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Cited by 62Adrenal Hormones and DisordersStress Responses and CortisolHormonal Regulation and Hypertension

Low-dose ACTH (1 µg) salivary test: a potential alternative to the classical blood test

Marcus‐Perlman, Y., Tordjman, K., Greenman, Y., Limor, R., Shenkerman, G., Osher, E., Stern, N.·2006·Clinical Endocrinology
DOI 10.1111/j.1365-2265.2006.02451.x
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Abstract

OBJECTIVES: Salivary cortisol is unaffected by cortisol binding globulin (CBG) and hence allows CBG-related variations in serum total cortisol to be bypassed. We assessed whether or not salivary cortisol can be used for the low-dose (1 microg) ACTH test in subjects with presumed normal and elevated levels of CBG. PATIENTS/METHODS: We measured serum and salivary cortisol responses to intravenous administration of 1 microg ACTH in 14 healthy volunteers, 14 'hyperoestrogenic' women [in their first or early second trimester of pregnancy, using oral contraceptives (OC) or on hormone replacement therapy (HRT)] and 10 patients with secondary hypoadrenalism. Cortisol levels were recorded before as well as 30 and 60 min (+30; +60 min) after ACTH administration. RESULTS: Baseline salivary cortisol did not differ significantly between the hypoadrenal and healthy patients (7.11+/-1.4 and 12.13+/-1.59 nmol/l; P=0.48) but there was a significant difference between hypoadrenal and hyperoestrogenic patients (18.94+/- 3.44 nmol/l; P=0.01). The largest difference between hypoadrenal patients and healthy individuals was observed at+30 min (9.16+/-2.8, 52.65+/-8.78 and 48.81+/- 6.9 nmol/l, in the hypoadrenal, healthy and hyperoestrogenic patients, respectively; P< 0.05). At this time-point values< 24.28 nmol/l were found in all hypoadrenal patients and cortisol levels >or= 27.6 nmol/l were found in 26 out of 28 healthy volunteers. ACTH-stimulated serum cortisol but not salivary cortisol was significantly higher in hyperoestrogenic women than in the healthy volunteers at either+30 or+60 min. CONCLUSIONS: The salivary low-dose ACTH test yields results that parallel the response of circulating cortisol to ACTH and may provide an alternative to the blood test, particularly in situations where increased CBG levels complicate the changes in serum cortisol levels.

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Authors
Marcus‐Perlman, Y., Tordjman, K., Greenman, Y., Limor, R., Shenkerman, G., Osher, E., & Stern, N.
Affiliations
Tel Aviv University (IL)
Corresponding author
Stern, N.
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2006-01-09
Volume
64
Issue
2
Pages
215-218
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.2006.02451.x
OpenAlex
W1987541461
Cited by
62
References
18
Citations by year
2026: 1 · 2025: 3 · 2024: 1 · 2023: 5 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 4 · 2015: 1 · 2014: 4 · 2013: 5 · 2012: 2
FWCI
4.53
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
Keywords
salivary cortisol, low-dose ACTH stimulation test, corticosteroid-binding globulin, hyperoestrogenism, pregnancy, oral contraceptives, hormone replacement therapy, cortisol measurement
MeSH terms
Adrenal Insufficiency, Adrenocorticotropic Hormone, Adult, Carrier Proteins, Contraceptives, Oral, Cushing Syndrome, Diagnostic Tests, Routine, Estrogens, Female, Humans, Hydrocortisone, Injections, Intravenous, Male, Middle Aged, Pregnancy, Pregnancy Trimester, First, Saliva, Hormone Replacement Therapy

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