scholarly journals Serum Cortisol Seems To Be a More Appropriate Marker for Adrenocortical Reserve Evaluation in ACTH Test in Comparison to Salivary Cortisol

2014 ◽  
pp. 229-236 ◽  
Author(s):  
M. KOSÁK ◽  
V. HÁNA ◽  
M. HILL ◽  
K. ŠIMŮNKOVÁ ◽  
Z. LACINOVÁ ◽  
...  
Keyword(s):  
Salivary Cortisol ◽  
Repeated Measures ◽  
Reference Group ◽  
Free Fraction ◽  
Serum Cortisol ◽  
Coefficient Of Determination ◽  
Acth Test ◽  
Promising Alternative ◽  
Cortisol Levels ◽  
Experimental Values

Salivary cortisol reflects the free fraction of serum cortisol. Monitoring salivary cortisol may be a promising alternative method for assessing serum cortisol in some clinical situations. We aimed to compare the reliability of salivary vs. serum cortisol during ACTH test. 84 subjects (mean age 63.2; 24-89 years; n=66 males) suspected for adrenocortical insufficiency underwent an ACTH test. Patients were divided based on peak serum cortisol into hypocortical group with cortisol <500 nmol/l and to reference group cortisol >500 nmol/l. Median serum cortisol levels in reference group were 445, 766, and 902 nmol/l at 0, 30, and 60 minutes, respectively, and in hypocortical group were 256, 394, and 453 nmol/l. Median salivary cortisol levels were 19.02, 40.02, and 62.1 nmol/l in reference group, and 9.60, 14.08, and 13.28 nmol/l in hypocortical group. Obtained values showed good correlation between serum and salivary cortisol (p<0.0001). The percentage of explained variability R2 (coefficient of determination for linear model) representing a measure of agreement between experimental values and predictions for repeated measures ANOVA, was significantly higher (p=0.021) for serum cortisol (R2=93.4 %) when compared to the salivary cortisol (R2=89.3 %). A stronger discriminating power of serum versus salivary cortisol suggests that it seems to be slightly, but statistically significantly more appropriate marker of adrenocortical reserve in ACTH test.

scholarly journals 50 Effects of post-weaning supplementation of immunomodulatory feed ingredient on body weight and cortisol levels in programmed fed beef heifers

2019 ◽  
Vol 97 (Supplement_1) ◽  
pp. 82-82
Author(s):  
Jessica L Danielo ◽  
Jessie Tipton ◽  
Ralph Ricks ◽  
Keelee J McCarty ◽  
Nathan Long
Keyword(s):  
Body Weight ◽  
Repeated Measures ◽  
Serum Cortisol ◽  
Corn Germ ◽  
Experimental Unit ◽  
Beef Heifers ◽  
Feed Ingredient ◽  
Repeated Measures Analysis ◽  
Post Infusion ◽  
Cortisol Levels

Abstract The objective of this study was to determine the effects of an immunomodulatory feed ingredient during post-weaning on growth and cortisol levels of beef heifers. Commercial Angus heifers (n = 72) from two AI sires were blocked (n = 9) by sire and BW and then randomly assigned to one of two pens per block. Each pen (4 heifers/pen) per block was assigned to one of the treatments. Heifers were fed a commercial TMR twice daily from d 0 to 60 to gain 0.75 kg/day. The feed was top-dressed once a day with either 72g of Celmanax (CEL) or 72g of corn germ (CON) per pen. Body weight was collected on d -1, 0, 15, 30, 45, 60 and 61. Blood samples were collected on d 0, 15, 30, 45 and 60. Sixteen heifers (n = 8 CEL; n = 8 CON) were randomly selected for a corticotropin releasing hormone/ arginine vasopressin (CRH/AVP) challenge after the 60 d period. Two heifers per pen (n = 32) were randomly selected for a transportation challenge to evaluate stress response on d 61 or 62 of the study. Pen was the experimental unit and data was analyzed by ANOVA or repeated measures analysis as appropriate. Feed efficiency and BW gain was increased (P = 0.04) in CEL heifers compared to CON heifers. Serum cortisol concentrations were decreased (P < 0.01) in CEL heifers compared to CON heifers on d 30 to 60 post-weaning. Serum cortisol concentrations were decreased (P < 0.05) in CEL heifers compared to CON heifers during the CRH/AVP challenge from 60 to 150 minutes post infusion. Serum cortisol concentrations were decreased (P < 0.05) in CEL heifers compared to CON heifers throughout the transportation challenge. In summary, supplementation of Celmanax post-weaning increased BW gain and reduced cortisol concentrations in beef heifers.

