Meulenberg P M, Hofman J A
Department of Experimental and Chemical Endocrinology, St. Radboud University Hospital, Nijmegen, The Netherlands.
Clin Chem. 1990 Jan;36(1):70-5.
We measured cortisol and cortisone in plasma--both total and free--and in saliva during the course of pregnancy and postpartum. Antepartum and postpartum concentrations and morning and afternoon concentrations of both steroids were compared. The mean concentrations of cortisol and cortisone increased towards term and were significantly greater at the end of pregnancy than postpartum, except for free cortisol in plasma in the afternoon. The daily rhythm of both steroids was maintained throughout pregnancy and postpartum. The correlations between salivary and plasma free concentrations of cortisol and cortisone as well as of the sum of cortisol + cortisone were highly significant. The mean concentrations of cortisone in saliva accurately reflected both total and free concentrations in plasma. For cortisol, however, the change of the concentrations in saliva, was somewhat different from that in plasma. Moreover, the mass ratio of plasma free cortisol to salivary cortisol was about 2, whereas for cortisone the ratio was only about 0.5, probably owing to the conversion of cortisol to cortisone by 11 beta-hydroxysteroid dehydrogenase in the salivary gland. Furthermore, the passage of cortisol and cortisone from plasma to saliva should not be regarded as simple diffusion, because in the first half of pregnancy the sum of the concentrations of cortisol + cortisone in saliva significantly exceeded the sum of their free concentrations in plasma.
我们在孕期及产后测量了血浆（包括总皮质醇和皮质酮以及游离皮质醇和皮质酮）和唾液中的皮质醇及皮质酮。比较了产前和产后以及上午和下午两种类固醇的浓度。皮质醇和皮质酮的平均浓度在接近足月时升高，且除下午血浆中的游离皮质醇外，妊娠末期的浓度显著高于产后。整个孕期及产后两种类固醇的日节律均得以维持。唾液与血浆中皮质醇、皮质酮以及皮质醇 + 皮质酮总和的游离浓度之间的相关性非常显著。唾液中皮质酮的平均浓度准确反映了血浆中的总浓度和游离浓度。然而，对于皮质醇，唾液中浓度的变化与血浆中的有所不同。此外，血浆游离皮质醇与唾液皮质醇的质量比约为2，而皮质酮的该比值仅约为0.5，这可能是由于唾液腺中11β - 羟基类固醇脱氢酶将皮质醇转化为皮质酮所致。此外，皮质醇和皮质酮从血浆到唾液的过程不应被视为简单扩散，因为在妊娠前半期，唾液中皮质醇 + 皮质酮的浓度总和显著超过其血浆游离浓度总和。
