Salivary cortisol and cortisone responses to tetracosactrin (synacthen)
Open accessAbstract
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.
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The pivot point in the control group for a steeper relative increase in salivary cortisol and cortisone was seen at plasma cortisol levels around 500 nmol/L, suggesting this to be the point of CBG saturation.
“The pivot point in the control group for a steeper relative increase in salivary cortisol and cortisone was seen at plasma cortisol levels around 500 nmol/L, suggesting this to be the point of CBG saturation (see Fig. 3) (25).”
From Salivary Cortisol and Cortisone Can Circumvent Confounding Effects of Oral Contraceptives in the Short Synacthen Test (2024) · cites this paper as [25]
The validity of the calculated lower reference limits for salivary cortisol and cortisone is strengthened by the similarities to previously published cutoffs.
“The validity of our calculated LRLs for salivary cortisol and cortisone is strengthened by the similarities to previously published cutoffs (25, 30, 36, 42).”
From Salivary Cortisol and Cortisone Can Circumvent Confounding Effects of Oral Contraceptives in the Short Synacthen Test (2024) · cites this paper as [25]
Salivary cortisol has been shown to be less affected by CBG alterations than plasma cortisol.
“Analysis of salivary cortisol has been proposed as an alternative to analyzing plasma free cortisol and has been shown to be less affected by CBG alterations (9, 14, 20-25).”
From Salivary Cortisol and Cortisone Can Circumvent Confounding Effects of Oral Contraceptives in the Short Synacthen Test (2024) · cites this paper as [25]
Cites
Salivary cortisol: a better measure of adrenal cortical function than serum cortisol
Vining, R. F., McGinley, R. A., Maksvytis, J. J., & Ho, K. Y. (1983) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/000456328302000601 · Cited by 684 · see citing works
Salivary cortisone is a potential biomarker for serum free cortisol
Perogamvros, I., Keevil, B. G., Ray, D. W., & Trainer, P. J. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-1215 · Cited by 222 · see citing works
Salivary steroid assays – research or routine?
Wood, P. J. (2009) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1258/acb.2008.008208 · Cited by 175 · see citing works
El‐Farhan, N., Pickett, A., Ducroq, D., Bailey, C., Mitchem, K., Morgan, N., Armston, A., Jones, L., Evans, C., & Rees, D. A. (2013) · Clinical Endocrinology · doi:10.1111/cen.12039 · Cited by 158 · see citing works
Perogamvros, I., Owen, L. J., Newell-Price, J., Ray, D. W., Trainer, P. J., & Keevil, B. G. (2009) · Journal of Chromatography B · doi:10.1016/j.jchromb.2009.09.014 · Cited by 140 · see citing works
Bishop, T. (2009) · Primary Health Care · doi:10.7748/phc.19.6.12.s17 · Cited by 68 · see citing works
Perogamvros, I., Owen, L. J., Keevil, B. G., Brabant, G., & Trainer, P. J. (2010) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2009.03582.x · Cited by 61 · see citing works
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LC–MS/MS analysis of steroids in the clinical laboratory
Keevil, B. G. (2016) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2016.04.009 · Cited by 149 · see citing works
Salivary cortisol and cortisone in the clinical setting
Blair, J., Adaway, J., Keevil, B., & Ross, R. (2017) · Current Opinion in Endocrinology, Diabetes & Obesity · doi:10.1097/med.0000000000000328 · Cited by 138 · see citing works
Antonelli, G., Ceccato, F., Artusi, C., Marinova, M., & Plebani, M. (2015) · Clinica Chimica Acta · doi:10.1016/j.cca.2015.10.004 · Cited by 111 · see citing works
The role of corticosteroid-binding globulin in the evaluation of adrenal insufficiency
Verbeeten, K. C., & Ahmet, A. H. (2018) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem-2017-0270 · Cited by 51 · see citing works
Use of salivary cortisol and cortisone in the high- and low-dose synacthen test
Elder, C. J., Harrison, R. F., Cross, A. S., Vilela, R., Keevil, B. G., Wright, N. P., & Ross, R. J. (2018) · Clinical Endocrinology · doi:10.1111/cen.13509 · Cited by 21 · see citing works
Mak, I. Y. F., Au Yeung, B. Y. T., Ng, Y. W., Choi, C. H., Iu, H. Y. P., Shek, C. C., & Tiu, S. C. (2017) · Journal of the Endocrine Society · doi:10.1210/js.2016-1056 · Cited by 20 · see citing works
Bäcklund, N., Lundstedt, S., Tornevi, A., Wihlbäck, A.-C., Olsson, T., Dahlqvist, P., & Brattsand, G. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad763 · Cited by 13 · see citing works
A comparison of salivary steroid levels during diagnostic tests for adrenal insufficiency
Dušková, M., Šimůnková, K., Vítků, J., Sosvorová, L., Jandíková, H., Pospíšilová, H., Šrámková, M., Kosák, M., Kršek, M., Hána, V., et al. (2016) · Prague Medical Report · doi:10.14712/23362936.2016.2 · Cited by 11 · see citing works
Tan, S. Y. T., Tan, H. C., Zhu, L., Loh, L. M., Lim, D. S. T., Swee, D. S., Chan, Y. L., Lim, H. B., Ling, S. L., Ou, E. J., et al. (2023) · Endocrine Connections · doi:10.1530/ec-23-0004 · Cited by 10 · see citing works
Kalaria, T., Agarwal, M., Kaur, S., Hughes, L., Sharrod-Cole, H., Chaudhari, R., Gherman-Ciolac, C., Chopra, R., Okeke, V., Ford, C., et al. (2020) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/0004563220961745 · Cited by 7 · see citing works
Self-citation
- Authors
- Cornes, M. P., Ashby, H. L., Khalid, Y., Buch, H. N., Ford, C., & Gama, R.
- Affiliations
- The Royal Wolverhampton NHS Trust (GB)
- University of Wolverhampton (GB)
- Corresponding author
- Cornes, Michael P
- Venue
- Annals of Clinical Biochemistry International Journal of Laboratory Medicine
- Publisher
- SAGE Publications
- Published
- 2015-02-27
- Volume
- 52
- Issue
- 5
- Pages
- 606-610
- ISSN
- 0004-5632 (ISSN-L)
- 1758-1001
- OpenAlex
- W2334189733
- Cited by
- 27
- References
- 7
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 5 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 4 · 2015: 1
- FWCI
- 3.76
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Annals of Clinical Biochemistry International Journal of Laboratory Medicine (publishedVersion)
- PubMed (publishedVersion)
- Wolverhampton Intellectual Repository and E-Theses (University of Wolverhampton) (acceptedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- salivary cortisol, salivary cortisone, ACTH stimulation test, tetracosactrin, adrenocortical function, adrenal hypofunction, cut-off values, liquid chromatography-tandem mass spectrometry, immunoassay comparison
- MeSH terms
- Adolescent, Adrenal Insufficiency, Adult, Aged, Aged, 80 and over, Cortisone, Cosyntropin, Female, Humans, Hydrocortisone, Male, Middle Aged, Prospective Studies, Saliva, Young Adult, Administration, Intravenous
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