Comparison of 1 mg versus 2 mg Dexamethasone Suppression Test in Patients with Obesity

2017 ◽  
Vol 49 (11) ◽  
pp. 854-859
Author(s):  
Sandrine Urwyler ◽  
Nina Cupa ◽  
Mirjam Christ-Crain
Keyword(s):  
Salivary Cortisol ◽  
False Positive ◽  
False Positive Rate ◽  
Serum Cortisol ◽  
Dexamethasone Suppression Test ◽  
Obese Patients ◽  
Positive Rate ◽  
Suppression Test ◽  
Cortisol Levels ◽  
Dexamethasone Suppression

AbstractIn this study, we compared the 2 mg dexamethasone suppression test (DST) with the gold-standard 1 mg DST in obese patients in order to reduce the false-positive rate for Cushing’s syndrome (CS). The primary endpoint was the comparison of serum cortisol levels after 1 mg versus 2 mg DST in patients with a BMI >30 kg/m2 and at least one additional feature of the metabolic syndrome. Secondary endpoints were comparison of salivary cortisol and ACTH levels, respectively. Fifty-four obese patients were included. Median serum cortisol levels after 1 mg DST and 2 mg DST were similar [28 nmol/l (20; 36) vs. 28 nmol/l (20; 38), p=0.53]. Salivary cortisol was 8.2 nmol/l (4.7; 11.7) after the 1 mg DST vs. 6.7 nmol/l (4.2; 9.5) after the 2 mg test, p=0.09. ACTH levels were higher after the 1 mg DST compared to the 2 mg DST [10.0 pg/ml (7.6; 10.7) vs. 5.0 pg/ml (5.0; 5.1), p<0.0001]. The false positive rate after the 1 mg DST was 14.8% (n=8) and was reduced to 11.1% (n=6) after the 2 mg DST. All non-suppressors (n=8) had type 2 diabetes and most of them took a medication interacting with cytochrome P450 3A4 (CYP3A4). In individuals with obesity, the 2 mg DST was not superior to the 1 mg DST in regard to serum cortisol levels. However, in some patients, particularly with poorly controlled diabetes or medication interacting with CYP3A4 and without adequate suppression after the 1 mg DST, the 2 mg DST might prove helpful to reduce the false-positive rate for CS. ClinicalTrials.gov Number: NCT02227420

scholarly journals Salivary Cortisol Determination in ACTH Stimulation Test to Diagnose Adrenal Insufficiency in Patients with Liver Cirrhosis

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Lara Albert ◽  
Joaquím Profitós ◽  
Jordi Sánchez-Delgado ◽  
Ismael Capel ◽  
José Miguel González-Clemente ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Adrenal Insufficiency ◽  
Salivary Cortisol ◽  
Serum Cortisol ◽  
Stimulation Test ◽  
Decompensated Cirrhosis ◽  
Acth Test ◽  
Acth Stimulation Test ◽  
Acth Stimulation ◽  
Cirrhotic Patients

Purpose. The prevalence of adrenal insufficiency (AI) in patients with decompensated liver cirrhosis is unknown. Because these patients have lower levels of cortisol-binding carrier proteins, their total serum cortisol (TSC) correlates poorly with free serum cortisol (FC). Salivary cortisol (SaC) correlates better with FC. We aimed to establish SaC thresholds for AI for the 250 μg intravenous ACTH test and to estimate the prevalence of AI in noncritically ill cirrhotic patients. Methods. We included 39 patients with decompensated cirrhosis, 39 patients with known AI, and 45 healthy volunteers. After subjects fasted ≥8 hours, serum and saliva samples were collected for determinations of TSC and SaC at baseline 0’(T0) and at 30-minute intervals after intravenous administration of 250 μg ACTH [30’(T30), 60’(T60), and 90’(T90)]. Results. Based on the findings in healthy subjects and patients with known AI, we defined AI in cirrhotic patients as SaC-T0< 0.08 μg/dL (2.2 nmol/L), SaC-T60 < 1.43 μg/dl (39.5 nmol/L), or ΔSaC<1 μg/dl (27.6 nmol/L). We compared AI determination in cirrhotic patients with the ACTH test using these SaC thresholds versus established TSC thresholds (TSC-T0< 9 μg/dl [248 nmol/L], TSC-T60 < 18 μg/dl [497 nmol/L], or ΔTSC<9 μg/dl [248 nmol/L]). SaC correlated well with TSC. The prevalence of AI in cirrhotic patients was higher when determined by TSC (48.7%) than by SaC (30.8%); however, this difference did not reach statistical significance. AI was associated with sex, cirrhosis etiology, and Child-Pugh classification. Conclusions. Measuring SaC was more accurate than TSC in the ACTH stimulation test. Measuring TSC overestimated the prevalence of AI in noncritically ill cirrhotic patients.

