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Salivary cortisol in low dose (1 mu g) ACTH test in healthy women: comparison with serum cortisol

机译:健康女性低剂量唾液皮质醇(1μg)ACTH测试:与血清皮质醇的比较

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摘要

To date, a single report has appeared on the use of salivary cortisol for adrenal function testing with a low dose ACTH, although 1 mu g has become preferred as a more physiological stimulus than the commonly used 250 mu g ACTH test. Our present study was aimed to obtain physiological data on changes of free salivary cortisol after 1 mu g ACTH stimulation. This approach was compared with the common method based on the changes of total serum cortisol. Intravenous, low-dose ACTH test was performed in 15 healthy women (aged 22-40 years) with normal body weight, not using hormonal contraceptives, in the follicular phase of the menstrual cycle. Blood and saliva for determination of cortisol were collected before ACTH administration and 30 and 60 min after ACTH administration. Basal concentration of salivary cortisol (mean +/- S. E. M., 15.9 +/- 1.96 nmol/l) increased after 1 mu g ACTH to 29.1 +/- 2.01 nmol/l after 30 min, and to 27.4 +/- 2.15 nmol/l after 60 min. The differences between basal and stimulated values were highly significant (p< 0.0001). The values of salivary cortisol displayed very little interindividual variability (p< 0.04) in contrast to total serum cortisol values (p< 0.0001) A comparison of areas under the curve (AUC) related to initial values indicated significantly higher AUC values for salivary cortisol than for total serum cortisol (1.89 +/- 0.88 vs. 1.22 +/- 0.19, p< 0.01). Correlation analysis of serum and salivary cortisol levels showed a borderline relationship between basal levels (r= 0.5183, p= 0.0525); correlations after stimulation were not significant. Low-dose ACTH administration appeared as a sufficient stimulus for increasing salivary cortisol to a range considered as a normal adrenal functional reserve.
机译:迄今为止,关于唾液皮质醇用于低剂量ACTH的肾上腺功能测试的报道只有一个,尽管比起通常使用的250μgACTH测试,1μg的生理刺激性更受欢迎。我们目前的研究旨在获得1μgACTH刺激后游离唾液皮质醇变化的生理数据。将该方法与基于总血清皮质醇变化的常用方法进行了比较。在月经周期的卵泡期,对15例体重正常,未使用激素避孕药的健康女性(22-40岁)进行了静脉低剂量ACTH测试。在ACTH给药前以及ACTH给药后30和60分钟收集血液和唾液以测定皮质醇。 1克ACTH后唾液皮质醇的基础浓度(平均+/- SEM,15.9 +/- 1.96 nmol / l)在30分钟后增加到29.1 +/- 2.01 nmol / l,并​​增加到27.4 +/- 2.15 nmol / l 60分钟后基础值和刺激值之间的差异非常显着(p <0.0001)。与总血清皮质醇值(p <0.0001)相比,唾液皮质醇的值几乎没有个体差异(p <0.04)。与初始值相关的曲线下面积(AUC)的比较表明,唾液皮质醇的AUC值明显高于总血清皮质醇水平(1.89 +/- 0.88与1.22 +/- 0.19,p <0.01)。血清和唾液皮质醇水平的相关性分析显示,基础水平之间存在临界关系(r = 0.5183,p = 0.0525)。刺激后的相关性不显着。低剂量ACTH给药似乎是将唾液皮质醇增加到正常肾上腺功能储备范围的足够刺激。

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