Abstract
OBJECTIVE
Measurement of Cortisol levels in saliva is a marker of free hormone. How salivary Cortisol rhythm is affected by age, gender, the metabolic syndrome and estrogen-progestin therapy was evaluated in a community sample of adults.
SUBJECTS AND METHODS
One hundred twenty volunteers recruited from the Hospital staff and family members of the Endocrinology Unit were instructed to collect 7 salivary samples: the first on awakening (F0) and 6 more (F1.5, F5, F6, F10, F11.5 and F14) over the next 14 hours. Each volunteer also underwent a complete physical evaluation and a comprehensive medical history was taken. Salivary Cortisol was measured using a radioimmunometric assay. Daily Cortisol secretion was evaluated computing the Area Under the Curve (AUCF0→F14); the F14/F0 ratio was calculated as a marker of Cortisol rhythm.
RESULTS
Median F14 levels were higher in the subjects in the third tertile of age than in those falling in the second or in the first age tertile (respectively, 2.09 vs 1.33 vs 1.25 ng/mL, p=0.023 and p=0.006), in the hypertensive volunteers (2.44 vs 1.44 ng/mL, p=0.030) and in those with the metabolic syndrome (2.95 vs 1.4 ng/mL, p=0.002), with an elevated median F14/F0 ratio (0.48 vs 0.19, p=0.006). According to the Kruskal-Wallis analysis of variance, the most important factor affecting F14 value was age (p=0.001). AUCF0→F14 was not influenced by gender, age, metabolic syndrome or estrogen-progestin therapy.
CONCLUSIONS
While it did not affect the daily Cortisol rate, late-night salivary cortisol levels were found to be increased in the subjects in the higher age tertile and in those with the metabolic syndrome.
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References
Lederbogen F, Kühner C, Kirschbaum C, et al, 2010 Salivary Cortisol in a middle-aged community sample: results from 990 men and women of the KORA-F3 Augsburg study. Eur J Endocrinol 163: 443–451.
Casella E, 1968 Variations in the salivary concentrations of Cortisol and cortisone in normal women and during pregnancy. Dental Cadmos 36: 1623–1639.
Raff H, 2012 Cushing’s syndrome: diagnosis and surveillance using salivary Cortisol. Pituitary 15: 64–70.
Ceccato F, Albiger N, Reimondo G, et al, 2012 Assessment of glucocorticoid therapy with salivary Cortisol in secondary adrenal insufficiency. Eur J Endocrinol 167: 769–776.
Champaneri S, Xu X, Carnethon MR, et al, 2013 Diurnal salivary Cortisol is associated with body mass index and waist circumference: the Multiethnic Study of Atherosclerosis. Obesity 21: E56–E63.
Goodman MP, 2012 Are all estrogens created equal? A review of oral vs. transdermal therapy. J Womens (Larchmt) Health 21: 161–169.
Manetti L, Rossi G, Grasso L, et al, 2013 Usefulness of salivary Cortisol in the diagnosis of hypercortisolism: comparison with serum and urinary Cortisol. Eur J Endocrinol 168: 315–321.
Waist Circumference and Waist-Hip Ratio Report of a WHO Expert Consultation 2008, available at http://whqlibdoc.who.int/publications/2011/9789241501491_eng.pdf
Alberti KG, Eckel RH, Grundy SM, et al, 2009 Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120: 1640–1645.
Pruessner JC, Kirschbaum C, Meinlschmid G, et al, 2003 Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology 28: 916–931.
Ceccato F, Barbot M, Zilio M, et al, 2013 Performance of salivary Cortisol in the diagnosis of Cushing’s syndrome, adrenal incidentaloma, and adrenal insufficiency. Eur J Endocrinol 169: 31–36.
Antonelli G, Artusi C, Marinova M, et al, 2014 Cortisol and cortisone ratio in urine: LC-MS/MS method validation and preliminary clinical application. Clin Chem Lab Med 52: 213–220.
Grossman AB, 2010 The Diagnosis and Management of Central Hypoadrenalism. J Clin Endocrinol Metab 95: 4855–4863.
Debono M, Price JN, Ross RJ, 2009 Novel strategies for hydrocortisone replacement. Best Pract Res Clin Endocrinol Metab 23: 221–232.
Peeters GM, van Schoor NM, van Rossum EF, et al, 2008 The relationship between Cortisol, muscle mass and muscle strength in older persons and the role of genetic variations in the glucocorticoid receptor. Clin Endocrinol 69: 673–682.
Nater UM, Hoppmann CA, Scott SB, 2013 Diurnal profiles of salivary Cortisol and alpha-amylase change across the adult lifespan: Evidence from repeated daily life assessments. Psychoneuroendocrinology 38: 3167–3171.
Pecori Giraldi F, Ambrogi AG, De Martin M et al, 2007 Specificity of first-line tests for the diagnosis of Cushing’s syndrome: assessment in a large series. J Clin Endocrinol Metab 92: 4123–4129.
Ceccato F, Antonelli G, Barbot M, et al, 2014 The diagnostic performance of urinary free Cortisol is better than the cortisol/cortisone ratio in detecting de novo Cushing’s syndrome: the use of a LC-MS/MS method in routine clinical practice. Eur J Endocrinol 171: 1–7.
Plat L, Leproult R, L’Hermite-Baleriaux M, et al, 1999 Metabolic effects of short-term elevations of plasma Cortisol are more pronounced in the evening than in the morning. J Clin Endocrinol Metab 84: 3082–3092.
Iacobone M, Citton M, Viel G, et al, 2012 Adrenalectomy may improve cardiovascular and metabolic impairment and ameliorate quality of life in patients with adrenal incidentalomas and subclinical Cushing’s syndrome. Surgery 152: 991–997.
Chiodini I, Morelli V, Salcuni AS, et al, 2010 Beneficial metabolic effects of prompt surgical treatment in patients with an adrenal incidentaloma causing biochemical hypercortisolism. J Clin Endocrinol Metab 95: 2736–2745.
Eckel RH, Grundy SM, Zimmet PZ, 2005 The metabolic syndrome. Lancet 365: 1415–1428.
Nieman LK, Biller BM, Findling JW, et al, 2008 The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 93: 1526–1540.
Carroll T, Raff H, Findling JW, 2009 Late-night salivary Cortisol for the diagnosis of Cushing syndrome: a meta-analysis. Endocr Pract 15: 335–342.
Terzolo M, Stigliano A, Chiodini I, et al, 2011 AME position statement on adrenal incidentaloma. Eur J Endocrinol 164: 851–870.
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Ceccato, F., Barbot, M., Zilio, M. et al. Age and the metabolic syndrome affect salivary Cortisol rhythm: data from a community sample. Hormones 14, 392–398 (2015). https://doi.org/10.14310/horm.2002.1591
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DOI: https://doi.org/10.14310/horm.2002.1591