SALIVARY CORTISOL LEVELS IN TRUE AND APPARENT HYPERCORTISOLISM
| Autor: | J. R. Peters, R. Hall, J. Dyas, P J Evans, D. Riad-Fahmy, R. F. Walker |
|---|---|
| Rok vydání: | 1984 |
| Předmět: |
Adult
Male Saliva medicine.medical_specialty Hydrocortisone Globulin Metabolic Clearance Rate Pregnancy Trimester Third Endocrinology Diabetes and Metabolism Dexamethasone Endocrinology Dexamethasone Sodium Phosphate Pregnancy Internal medicine medicine Humans Circadian rhythm Cushing Syndrome biology business.industry Middle Aged medicine.disease Adrenal Cortex Neoplasms Circadian Rhythm Depression Chemical Dexamethasone suppression test Adrenal Cortex biology.protein Female Pituitary-Adrenal Function Tests business Protein Binding medicine.drug |
| Zdroj: | Clinical Endocrinology. 20:709-715 |
| ISSN: | 1365-2265 0300-0664 |
| DOI: | 10.1111/j.1365-2265.1984.tb00121.x |
| Popis: | Total plasma cortisol measurements may be misleading when there are variations in the plasma cortisol-binding protein capacity resulting from drugs, pregnancy or congenital alterations in cortisol-binding globulin (CBG). Salivary cortisol levels, which represent the free component of plasma cortisol, are less affected by alterations in protein binding and have been used in the investigation of hypothalamic-pituitary-adrenal disorders. This study compares these two indices of adrenal function in conditions of true hypercortisolism and spurious hypercortisolism (resulting from oral contraceptive medication or pregnancy). The circadian variation of cortisol in plasma and saliva was studied in six patients with unequivocal hypercortisolism and compared with normal volunteers. In the normal group, plasma and salivary cortisol levels taken at 0900 h were significantly higher than those taken at 2400 h. Patients with Cushing's syndrome failed to show a significant difference between plasma and salivary cortisol levels collected at 0900 and 2400 h. Five patients with pituitary-dependent Cushing's disease, one patient with an adrenal carcinoma causing Cushing's syndrome and seven normal subjects each received a dexamethasone suppression test using a continuous infusion of dexamethasone sodium phosphate at a rate of 1 mg/h. There was no significant difference in the half-life disappearance rate of endogenous cortisol in either plasma or saliva comparing grouped data from patients with pituitary-dependent Cushing's disease with that of normal subjects. Failure of suppression of both plasma and salivary cortisol levels was observed in the one patient with adrenal carcinoma during dexamethasone infusion.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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