Salivary Cortisol Response to ACTH Stimulation Is a Reliable Alternative to Serum Cortisol in Evaluating Hypoadrenalism
Authors' conclusion
Salivary cortisol response to ACTH stimulation offers a reliable alternative to serum and may be especially useful in conditions of altered CBG concentration.
Study context
- Population
- Healthy volunteers, patients with altered cortisol-binding globulin (CBG) concentrations and patients with suspected hypoadrenalism
- Participants
- 139 / 24 / 10 / 30
- Comparison
- 30-min salivary cortisol response to ACTH stimulation vs serum cortisol response
- Healthy volunteersn = 139reference
- OCP-femalesn = 24
- LP-patientsn = 10
- SH-patientsn = 30
- Outcome
- 30-minute salivary cortisol response to ACTH stimulation (mean and LRL, mean-1.96 SD, from log-transformed concentrations)
- Follow-up
- 30 minutes
Methodological details250 µg ACTH stimulation test, LC-MS/MS salivary cortisol
- 250 µg ACTH stimulation test
- LC-MS/MS salivary cortisol
Performance
As reported in the abstract
30-minute salivary cortisol concentration
OCP-females vs Healthy volunteers: P = 0.59 · LP-patients vs Healthy volunteers: P = 0.97
Further findings
Mean, mg/L
| Outcome | OCP-females | LP-patients |
|---|---|---|
| Mean CBG concentration (range) | 116 (range 84–159) | 41 (range 28–60) |
- Mean CBG concentration (range): Males mean 58 (range 42–81) mg/L
- Mean CBG concentration (range): Females mean 64 (range 43–95) mg/L
Diagnostic agreement between salivary and serum responses in SH-patients (lower reference limit (LRL) as cut-off)
- Overall diagnostic agreement
- 79%
Original publication
Salivary Cortisol Response to ACTH Stimulation Is a Reliable Alternative to Serum Cortisol in Evaluating Hypoadrenalism. J Clin Endocrinol Metab. Published 28 September 2023. doi:10.
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