Is the Correlation between Salivary Cortisol and Serum Cortisol Reliable Enough to Enable Use of Salivary Cortisol Levels in Preterm Infants?

2017 ◽  
Vol 34 (13) ◽  
pp. 1302-1305
Author(s):  
Katherine Wynne-Edwards ◽  
Parthiv Amin ◽  
Ruokun Zhou ◽  
Arun Sundaram ◽  
Tania Martinez-Soto ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Preterm Infants ◽  
Salivary Cortisol ◽  
Saliva Sample ◽  
Serum Cortisol ◽  
Relative Adrenal Insufficiency ◽  
Free Cortisol ◽  
Cortisol Levels ◽  
Paired Serum ◽  
Gestational Age At Birth

Background Newborn premature infants are susceptible to development of relative adrenal insufficiency following transition from fetal to extrauterine life. However, the best diagnostic test for adrenal insufficiency in neonates has yet to be developed. Objectives and Methods The aim of this study was (1) to assess the feasibility of obtaining sufficient saliva sample to allow measurement of cortisol by liquid chromatography coupled to tandem mass spectrometry and (2) to assess the correlation, if any, between salivary and serum cortisol in preterm infants of ≤32 weeks' gestational age at birth. Results Samples for 230 paired serum and saliva cortisol levels from 90 preterm infants were analyzed. 87.5% of samples collected had sufficient salivary volumes for measurement. Despite being statistically significant (p < 0.0001), the correlation (Spearman r = 0.674) between serum and salivary cortisol was not strong. Conclusion Salivary free cortisol measurement is feasible but cannot be used to accurately reflect serum total cortisol. Further studies comparing salivary free cortisol to serum free cortisol and establishing normative data are needed before salivary cortisol can be used for diagnostic purposes.

scholarly journals Is There Value in Routine Screening for Cushing’s Syndrome in Patients with Diabetes?

2010 ◽  
Vol 95 (5) ◽  
pp. 2262-2265 ◽  
Author(s):  
K. Mullan ◽  
N. Black ◽  
A. Thiraviaraj ◽  
P. M. Bell ◽  
C. Burgess ◽  
...  
Keyword(s):  
Clinical Features ◽  
Cushing’S Syndrome ◽  
Salivary Cortisol ◽  
Serum Cortisol ◽  
Cushing's Syndrome ◽  
Diabetic Patients ◽  
Diabetes Clinic ◽  
Free Cortisol ◽  
Cortisol Levels ◽  
Dexamethasone Test

Abstract Context: Subclinical Cushing’s syndrome has been described among diabetic populations in recent years, but no consensus has emerged about the value of screening. Methods: We enrolled 201 consecutive patients attending our diabetes clinic and 79 controls. Patients with at least two of the following three criteria were offered screening using a 2300 h salivary cortisol test: glycosylated hemoglobin of at least 7%, body mass index of at least 25 kg/m2, and a history of hypertension or blood pressure of at least 140/90 mm Hg. Results are expressed as mean ± sem. Results: Mean nighttime salivary cortisol levels were similar in the two groups (8.5 ± 1.0 nmol/liter for diabetic patients vs. 5.8 ± 1.0 nmol/liter for controls). Forty-seven patients (23%) had a value of at least 10 nmol/liter, which was set as a conservative threshold above which further investigation would be performed. Thirty-five (75%) agreed to further testing with a 1-mg overnight dexamethasone test. Of the remaining 12 patients, 10 were followed up clinically for at least 1 yr, and no evidence was found of the syndrome evolving. In 28 patients, serum cortisol suppressed to 60 nmol/liter or less. Of the seven patients who failed this test, four agreed to a 2 mg/d 48-h dexamethasone test, with serum cortisol suppressing to 60 nmol/liter or less in all four. Three declined this test but had normal 24-h urinary free cortisol levels. No patient had clinical features of hypercortisolism. Conclusions: The 1–3% detection rates of three recently published series have not been realized at our center where we studied a group using criteria making patients more likely to have hypercortisolism. Our results do not support the validity of screening patients without clinical features of Cushing’s syndrome in the diabetes clinic.

