Cetinkaya Semra, Ozon Alev, Yordam Nursen
Department of Pediatric Endocrinology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Horm Res. 2007;67(6):301-6. doi: 10.1159/000100363. Epub 2007 Feb 28.
It has been shown that the free cortisol level in saliva may reflect plasma free cortisol. The measurement of cortisol in saliva is a simple method, and as such it is important in the pediatric age group. In this research, the diagnostic value of measurement of salivary cortisol (SC) measurement was examined in adrenal insufficiency (AI).
Fifty-one patients, mean age 10.8 +/- 4.29, who were investigated for possible AI, were included. Basal cortisol levels were below 18 microg/dl. Adrenal function was determined by low-dose ACTH test. During the test, samples for SC were obtained simultaneously with serum samples (at 0-10-20-30-40 min).
Mean basal serum cortisol level was 8.21 +/- 4.10 microg/dl (mean +/- SD). Basal SC was correlated to basal serum cortisol (r = 0.64, p < 0.001). A cut-off of 0.94 microg/dl for SC differentiated adrenal insufficient subjects from normals with a sensitivity and specificity of 80 and 77%, respectively. A peak SC less than 0.62 microg/dl defined AI with a specificity of 100%; however, sensitivity was 44%.
Measurement of SC may be used in the evaluation of AI. It is well-correlated to serum cortisol. Peak SC in low-dose ACTH test can be used to differentiate patients with AI in the initial evaluation of individuals with suspected AI.
研究表明，唾液中游离皮质醇水平可反映血浆游离皮质醇水平。唾液皮质醇检测是一种简单的方法，在儿科年龄组中具有重要意义。本研究探讨了唾液皮质醇（SC）检测在肾上腺功能不全（AI）中的诊断价值。
纳入51例平均年龄为10.8±4.29岁、因可能患有AI而接受检查的患者。基础皮质醇水平低于18μg/dl。通过低剂量促肾上腺皮质激素（ACTH）试验测定肾上腺功能。试验期间，在0、10、20、30、40分钟时同时采集SC样本和血清样本。
基础血清皮质醇平均水平为8.21±4.10μg/dl（平均值±标准差）。基础SC与基础血清皮质醇相关（r = 0.64，p < 0.001）。以0.94μg/dl为SC的临界值可区分肾上腺功能不全患者与正常人群，敏感性和特异性分别为80%和77%。SC峰值低于0.62μg/dl诊断AI的特异性为100%；然而，敏感性为44%。
SC检测可用于AI的评估。它与血清皮质醇相关性良好。低剂量ACTH试验中的SC峰值可用于在疑似AI个体的初始评估中鉴别AI患者。
