title: Reduced basal salivary cortisol in children with asthma and allergic rhinitis.
abstract: OBJECTIVE
  Reduced basal cortisol is reported in allergic disease. We investigated if basal salivary cortisol levels were reduced in children with asthma or allergic rhinitis, controlling for inhaled corticosteroids (ICS) use.
  
  
  METHODS
  Morning and evening saliva of asthmatic children aged 7-12 years (n = 50) and that of controls (n = 52) were sampled. A total of 19 asthmatics and four controls had allergic rhinitis. Healthy children were controls without rhinitis. Of all, 14 asthmatic children used low, and 12 used moderate or high doses of ICS. Cortisol was analysed by radioimmunoassay.
  
  
  RESULTS
  Morning salivary cortisol median (95% CI) was lower in asthmatics (8.7 (7.1, 9.7)) compared with that in controls (10.4 (9.6, 11.8); p = 0.006), which was similar for evening cortisol levels. Regression analyses demonstrated that asthmatics using moderate or high doses of ICS had reduced morning salivary cortisol adjusted (for age and gender) odds ratio (aOR) (95% CI) (0.54 (0.37, 0.80); p = 0.002) and reduced evening cortisol aOR (0.09 (0.01, 0.6); p = 0.02) compared with that in healthy children. Asthmatics with rhinitis on no or low doses of ICS had reduced morning cortisol aOR (0.73 (0.56, 0.96); p = 0.02) compared with that in healthy children.
  
  
  CONCLUSIONS
  Asthmatic children on moderate or high doses of inhaled corticosteroids had reduced salivary cortisol, but co-morbidity of asthma and rhinitis was also associated with reduced cortisol levels.
authors.affiliation: Department of Paediatrics, Oslo University Hospital, Ullevål, Oslo, Norway. bake@uus.no
authors.forename: E
authors.initials: E
authors.lastname: Bakkeheim
authors.forename: P
authors.initials: P
authors.lastname: Mowinckel
authors.forename: K H
authors.initials: KH
authors.lastname: Carlsen
authors.forename: P
authors.initials: P
authors.lastname: Burney
authors.forename: K C
authors.initials: KC
authors.lastname: Lødrup Carlsen
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D008297:Male; D012221:Rhinitis, Allergic, Perennial / Q000150:complications / Q000378:metabolism*; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000378:metabolism*; D012463:Saliva / Q000737:chemistry*; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D006854:Hydrocortisone