Elder, C.J., Harrison, R.F., Cross, A.S. et al. (4 more authors) (2018) Use of salivary cortisol and cortisone in the high and low dose synacthen test. Clinical Endocrinology , 88 (6). pp. 772-778. ISSN 2045-2322
Abstract
CONTEXT: Salivary cortisone reflects serum cortisol levels, is more sensitive than salivary cortisol at lower values of serum cortisol and is non-invasive. OBJECTIVE: To investigate the relationship between serum cortisol and salivary cortisol and cortisone following low and high-dose synacthen. DESIGN AND SETTING: Prospective pharmacodynamic studies in clinical research facilities. PARTICIPANTS AND INTERVENTION: 35 dexamethasone-suppressed, healthy adult males underwent an intravenous synacthen test: N=23 low-dose (1mcg), N=12 high-dose (250mcg). Paired serum and salivary samples were taken at 15 sampling points over 120 minutes. MAIN OUTCOME MEASURE: Serum cortisol and salivary cortisol and cortisone were analyzed for correlations and by a mixed effects model. RESULTS: At baseline the correlation between serum cortisol and salivary cortisol was weak with many samples undetectable (r=0.45, NS), but there was a strong correlation with salivary cortisone (r=0.94, p<0.001). Up to 50 minutes following synacthen the correlation coefficient between serum cortisol and salivary cortisol and cortisone was <0.8, but both had a stronger correlation at 60 minutes (salivary cortisol r=0.89, p<0.001, salivary cortisone r=0.85, p<0.001). The relationship was examined excluding samples in the dynamic phase (baseline to 60 minutes). Salivary cortisol and cortisone showed a close relationship to serum cortisol. Salivary cortisone showing the stronger correlation: Salivary cortisol r=0.82, p<0.001, salivary cortisone r=0.96, p<0.001. CONCLUSION: Following synacthen, both salivary cortisol and cortisone reflect serum cortisol levels but there is a lag in their rise up to 60mins. The results support further research for possible future use of a 60min salivary cortisone measurement during the synacthen test.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Elder, C. J., Harrison, R. F., Cross, A. S., Vilela, R., Keevil, B. G., Wright, N. P. and Ross, R. J. (2017), Use of salivary cortisol and cortisone in the high and low dose synacthen test. Clin Endocrinol., which has been published in final form at 10.1111/cen.13509. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |
Keywords: | ACTH stimulation test; Synacthen; Cosyntropin; Saliva; Cortisol; cortisone; adrenal insufficiency; Addisons |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) > Division of Genomic Medicine (Sheffield) > Department of Oncology and Metabolism (Sheffield) The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 14 Nov 2017 16:09 |
Last Modified: | 14 Dec 2023 12:36 |
Status: | Published |
Publisher: | Nature Publishing Group |
Refereed: | Yes |
Identification Number: | 10.1111/cen.13509 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:123959 |