Salivary cortisol as a tool for physiological studies and diagnostic strategies
Open accessAbstract
Salivary cortisol is an index of plasma free cortisol and is obtained by a noninvasive procedure. We have been using salivary cortisol as a tool for physiological and diagnostic studies, among them the emergence of circadian rhythm in preterm and term infants. The salivary cortisol circadian rhythm in term and premature infants was established between 8 and 12 postnatal weeks. In the preterm infants the emergence of circadian rhythm was parallel to the onset of sleep rhythm. We also studied the use of salivary cortisol for screening for Cushing's syndrome (CS) in control and obese outpatients based on circadian rhythm and the overnight 1 mg dexamethasone (DEX) suppression test. Salivary cortisol was suppressed to less than 100 ng/dl after 1 mg DEX in control and obese patients. A single salivary cortisol measurement at 23:00 h and again after 1 mg DEX above the 90th percentile of the obese group values had sensitivity and specificity of 93 and 93% (23:00 h), and 91 and 94% (after DEX), respectively. The sensitivity improved to 100% when we combined both parameters. We also studied 11 CS children and 21 age-matched primary obese children for whom salivary cortisol sensitivity and specificity were 100/95% (23:00 h), and 100/95% (1 mg DEX), respectively. Similar to adults, sensitivity and specificity of 100% were obtained by combining 23:00 h and 1 mg DEX. The measurement of salivary cortisol is a useful tool for physiological studies and for the diagnosis of CS in children and adults on an outpatient basis.
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A nonlinear and differential relationship between human stress levels and salivary cortisol concentrations has been reported in another study.
“Such a nonlinear and differential relationship between human stress levels and salivary cortisol concentrations has also been reported in another study.[ 34 ]”
From MicroSweat: A wearable microfluidic patch for noninvasive and reliable sweat collection enables human stress monitoring (2023) · cites this paper as [34]
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References 36 · Cited by 83
- Authors
- Castro, M., Elias, P. C. L., Martinelli Jr., C. E., Antonini, S. R. R., Santiago, L., & Moreira, A. C.
- Affiliations
- Universidade de São Paulo (BR)
- Universidade de São Paulo, Brasil
- Venue
- Brazilian Journal of Medical and Biological Research
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2000-10
- Volume
- 33
- Issue
- 10
- Pages
- 1171-1175
- ISSN
- 0100-879X (ISSN-L)
- OpenAlex
- W2103053010
- Cited by
- 83
- References
- 36
- Citations by year
- 2026: 1 · 2024: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 1 · 2016: 1 · 2015: 4 · 2014: 6 · 2013: 4 · 2012: 4
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Brazilian Journal of Medical and Biological Research (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Fundação de Amparo à Pesquisa do Estado de São Paulo
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Fundação de Apoio ao Ensino, Pesquisa e Assistência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo
- 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 › Pituitary Gland Disorders and Treatments
- Keywords
- salivary cortisol, circadian rhythm, preterm infants, term infants, sleep onset, Cushing's syndrome, dexamethasone suppression test, obesity, diagnostic screening, non-invasive biomarkers, children
- MeSH terms
- Adolescent, Adult, Circadian Rhythm, Cushing Syndrome, Dexamethasone, Female, Glucocorticoids, Humans, Hydrocortisone, Infant, Infant, Newborn, Obesity, Saliva, Biomarkers
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