ارتباط بین سطح سرمی و بزاقی هورمون کورتیزول

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار و فوق تخصص غدد،

2 استاد و فوق تخصص غدد،

3 استادیار آسیب شناسی

چکیده

مقدمه: اندازه گیری کورتیزول بزاق، علی رغم اطمینان و ارزان بودن هنوز به صورت گسترده استفاده نمی شود. مفید بودن آن در بررسی فعالیت محور هیپوتالاموس- هیپوفیز- آدرنال در موارد مختلف کلینیکی اثبات شده است. مراکز مختلفی هنوز در مقابل استفاده از این روش مقاومت می کنند. هدف از این مطالعه بررسی ارتباط سطح سرمی و بزاقی هورمون کورتیزول با روش رادیو ایمونواسی (RIA) است.
روش کار: این مطالعه توصیفی مقطعی از شهریور 1384 لغایت اسفند ماه 1384 بر 80 مراجعه کننده به آزمایشگاه بیمارستان قائم (عج) انجام شد. از 38 مرد و 42 زن با متوسط سن 5/16 ± 46 سال با در نظر گرفتن شرایط ورود به مطالعه نمونه سرمی و بزاقی گرفته شد. نمونه های سرمی و بزاقی بین ساعت 8 تا 9 صبح جمع آوری شد. کورتیزول بزاق و کورتیزول تام سرمی به روش رادیوایمونواسی (RIA) اندازه گیری شد.
نتایج: میانگین کورتیزول سرم 35/8 ± 72/19 میکروگروم در دسی لیتر و میانگین کورتیزول بزاق 07/0 ± 18/0 میکروگرم در دسی لیتر محاسبه شد. همبستگی معنی داری بین میانگین کورتیزول سرم و بزاق وجود دارد (003/0=p ، 35/0=r).
نتیجه گیری: نتایج این مطالعه نشان می دهد که اندازه گیری کورتیزول بزاق با روش رادیوایمونواسی (RIA) می تواند جایگزین اندازه گیری تام سرمی این هورمون شود. چرا که اندازه گیری بزاقی این هورمون نشانه قسمت آزاد و از نظر بیولوژیک فعال این هورمون است و نیز روش ساده غیر تهاجمی و بدون استرس می باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Evaluation of the Level of Salivary and Serum Cortisol

نویسندگان [English]

  • M Haratian 1
  • R Rajabian 2
  • H Ayatollahi 3
چکیده [English]

I





ntroduction:In spite of its convenience and inexpensiveness, measurement of salivary cortisol has not gained widespread popularity. Indeed, even though its usefulness in the assessment of activity of hypothalamic-pituitary-adrenal (HPA) axis has been reported in various clinical conditions, several centers are still resistant to adopting this procedure. The aim of this study is to evaluate the correlation between salivary and serum cortisol by radioimmunoassay (RIA).
Materials and Methods: This descriptive crass-sectional study carried out in September to February 2005 on 80 patients at laboratory of Ghaem Hospital of Mashhad University of Medical Sciences. A total of 42 women and 38 men aged 46 16.5 were studied. Paired saliva and serum samples were obtained after specialized protocols. Salivary and blood samples were collected at 8 to 9 A.M. Cortisol in saliva and total cortisol in serum were measured with a commercial radioimmunoassay (RIA).
Results: Mean serum cortisol was 19.72 8.35 and mean salivary cortisol was 0.18 0.07 µg/dL. Significant linear correlation was found between salivary and serum total cortisol (r=0/35, p<0.001).
Conclusion: Results indicate that salivary cortisol measures with radioimmunoassay (RIA) can be used in place of serum total cortisol, based on the evidence that salivary level represents the biologicaly active and free fraction of this hormone, and is non invasive and unstressful.

کلیدواژه‌ها [English]

