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). However, salivary cortisol may be falsely elevated due to preanalytical errors including liquorice consumption and contamination with dermal hydrocortisone or blood in the saliva sample ( 11 , 12 , 13 ). Salivary cortisone might be less sensitive to
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-hydroxysteroid dehydrogenase (11B-HSD2) which converts salivary cortisol to cortisone. The amount of salivary cortisone is significantly greater than salivary cortisol and an increased cortisol/cortisone ratio reflects exposure to both endogenous and exogenous cortisol
Department of Clinical Chemistry and Haematology, Zuyderland Medical Centre, Heerlen, The Netherlands
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and cortisone in one run. Possible interference of 11β-hydroxysteroid dehydrogenase-modulating agents can thus be evaluated. We investigated whether early morning salivary cortisol determined by LC–MS/MS could be used in the diagnosis of AI. In our
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-HC and 85–130% with DR-HC and for E 70–91% with conv-HC and 66–88% with DR-HC (both similar to controls: F 66–84%, E 32–62%). Table 1 Salivary cortisol (F), cortisone (E), cortisol-to-cortisone ratio (FEratio) levels and daily cortisol exposure
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this study was smaller compared to other existing studies. Lastly, salivary cortisone was not measured in this study. Salivary cortisol is converted to salivary cortisone by the 11β-hydroxysteroid dehydrogenase 2 enzyme that is present in high levels
Endocrine Disease Unit, University-Hospital of Padova, Padova, Italy
Department of Neuroscience DNS, University of Padova, Padova, Italy
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Laboratory Medicine, University-Hospital of Padova, Padova, Italy
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Endocrine Disease Unit, University-Hospital of Padova, Padova, Italy
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. Table 1 Basal and post-synacthen serum or salivary cortisol (F) and cortisone (E) levels. Data are expressed as means and s.e. Adrenal sufficient patients, n = 137 Central AI, n = 37 Normal HPA axis, n = 106 RAS, n
Division of Endocrinology, Division of Nephrology, Endocrine Research Laboratory, Department of Medicine
Division of Endocrinology, Division of Nephrology, Endocrine Research Laboratory, Department of Medicine
Division of Endocrinology, Division of Nephrology, Endocrine Research Laboratory, Department of Medicine
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. Journal of Clinical Endocrinology and Metabolism 1998 83 1163 – 1167 . ( doi:10.1210/jc.83.4.1163 ). 17 Raff H Singh RJ . Measurement of late night salivary cortisol and cortisone by liquid chromatography–tandem mass
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estriol) and precursor GCs, since the adrenocortical enzymes are not fully matured yet ( 5 ). Subsequently, during the last 6–8 weeks of pregnancy, the more matured fetal adrenal produces increasing amounts of cortisol and cortisone under the control of
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suspicion of endogenous Cushing's syndrome between February 2008 and March 2010. Subjects were instructed to take two tablets of 0.5 mg dexamethasone at 2300 h. The following morning, before eating and tooth brushing, they collected a salivary sample by
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. Secondary objectives Time to response. Dose–response relationship. Effect of metyrapone on levels of serum cortisol, UFC, salivary cortisol, ACTH, 11-deoxycortisol, total testosterone, androstenedione, DHEAS in terms of percent variation