Salivary Cortisol and Cortisone Can Circumvent Confounding Effects of Oral Contraceptives in the Short Synacthen Test
Authors' conclusion
Salivary cortisol and especially salivary cortisone are considerably less affected by COC use than plasma cortisol during SST. Due to similar LRLs, a common cutoff for salivary cortisol and cortisone during SST can be used to exclude AI in premenopausal women irrespective of COC use.
Study context
- Population
- Healthy premenopausal women undergoing short Synacthen test (SST) with plasma and salivary samples at 0, 30 and 60 minutes after Synacthen injection
- Participants
- 41 vs 46
- Exposure
- Healthy women on COCs vs healthy women without exogenous estrogens
- COCn = 41
- Controlsn = 46reference
- Outcome
- Whether salivary cortisol or cortisone during SST is more robust against the COC effect; LRLs as tentative diagnostic cutoffs to exclude adrenal insufficiency (AI)
- Follow-up
- 0, 30 and 60 minutes after Synacthen
Main finding
As reported in the abstract
SST-stimulated cortisol and cortisone levels and LRLs
- SST-stimulated plasma cortisol significantly higher in COC vs controls
- Mean salivary cortisol and cortisone slightly lower in COC
- COC use did not significantly alter lower reference limits (LRLs) for salivary cortisol or cortisone
- Smallest LRL difference between groups for salivary cortisone
- Regression analysis with age as covariate; LRLs calculated parametrically
Observational data: associations, not effects.
Original publication
Salivary Cortisol and Cortisone Can Circumvent Confounding Effects of Oral Contraceptives in the Short Synacthen Test. J Clin Endocrinol Metab. Published 4 January 2024. doi:10.
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