ArticleJournal of endocrinological investigation2010
Salivary cortisol as an alternative for serum cortisol in the low-dose adrenocorticotropic hormone stimulation test?
Article in Journal of endocrinological investigation, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed, 7 citations in OpenAlex.
- The Reliability of Salivary Cortisol Compared to Serum Cortisol for Diagnosing Adrenal Insufficiency with the Gold Standard ACTH Stimulation Test in Children.Children (Basel, Switzerland) · 2023Article
- Comparison of total, salivary and calculated free cortisol levels in patients with severe sepsis.Journal of intensive care · 2016Article
- Are we correctly diagnosing adrenal insufficiency or are we just spitting into the wind?Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2015Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSalivary cortisol is unaffected by cortisol binding globulin and reflects free serum cortisol as compared to total serum cortisol.
aimThe aim of the present study was to compare the salivary cortisol response with the serum cortisol response in a low-dose (1-microg) ACTH test in a clinical setting and to determine the optimal cut-off value of salivary cortisol as an alternative to serum cortisol. MATERIAL/SUBJECTS AND
methodsWe measured serum and salivary cortisol responses to iv administration of 1-microg ACTH in 51 patients (17 males) referred to the Department of Clinical Chemistry for ACTH-testing. Serum cortisol was assessed before, 20, and 30 min after ACTH-administration, and salivary cortisol was assessed before and 30 min after ACTH administration.
resultsMean cortisol at baseline, 20, and 30 min were 0.44 micromol/l (SD: 0.22), 0.64 micromol/l (SD: 0.24), and 0.70 micromol/l (SD: 0.25), respectively. Median basal salivary cortisol was 8.4 nmol/l [interquartile range (IQR): 3.8-14.2]. Salivary cortisol at 30 min equaled 35.9 nmol/l (IQR: 21.1-46.2). Basal salivary cortisol was significantly correlated with salivary cortisol at 30 min (r=0.53; p<0.001). Salivary cortisol at 30 min of 23.5 nmol/l had a sensitivity and specificity of 78.1% and 70.0%, respectively as compared to the serum cortisol cut-off values of >0.50 micromol/l.
conclusionsThe salivary low-dose ACTH-test yields more dynamic responses than serum cortisol. However, the sensitivity and specificity of salivary cortisol are too low to be adequate as an alternative to the serum cortisol measurements. In women on estrogen therapy, however, the use of salivary cortisol might be superior to serum cortisol.
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