Salivary cortisol: an alternative to serum cortisol determinations in dynamic function tests
Abstract
Salivary cortisol was measured as an alternative to serum cortisol as a marker for adrenocortical function following insulin tolerance test, corticotropin-releasing-hormone stimulation and adreno-corticotrophic hormone stimulation. During insulin tolerance test and corticotropin-releasing-hormone stimulation adreno-corticotrophic hormone was also measured. The tests were performed on healthy control subjects as well as on patients under investigation for various disturbances in the hypothalamic-pituitary-adrenocortical axis (insulin tolerance test: 3 controls on two occasions and 14 patients; corticotropin-releasing-hormone stimulation: 4 controls and 18 patients; adreno-corticotrophic hormone stimulation: 6 controls and 10 patients). Five patients underwent both insulin tolerance test and corticotropin-releasing-hormone stimulation. Using criteria for adequate cortisol response in serum, the patients were classified as good or poor responders. In 42 of the 45 tests performed the same conclusion as to cortisol status was drawn when based on serum and salivary cortisol responses. In healthy subjects and good responders the mean cortisol relative increase was greater in saliva than in serum in all three tests (p < 0.05). Characteristic of the results for the insulin tolerance test was a significant initial mean decrease (p < 0.05), not found in serum, and the highest observed salivary cortisol value was delayed for at least 30 minutes compared to that in serum. Plasma adreno-corticotrophic hormone correlated significantly with the cortisol concentrations determined 15 minutes later in serum (r = 0.54-0.64) and in saliva (r = 0.76-0.85). The more pronounced cortisol response in saliva than in serum and its closer correlation with adreno-corticotrophic hormone offer advantages over serum cortisol, suggesting salivary cortisol measurement may be used as an alternative parameter in dynamic endocrine test.
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Salivary samples can be used during the short Synacthen test in the diagnostic work-up for adrenal insufficiency.
“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 [29]
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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).”
BackgroundResult
- Authors
- Aardal-Eriksson, E., Karlberg, B. E., & Holm, A.-C.
- Affiliations
- Linköping University (SE)
- Venue
- cclm
- Publisher
- Walter de Gruyter GmbH
- Published
- 1998-04-30
- Volume
- 36
- Issue
- 4
- Pages
- 215-222
- ISSN
- 1434-6621 (ISSN-L)
- OpenAlex
- W1968354129
- Cited by
- 127
- References
- 7
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 1 · 2020: 5 · 2019: 4 · 2018: 4 · 2017: 3 · 2016: 4 · 2015: 12 · 2014: 6 · 2013: 7 · 2012: 5
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Chemistry and Laboratory Medicine (CCLM) (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Arizona
- 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, serum cortisol, adrenocortical function, insulin tolerance test, corticotropin-releasing hormone stimulation, ACTH stimulation test, hypothalamic-pituitary-adrenal axis, cortisol response
- MeSH terms
- Adrenal Cortex, Adrenocorticotropic Hormone, Adult, Aged, Corticotropin-Releasing Hormone, Endocrine System Diseases, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Insulin, Male, Middle Aged, Pituitary-Adrenal System, Saliva, Biomarkers
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