The Journal of clinical endocrinology and metabolism
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J. Clin. Endocrinol. Metab. · Aug 2007
Measurement of salivary cortisol concentration in the assessment of adrenal function in critically ill subjects: a surrogate marker of the circulating free cortisol.
Baseline and cosyntropin-stimulated serum (total and free) and salivary cortisol concentrations were measured, in the early afternoon, in 51 critically ill patients and healthy subjects. Patients were stratified according to their serum albumin at the time of testing: those whose serum albumin levels were 2.5 gm/dl or less vs. others whose levels were greater than 2.5 gm/dl. ⋯ Salivary cortisol measurements are simple to obtain, easy to measure in most laboratories, and provide an indirect yet reliable and practical assessment of the serum free cortisol concentrations during critical illnesses. The concentrations of the two measures of unbound cortisol determined in two different body fluids correlated very well, regardless of the serum protein concentrations. Measurements of salivary cortisol can serve as a surrogate marker for the free cortisol in the circulation.