Salivary cortisol and cortisone responses to tetracosactrin (synacthen).
BACKGROUND
To establish cutoff values for salivary liquid chromatography tandem mass spectroscopy cortisol and cortisone in defining adequate adrenocortical function during a standard synacthen test.


METHODS
We compared salivary liquid chromatography tandem mass spectroscopy cortisol and cortisone responses to those of serum cortisol measured on the Roche E170 immunoassay analyser and the Abbott Architect i2000 before and 30 min and 60 min following 0.25 mg of intravenous synacthen.


RESULTS
Correlations of salivary cortisol and cortisone were bimodal and linear, respectively. Based on these correlations, adequate salivary cortisol and cortisone responses to synacthen were extrapolated from a serum cortisol (Roche) cut-off of 550 nmol/L and defined as 15 nmol/L and 45 nmol/L, respectively. The Abbott method correlated well with the Roche but gave results that were about 20% lower than the Roche method.


CONCLUSIONS
Measurement of salivary cortisol and cortisone responses offers an alternative to those of serum cortisol during a synacthen test in the investigation of adrenal hypofunction.
Department of Clinical Chemistry, Royal Wolverhampton NHS Trust, Wolverhampton, UK michael.cornes@nhs.net.
Michael P
MP
Cornes
Department of Clinical Chemistry, Royal Wolverhampton NHS Trust, Wolverhampton, UK.
Helen L
HL
Ashby
Department of Diabetes, Royal Wolverhampton NHS Trust, Wolverhampton, UK.
Yasmeen
Y
Khalid
Department of Diabetes, Royal Wolverhampton NHS Trust, Wolverhampton, UK.
Harit N
HN
Buch
Department of Clinical Chemistry, Royal Wolverhampton NHS Trust, Wolverhampton, UK.
Clare
C
Ford
Department of Clinical Chemistry, Royal Wolverhampton NHS Trust, Wolverhampton, UK Department of Research Institute, Healthcare Sciences, Wolverhampton University, Wolverhampton, UK.
Rousseau
R
Gama
D061605:Administration, Intravenous; D000293:Adolescent; D000309:Adrenal Insufficiency / Q000097:blood / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003348:Cortisone / Q000032:analysis* / Q000097:blood; D003366:Cosyntropin / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry* / Q000378:metabolism; D055815:Young Adult
D003366:Cosyntropin; D003348:Cortisone; D006854:Hydrocortisone
Saliva; cortisol; cortisone; synacthen; tetracosactrin