SFEBES2009 Poster Presentations Clinical practice/governance and case reports (96 abstracts)
Salivary cortisol is a reliable marker to monitor hydrocortisone replacement
Bharat Pahilwani 1 , Sarah Darch 2 , Radha Ramachandran 1 , Jaimini Cegla 1 , Monica Nijher 1 , Karim Meeran 1 , Richard Chapman 2 , Mandy Donaldson 2 & Tricia Tan 1
1Department of Investigative Medicine, Imperial College, London, UK; 2Department of Clinical Biochemistry, Imperial College Healthcare NHS Trust, London, UK.
Context: Hydrocortisone day curves (HCDC) are used to monitor hydrocortisone replacement by obtaining serum samples to measure cortisol levels throughout the day. Salivary measurement of free cortisol offers a non-invasive alternative to serum measurements.
Objective: To validate salivary cortisol measurement as an alternative method to assess the adequacy of hydrocortisone replacement in patients with hypoadrenalism.
Setting, patients, and design: Dual-centre cross-sectional study of 23 patients, taking hydrocortisone for hypoadrenalism and admitted for a HCDC to day-case clinical investigation centres (09/H0711/7). Simultaneous blood and saliva samples were obtained to determine total and free cortisol, respectively.
Outcome measures: Serum free cortisol was estimated using measurements of total serum cortisol, corticosteroid-binding globulin, albumin and previously validated mass-action formulae. Salivary cortisol levels were also measured in 24 healthy volunteers to determine a control profile.
Results: Serum total and salivary free cortisol correlated well (Spearman r=0.850, P<0.0001). Salivary free cortisol correlated well with estimated serum free cortisol calculated by the Coolens formula (r=0.8764, P<0.0001) and the Dorin formula (r=0.8635, P<0.0001). Salivary cortisol measurements were significantly higher in patients than controls in the samples taken after doses of hydrocortisone but not significantly different in the samples taken before doses of hydrocortisone.
Conclusion: Salivary cortisol measurements offer a more cost–effective, non-invasive and well tolerated alternative to serum cortisol during HCDC.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more