scholarly journals Comparison of Total and Salivary Cortisol in a Low-Dose ACTH (Synacthen) Test: Influence of Three-Month Oral Contraceptives Administration to Healthy Women

2008 ◽  
pp. S193-S199
Author(s):  
K Šimůnková ◽  
L Stárka ◽  
M Hill ◽  
L Kříž ◽  
R Hampl ◽  
...  
Keyword(s):  
Salivary Cortisol ◽  
Adrenocorticotropic Hormone ◽  
Low Dose ◽  
Serum Cortisol ◽  
Acth Test ◽  
Basal Serum ◽  
Free Cortisol ◽  
Synacthen Test ◽  
Significant Change ◽  
Calculated Free Cortisol

The objective of this study was to evaluate the influence of low-dose combined oral contraception (COC) on basal and stimulated (1 microg ACTH test) levels of serum and salivary cortisol (F), cortisone and on basal serum cortisol binding globulin (CBG), adrenocorticotropic hormone (ACTH), dehydroepiadrosterone (DHEA) and calculated free cortisol in healthy young women. Three-month administration of COC resulted in 1) significant increase of basal (454.0+/-125.0 to 860.9+/-179.7 nmol/l) and ACTH-stimulated serum cortisol in 30th min (652.3+/-60.5 to 1374.1+/-240.6 nmol/l); 2) no significant change of basal (15.4+/-7.3 to 18.9+/-8.5 nmol/l) and ACTH-stimulated salivary cortisol at the 30th min (32.4+/-8.8 to 32.9+/-9.0 nmol/l); 3) no significant change of basal serum cortisone (38,8+/-7.68 to 45.2+/-24.2 nmol/l) and ACTH-stimulated cortisone at the 30th (34.8+/-10.9 to 47.0+/-35.7 nmol/l); 4) significant increase of basal ACTH (17.2+/-9.0 to 38.2+/-29.4 ng/l), CBG (991.0+/-161.0 to 2332.0+/-428.0 nmol/l), and 5) no significant change of basal DHEA (24.6+/-15.7 to 22.6+/-11.7 micromol/l) and calculated basal value for free cortisol (22.8+/-14.9 to 19.2+/-6.9 nmol/l). In conclusions, higher basal and ACTH-stimulated serum cortisol were found after three-month administration of COC, while basal and stimulated salivary cortisol were not significantly affected. Therefore, salivary cortisol can be used for assessment of adrenal function in women regularly using COC.

The effect of dairy products and non-dairy snacks on food intake, subjective appetite and cortisol levels in children: A randomized control study.

2021 ◽  
Author(s):  
Brandon Gheller ◽  
Athena Li ◽  
Mary Gheller ◽  
Tove Armstrong ◽  
Erik Vandenboer ◽  
...  
Keyword(s):  
Food Intake ◽  
Salivary Cortisol ◽  
Repeated Measures ◽  
Potato Chips ◽  
Short Term ◽  
Study Session ◽  
Cortisol Levels ◽  
Semi Solid ◽  
Snack Consumption ◽  
Control Study