  • Serum
  • Salivary
  • Cortisol
1- Stewart PM. The Adrenal Cortex. In: Larsen PR, Kronrenberg HM, Melmed S, Polonsky KS. Williams Textbook
of Endocrinology 11th ed. Philadelphia: Saunders; 2008. 464-77.
2- Loriaux DL.Tests of Adrenocortical Function. In: Becker KL, Bilizikian JP, Bremner WJ, Hung W, Kahn CR,
Loriaux DL, et al. Principles And Practice Of Endocrinology And Metabolism. 3rd ed.Philadelphia: Lippincott Williams
and Wilkins; 2001. 720-33.
3- Wlliams JH, Deluhy RG. Disorders of the Adrenal Cortex. In: Kasper DL, Fauci AS, Longo DL, Braunwald E,
Hauser SL, Jamsson JL,. Harrison's Principles of Internal Medicine. 16th ed. New York: Mc Graw Hill; 2005. 2134-9.
4- Gozansky WS, Lynn JS, Laudenslager ML, Rohrt WM. Salivary cortisol determined by enzyme immunoassay is
preferable to serum total cortisol for assessment of dynamic hypothalamic-pituitary-adrenal axis activity. Clin
endocrinol 2005; 63: 336-341.
5- Viardot A, Huber P, Puder J, Zulewski H, Keller V, Muller B. Reproducibility salivary cortisol and its use in the
diagnosis of hypercortisolism as compared to urinary free cortisol and overnight dexametazone suppression test. J Clin
Endocrinol metab 2005; 90(10): 5730-5736.
6- Liu H, Bravata DM, Cabaccan J, Raff H, Ryzen E. Elevated late-night salivary cortisol levels in elderly male type 2
diabetic veterans. Clin endocrinol 2005 Dec; 63(6): 642-649.
7- Yehuda R, Halligan SL, Vang RK, Guo LS, Makotkine I. Relationship between 24-hour urinary free cortisol
excretion and salivary cortisol levels sampled from awakening to bedtime in healthy subjects. Life sciences 2003; 73(3):
349-358.
8- Castro M, Elias LL, Elias PD, Moreira AD. A dose response study of salivary cortisol after dexametasone
suppression test in Cushing’s disease and its potential use in the differential diagnosis of Cushing syndrome. Clin
Endocrinol 2003 Dec; 59(6): 800-5.
9- Simard M. The biochemical investigation of Cushing syndrome. Neuro Surg Focus 2004 Apr; 16(4): E4.
10- Putignano P, Toja P, Dubini A, Grald FP, Corsello SM, Cavagnini F.Midnight salivary cortisol versus urinary free
and midnight serum cortisol as screening tests for Cshing’s syndrome. J Clin Endocrinol 2003; 88(9): 4153-7
11- Lopez, Mondegar P, Fuentes M, Mauri M, Mora A. Salivary cortisol determination in the diagnosis of pediatric
Cushing’s disease. A pediatr. (Barc) 2006; 64(3): 270-272.
12- Castro M, Elias PG, Mortinelli CEJ, Antoniu SR, Santiago L, Moreira AD. Salivary cortisol as a tool for
physiological studies and diagnostic strategies. Braz J Med Biol Res 2000 Oct; 33(10): 1171-5.
13- Gafni RI, Papaniolaou. DA, Nieman LK. Nighttime salivary cortisol measurement as a simple, non invasive,
outpatient screening test for Cushing syndrome is children and adolescents. J pediatr 2000 Jul, 137(1): 30-5.
14- Martinelli CE Jr, Soder SL, Oliveria FB, Daneluzzi JC, Moreira AD. Salivary cortisol for screening of Cushing’s
syndrome in children. Clin Endocrinol 1999 Jul; 51(1): 67-71
15- Fogaca MD, Carvalho WB, Peres Cde A, Lora MI, Hayashi LF, Verreschi IT. Salivary cortisol as an indicator of
adreno cortical function in healthy infants, using message therapy. Sao Paulo Med J 2005; 123(5): 215-218. 
 
16- Kidd S, Midgley P, Nicol M, Smith J, Mclntosh N. lack of adult type salivary cortisol circadian rhythm in
hospitalized pre term infants. Horm Res 2005; 64(1): 20-27
17- Garde AH, Hansen AM. Long term stability of salivary cortisol scand. J Clin Lab Invest 2005; 65(5): 433-36.
18- Raff OH, Raff JL, Find Ling JW. Late-night salivary cortisol as a screening test for Cushing’s syndrome. J Clin
Endocrinol Metab 1998; 83(8): 2681-6.
19- Bals-pratsch. M, Hanker JP, Helhammer DH, Ludecks DK, Schlegel W, Schneidx HP. Intermittent Cushing’s
disease in hirsute women. Horm Metab Res 1996; 28(2): 105-10.
20- Mosnier-padar H, Thomopoulas P, Isertagna X, Fournier D, Guiban D, Luton JP. Long distance and long-term
follow up of a patient with intermittent Cushing’s disease by salivary cortisol measurements. Eur Endocrinol 1995;
133(3): 313-6.
21- Hermas AR, Pieters GF, Borm GF, Verhofstad AA. Unpredictable hypersecretion of cortisol in Cushing’s disease
detection by daily salivary cortisol measurements. Acta Endocrinol (Copenh) 1993. 128(5): 428-32.
22- Issa BG, Page MD, Read G, John R, Douglas-Jones A, Scanlon MF. Undetectable urinary free cortisol
concentrations in a case of Cushing’s disease. Eur J Endocrinol 1999; 142(2): 148-51.
23- Broderick JE, Arnold D, Rudielka BM, Kirschbaum C. Salivary cortisol sampling compliance. Comparison of
patients and healthy volunteers. Psychoneuroendocrinol 2004; 29(5): 636-650.
24- Yaneva M, Mosnier-pudar II, Dugue MA, Grabai S, Falla Y, Bertagna X. midnight salivary. Cortisol for the initial
diagnosis of cushing’s syndrome of various causes. J Clin Endocrinol metab 2004 Jul. 89(7): 3345-51.
25- Hansen AM, Garde AH, Christensen JM, Eiler NH, Netter storm B. Evaluation of a radio immunoassay and
establishment of a reference interval for salivary cortisol in healthy subjects in Denmark. Scand J Clin Lab Invest 2003;
63(4): 303-310.
26- Barrou Z, Guiban D, Maroufi A, Fournier C, Dugue MA, Luton JP, et al. Overnight dexamethasone suppression
test: comparison of plasma and salivary cortisol measurement for the screening of Cushing's syndrome. Eur J
Endocrinol 1996 Jan; 134(1):93-6.
27- Findling JW, Raff H. Diagnosis and differential diagnosis of Cushing’s syndrome. Endocrinol Metab Clin North
Am 2001 Sep; 30(3): 729-47.
28- Castro M, Elias PD, Quidate AR, Halah FP, Moreria D. Outpatient screening for Cushing syndrome: the sensitivity
of the combination of circadian rhythm and overnight dexametasone suppression salivary cortisol tests. J Clin
Endocrinol Metab 1999; 84(3): 878-82.
29- Trilck M, Flitsch J, Luedecke DK, Jung R, Petersenn S. Salivary cortisol measurement a reliable method for the
diagnosis of Cushing’s syndrome. Exp Clin Endocrinol Diabetes 2005; 113(4): 225-230.
30- Ring JA, Rosal MD, Ma Y, Reed G, Kelly TA, Stanek EJ, et al. Sequence and seasonal effects of salivary cortisol.
Behav Med 2000; 26(2): 67-73.