Use of saliva for monitoring unbound free cortisol levels in serum

Umeda, Teruhisa; Hiramatsu, Ryoji; Iwaoka, Taisuke; Shimada, Tatsuya; Miura, Fumihiro; Satô, Tatsuo

doi:10.1016/0009-8981(81)90353-3

Cited by 251 publications

(50 citation statements)

References 21 publications

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“…How reliable is this biological marker as an indicator of stress? Salivary cortisol was chosen as a biological index of stress [13, 14]since the procedure for its measurement is non-invasive and to date a widely accepted and frequently employed method in psychoneuroendocrinology [18, 19]. Acute stress elicits a cascade of neuroendocrinological events, including secretion of noradrenaline and adrenaline, together with stimulation of the hypothalamic-pituitary-adrenal axis with the result of increased cortisol secretion [26].…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 80% of total serum cortisol is bound to serum cortisol-binding globulin, 10% is bound to albumin and the remaining free serum cortisol is the biologically active component [17]. Recently, valid and reliable non-invasive methods for measurements of cortisol in saliva which accurately reflect the free cortisol fraction of the blood have been developed [18, 19]. The primary aim of the present study was to investigate the relationship between BP and stress as evaluated by testing the level of salivary cortisol in patients with acute ischaemic stroke.…”

Section: Introductionmentioning

confidence: 99%

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Salivary Cortisol, a Biological Marker of Stress, Is Positively Associated with 24-Hour Systolic Blood Pressure in Patients with Acute Ischaemic Stroke

2004

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Background/Aim: The cause of elevated blood pressure (BP) in acute stroke is unknown. Stress is often suggested as a main contributing factor. We aimed to investigate the relationship between BP and stress in patients with acute stroke. Methods: 58 patients with clinical symptoms of stroke were recruited prospectively after exclusion of haemorrhage by CT scan within 14 h and 15 min (mean) after symptom onset (range 2 h and 45 min–23 h and 40 min). The mean age of the patients was 66 years (range 39–86 years), and the mean National Institute of Health Stroke Scale score was 7 (range 1–26). BP and pulse rate were recorded by non-invasive automatic monitoring hourly for 24 h. Stress was evaluated by testing the level of salivary cortisol. Four samples of saliva were obtained at inclusion, on the evening of the inclusion day (20.00–22.00 h), on the morning of the next day (7.00–9.00 h) and on the afternoon of the inclusion day/next day (15.00–17.00 h) within 24 h after inclusion in the study. Logarithmic transformation was done for cortisol levels. Results: The 24-hour mean cortisol level (geometric mean 13.6 nmol/l) was related to 24-hour mean systolic BP [SBP; r = 0.36, p = 0.01, multivariate p = 0.02], mean night-time (22.00–6.00 h) SBP (r = 0.43, p = 0.001, multivariate p < 0.005) and mean night-time diastolic BP (r = 0.31, p = 0.02, multivariate p = 0.02). Cortisol levels at inclusion (r = 0.31, p = 0.02, multivariate p = 0.05 for 24-hour SBP) and in the evening were also statistically significantly related to the above BP variables. The morning cortisol (r = 0.28, p = 0.04, multivariate p = 0.04) was related to night-time SBP. Conclusions: Salivary cortisol was positively correlated with 24-hour SBP and night-time BP, suggesting that stress is a contributing factor for high BP in acute stroke.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Salivary Cortisol, a Biological Marker of Stress, Is Positively Associated with 24-Hour Systolic Blood Pressure in Patients with Acute Ischaemic Stroke

2004

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“…Erturk et al [12] have demonstrated that basal serum cortisol levels below 5 µg/ml have a specificity of 100% and a sensitivity of 36% for AI [12]. Under the light of these studies, it is suggested that basal serum cortisol measurements are not in themselves sufficient for a diagnosis of AI [13,14,15,16]. …”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Salivary Cortisol in Children with Abnormal Adrenal Cortex Functions

2007

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Aims: It has been shown that the free cortisol level in saliva may reflect plasma free cortisol. The measurement of cortisol in saliva is a simple method, and as such it is important in the pediatric age group. In this research, the diagnostic value of measurement of salivary cortisol (SC) measurement was examined in adrenal insufficiency (AI). Methods: Fifty-one patients, mean age 10.8 ± 4.29, who were investigated for possible AI, were included. Basal cortisol levels were below 18 µg/dl. Adrenal function was determined by low-dose ACTH test. During the test, samples for SC were obtained simultaneously with serum samples (at 0–10–20–30–40 min). Results: Mean basal serum cortisol level was 8.21 ± 4.10 µg/dl (mean ± SD). Basal SC was correlated to basal serum cortisol (r = 0.64, p < 0.001). A cut-off of 0.94 µg/dl for SC differentiated adrenal insufficient subjects from normals with a sensitivity and specificity of 80 and 77%, respectively. A peak SC less than 0.62 µg/dl defined AI with a specificity of 100%; however, sensitivity was 44%. Conclusion: Measurement of SC may be used in the evaluation of AI. It is well-correlated to serum cortisol. Peak SC in low-dose ACTH test can be used to differentiate patients with AI in the initial evaluation of individuals with suspected AI.

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“…The plasma is stripped of steroids with charcoal Norit A in a concentration of 50 mg/ml of plasma, filtered twice using Whatman NQ 50 filter paper (Fisher Scientific Co.) and stored in 1 ml aliquots at 0-10 C. The scintillation fluid is composed of 42 ml of liquofluor (New England Nuclear Co.), 21 mI of absolute ethanol and 6.5 ml of Biosolvsolubilizer (Beckman NQ 184983) in 1 liter of toluene (spectroanalysed grade) [23].…”

Section: Determination Of Cortisol By Radiostereoassay or Competitivementioning

confidence: 99%

The Cortisol Steroid Levels as a Determinant of Health Status in Animals

Isaac¹,

Ibrahim²,

Andrew³

et al. 2017

J Proteomics Bioinform

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The veterinarian is daily faced with the challenge of diagnosing several disease conditions in different animals. Quantifying cortisol levels has been used in the evaluation of anxiety and distress initiated by infectious and noninfectious disease conditions, mismanagement, transportation, adverse environmental temperature and surgical operations. The hormone-cortisol has been implicated in several immunologic and metabolic processes and can thus serve as a marker to monitor animal welfare. Several factors affect the specific test to be carried out and which sample is to be used. Recently, RIA has been identified as the gold standard for determination of cortisol levels. However it also has its own short comings hence the need to utilize other assay techniques such as ELISA, fluorescence techniques and chemical assays which are more common in our environment. There is also prospect for the analysis of cortisol using non-invasive samples such finger nails as well as ear wax for enhanced test results.

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Use of saliva for monitoring unbound free cortisol levels in serum

Cited by 251 publications

References 21 publications

Salivary Cortisol, a Biological Marker of Stress, Is Positively Associated with 24-Hour Systolic Blood Pressure in Patients with Acute Ischaemic Stroke

Salivary Cortisol, a Biological Marker of Stress, Is Positively Associated with 24-Hour Systolic Blood Pressure in Patients with Acute Ischaemic Stroke

Diagnostic Value of Salivary Cortisol in Children with Abnormal Adrenal Cortex Functions

The Cortisol Steroid Levels as a Determinant of Health Status in Animals

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