Dairy snacks are available in various physical forms and their consumption is linked to improved metabolic health. The objective of this study was to determine the effect of dairy snacks of different physical forms on short-term food intake (FI), subjective appetite, and the stress hormone, cortisol, in children. Following a repeated-measures crossover design, 40 children aged 9-14 y randomly consumed one of five isoenergetic (180 kcal) snacks per study session. These snacks included solid: potato chips, cookies, and cheese, semi-solid: Greek yogurt, and fluid: 2% fat milk snacks. FI was measured 120 min after snack consumption. Subjective appetite was measured at 0 (immediately before the snack), 15, 30, 45, 60, 90, and 120 min. Salivary cortisol (n=18) was measured after the Greek yogurt and cookie snacks at 0 , 30, 60, 90, and 120 min. FI did not differ between snacks (P=0.15). The Greek yogurt (P<0.0001) and cheese (P=0.0009) snacks reduced average appetite compared to the 2% fat milk snack. Salivary cortisol levels were not affected by snack (P=0.84). This study demonstrates that dairy snacks are as effective as other popular snacks at influencing subsequent FI however, solid and semi-solid dairy snacks are more effective at repressing subjective appetite than a fluid dairy snack. Registered at clinicaltrials.gov (NCT02484625). Novelty bullets: • Milk, Greek yogurt and cheese has a similar effect on short-term food intake in children as popular potato chips and cookies. • Solid, semi-solid and liquid snacks have a similar effect on short-term food intake in children.

Comparison of Salivary Cortisol, Serum Cortisol, Plasma ACTH and Urinary Free Cortisol Levels in Thyrotoxic and Hypothyroid Patients

2012 ◽  
Vol 32 (1) ◽  
pp. 54-58
Author(s):  
Mustafa Sait GÖNEN ◽  
Emin ÖZKAYA ◽  
Sevil KURBAN ◽  
Süleyman Hilmi İPEKCİ ◽  
Cevdet DURAN ◽  
...  
Keyword(s):  
Salivary Cortisol ◽  
Serum Cortisol ◽  
Urinary Free Cortisol ◽  
Plasma Acth ◽  
Free Cortisol ◽  
Cortisol Levels ◽  
Hypothyroid Patients

Effect of sleep apnea syndrome on the circadian profile of cortisol in obese men

2007 ◽  
Vol 293 (2) ◽  
pp. E466-E474 ◽  
Author(s):  
F. Dadoun ◽  
P. Darmon ◽  
V. Achard ◽  
S. Boullu-Ciocca ◽  
F. Philip-Joet ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Salivary Cortisol ◽  
Repeated Measures ◽  
Plasma Cortisol ◽  
Sleep Apnea Syndrome ◽  
Visceral Obesity ◽  
Normal Weight ◽  
Apnea Hypopnea Index ◽  
Apnea Syndrome ◽  
Cortisol Levels

It has been hypothesized that sleep apnea syndrome (SAS) increases hypothalamic-pituitary-adrenal axis activity and, through increased cortisol levels, participates in the pathophysiology of metabolic and cardiovascular complications. We compared the circadian profiles of cortisol in obese men with [obSAS+; apnea-hypopnea index (AHI) ≥ 20/h] and without SAS (obSAS−; AHI ≤ 5/h). 1) Salivary cortisol (5 samples: before/30 min after dinner, 2100, upon/30 min after awakening) was measured in 15 obSAS+, 19 obSAS−, and 19 normal-weight controls (NWC). 2) Plasma cortisol (every 30 min for 24 h under highly controlled conditions and portable EEG device) was measured in 9 obSAS+, 8 obSAS−, and 10 NWC men. Visceral adipose tissue surface was measured by CT scan. In both studies, obSAS+ and obSAS− men were comparable for age, BMI, waist circumference, and waist-to-hip ratio. First, no difference was found, using ANOVA for repeated measures, between obSAS+ and obSAS− subjects for any salivary cortisol measurement. No correlation was found between salivary cortisol and AHI or nocturnal SaO2. Similarly, obSAS+ and obSAS− men showed no difference in plasma cortisol rhythmicity: 24-h minimum, maximum, and mean, ANOVA for repeated measures, mathematical modeling of cortisol rhythm (COSINOR), and morning secretory peak. Conversely, ANOVA for repeated measures showed decreased cortisol levels in obese vs. NWC men during both the trough (2200–0130) and the peak (0600–0900) independently of SAS status. We show that SAS per se is not associated with any change of the level or of the features of salivary and plasma cortisol rhythmicity and confirm that men with visceral obesity display lower plasma cortisol levels than NWC men.

Sign in / Sign up

Export Citation Format

Share Document