[Usefulness of the determination of saliva cortisol in the study of adrenal gland glucocorticoid function].
To validate the adequacy of saliva as a biological specimen for the study of glucocorticoid adrenal function, the concentrations of salivary cortisol (SC) and serum total cortisol (TC) were measured by radioimmunoassay (RIA) in several groups of individuals in baseline state and during stimulation tests. The study of diurnal variations of SC in the reference population (n = 29) showed a nyctohemeral rhythm similar to that of TC, with maximal concentrations at 08.00-09.00 h (18 +/- 9 nmol/L) and 61% and 80% decreases at 15.30 and 23.00 h, respectively. After the administration of 1 mg of dexamethasone, SC was reduced in a 95% of its baseline value (n = 18). In all patients with Cushing's syndrome (n = 8) SC was increased whereas TC was normal in 3. All patients with adrenal failure (n = 11) had subnormal SC levels, while TC was normal in 4. The SC response to stimulation with intravenous synthetic adrenocorticotropin (Nuvacthen) (with and without previous suppression with 1 mg dexamethasone), insulin hypoglycemia and glucagon were qualitatively similar to those of TC, although more marked in proportion. These results, together with the practical advantages of saliva as a biological sample (easy obtention of specimen, absence of stress during its collection, and stability of cortisol in it), indicate that SC represents a more reliable measurement than TC as a useful clinical test to detect glucocorticoid dysfunction.
Montañés
R
R
Rodríguez
J
J
Pérez
A
A
Cortés
M
M
Ordóñez
J
J
González
F
F
D000307:Adrenal Gland Diseases / Q000097:blood / Q000175:diagnosis*; D000309:Adrenal Insufficiency / Q000175:diagnosis; D003480:Cushing Syndrome / Q000175:diagnosis; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000097:blood; D008297:Male; D012463:Saliva / Q000032:analysis*
D006854:Hydrocortisone
Utilidad de la medida de cortisol salival en el estudio de la función glucocorticoide suprarrenal.