The DOI matches its Crossref record; 100 of the 102 references it cites were found in a registry or an index.
Utility of salivary cortisol measurements in Cushing's syndrome and adrenal insufficiency
Abstract
CONTEXT: The measurement of cortisol in saliva is a simple, reproducible, and reliable test to evaluate the normal and disordered control of the hypothalamic-pituitary-adrenal (HPA) axis. There are a variety of simple methods to obtain saliva samples without stress, making this a robust test applicable to many different experimental and clinical situations. EVIDENCE ACQUISITION: Ovid Medline and PubMed from 1950 to present were searched using the following strategies: [ and and ] and [ and and ]. The bibliographies of all relevant citations were evaluated for any additional appropriate citations. EVIDENCE SYNTHESIS: Measurement of an elevated late-night (2300 to 2400 h) salivary cortisol has a greater than 90% sensitivity and specificity for the diagnosis of endogenous Cushing's syndrome. Late-night salivary cortisol measurements are also useful to monitor patients for remission and/or recurrence after pituitary surgery for Cushing's disease. Because it is a surrogate for plasma free cortisol, the measurement of salivary cortisol may be useful during an ACTH stimulation test in patients with increased plasma binding protein concentrations due to increased estrogen, or decreased plasma binding protein concentrations during critical illness. Most reference laboratories now offer salivary cortisol testing. CONCLUSIONS: It is expected that the use of the measurement of salivary cortisol will become routine in the evaluation of patients with disorders of the HPA axis.
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“It has previously been shown that salivary samples can be used during the short Synacthen test (SST) in the diagnostic work-up for AI (29-34).”
From Salivary Cortisol and Cortisone Can Circumvent Confounding Effects of Oral Contraceptives in the Short Synacthen Test (2024) · cites this paper as [33]
Citations
Cites
The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline.
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Salivary cortisol in psychoneuroendocrine research: recent developments and applications
Kirschbaum, C., & Hellhammer, D. H. (1994) · Psychoneuroendocrinology · doi:10.1016/0306-4530(94)90013-2 · Cited by 2,107
Salivary cortisol as a biomarker in stress research
Hellhammer, D. H., Wüst, S., & Kudielka, B. M. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.10.026 · Cited by 1,925
Diagnosis and complications of Cushing’s syndrome: a consensus statement
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Oelkers, W. (1996) · New England Journal of Medicine · doi:10.1056/nejm199610173351607 · Cited by 737
DICKSTEIN, G., SHECHNER, C., NICHOLSON, W. E., ROSNER, I., SHEN-ORR, Z., ADAWI, F., & LAHAV, M. (1991) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-72-4-773 · Cited by 457
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Grinspoon, S. K., & Biller, B. M. (1994) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.79.4.7962298 · Cited by 442
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Salivary cortisol measurement: a practical approach to assess pituitary-adrenal function.
LAUDAT, M. H., CERDAS, S., FOURNIER, C., GUIBAN, D., GUILHAUME, B., & LUTON, J. P. (1988) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-66-2-343 · Cited by 393
Current Status of Salivary Hormone Analysis
Gröschl, M. (2008) · Clinical Chemistry · doi:10.1373/clinchem.2008.108910 · Cited by 370
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Bornstein, S. R., Allolio, B., Arlt, W., Barthel, A., Don-Wauchope, A., Hammer, G. D., Husebye, E. S., Merke, D. P., Murad, M. H., Stratakis, C. A., et al. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-1710 · Cited by 1,769
“There are some limitations from the collection and analysis perspective, but these can be dealt with (165).”
BackgroundCharmandari, E., Nicolaides, N. C., & Chrousos, G. P. (2014) · The Lancet · doi:10.1016/s0140-6736(13)61684-0 · Cited by 644
Saliva sampling: Methods and devices. An overview
Bellagambi, F., Lomonaco, T., Salvo, P., Vivaldi, F., Hangouët, M., Ghimenti, S., Biagini, D., di Francesco, F., Fuoco, R., & Errachid, A. (2020) · TrAC Trends in Analytical Chemistry · doi:10.1016/j.trac.2019.115781 · Cited by 283
Cushing's syndrome: epidemiology and developments in disease management
Feelders, R., Sharma, S., & Nieman, L. (2015) · Clinical Epidemiology · doi:10.2147/clep.s44336 · Cited by 210
The Diagnosis and Management of Central Hypoadrenalism
Grossman, A. B. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0982 · Cited by 187
Metadata
- Authors
- Raff, H.
- Affiliations
- Medical College of Wisconsin (US)
- Corresponding author
- Raff, Hershel
- ORCID
- Raff, Hershel
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2009-10-01
- Volume
- 94
- Issue
- 10
- Pages
- 3647-3655
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2026990065
- Cited by
- 186
- References
- 102
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 6 · 2023: 6 · 2022: 5 · 2021: 3 · 2020: 15 · 2019: 17 · 2018: 6 · 2017: 9 · 2016: 12 · 2015: 10 · 2014: 16 · 2013: 16 · 2012: 20
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- salivary cortisol, Cushing's syndrome, adrenal insufficiency, hypothalamic-pituitary-adrenal axis, late-night salivary cortisol, Cushing's disease, pituitary surgery, ACTH stimulation test, plasma cortisol, critical illness
- MeSH terms
- Adrenal Insufficiency, Circadian Rhythm, Cushing Syndrome, Humans, Hydrocortisone, Saliva, Sensitivity and Specificity, Biomarkers
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