known to accurately reflect the free fraction of cortisol in the body. Obtaining saliva is painless and non-invasive and therefore especially useful in neonates; it is unlikely to cause stress and thus salivary cortisol values are more likely to reflect the true plasma level [14].There is good evidence from studies in older children [15] and adults that salivary cortisol concentrations correlate well with plasma cortisol concentrations at baseline/rest as well as during exercise and during dynamic function tests involving the hypothalamic-pituitary-adrenal axis [16]. These studies suggest that plasma cortisol measurement can be replaced by salivary cortisol measurement. However, few studies [17] have been reported on salivary cortisol determination in neonates and particularly, extremely premature infants.We previously reported a novel method of collecting saliva, which is effective in obtaining a good quantity of saliva to enable relia...

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Realising the Potential of Urine and Saliva as Diagnostic Tools in Sport and Exercise Medicine

Lindsay

Costello

2016

Sports Med

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Accurate monitoring of homeostatic perturbations following various psychophysiological stressors is essential in sports and exercise medicine. Various biomarkers are routinely used as monitoring tools in both clinical and elite sport settings. Blood collection and muscle biopsies, both invasive in nature, are considered the gold standard for the analysis of these biomarkers in exercise science. Exploring non-invasive methods of collecting and analysing biomarkers that are capable of providing accurate information regarding exercise-induced physiological and psychological stress is of obvious practical importance. This review describes the potential benefits, and the limitations, of using saliva and urine to ascertain biomarkers capable of identifying important stressors that are routinely encountered before, during, or after intense or unaccustomed exercise, competition, over-training, and inappropriate recovery. In particular, we focus on urinary and saliva biomarkers that have previously been used to monitor muscle damage, inflammation, cardiovascular stress, oxidative stress, hydration status, and brain distress. Evidence is provided from a range of empirical studies suggesting that urine and saliva are both capable of identifying various stressors. Although additional research regarding the efficacy of using urine and/or saliva to indicate the severity of exercise-induced psychophysiological stress is required, it is likely that these non-invasive biomarkers will represent "the future" in sports and exercise medicine.

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The relationship of salivary and cord blood cortisol inpreterm infants

Cited by 12 publications

References 24 publications

Relationship of Salivary and Plasma Cortisol Levels in Preterm Infants: Results of a Prospective Observational Study and Systematic Review of the Literature

Relationship of Salivary and Plasma Cortisol Levels in Preterm Infants: Results of a Prospective Observational Study and Systematic Review of the Literature

Correlation of Plasma and Salivary Cortisol in Extremely Premature Infants

Realising the Potential of Urine and Saliva as Diagnostic Tools in Sport and Exercise Medicine

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