Monitoring adrenal insufficiency through salivary steroids: a pilot study
Authors' conclusion
None of the GRTs mimics normal glucocorticoid rhythmicity and exposure. SalE, SalF, and Z-score may be useful markers for monitoring and comparing different GRTs. Excess glucocorticoid in early afternoon best associated with depressive symptoms and worse life and sleep quality.
Study context
- Population
- Adrenal insufficiency (AI) patients on GRT and control subjects; 9 saliva samples 07:00–23:00, SalF and SalE by liquid chromatography-mass spectrometry
- Participants
- 28 / 9 / 23 / 10 / 6
- Comparison
- Glucocorticoid replacement therapies vs control subjects
- CSsn = 28reference
- Hydrocortisone (HC)n = 9
- Cortisone acetate (CA)n = 23
- DRHC-odn = 10
- DRHC-tdn = 6
- Outcome
- Diurnal salivary glucocorticoid exposure (Z-scores) by GRT
Main finding
As reported in the abstract
- All glucocorticoid replacement therapies (GRTs) resulted in glucocorticoid overexposure in the morning vs controls
- HC, CA and DRHC-td caused overexposure also in afternoon and evening
- CA vs Other treatments: P < 0.001
- DRHC-td vs Other treatments: P = 0.007
- DRHC-od vs Other treatments: P = 0.015
Further findings
Predictors of questionnaire scores
- Z-scores-AUC14:00→16:00 threshold best predicting questionnaire scores
- ≥ .619
Original publication
Monitoring adrenal insufficiency through salivary steroids: a pilot study. Eur J Endocrinol. Published 4 April 2024. doi:10.
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