Related Experiment Video

Updated: Jul 16, 2026

A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents
06:15

A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents

Published on: July 10, 2017

Diagnostic value of salivary cortisol in children with abnormal adrenal cortex functions

Semra Cetinkaya1, Alev Ozon, Nursen Yordam

  • 1Department of Pediatric Endocrinology, Hacettepe University Faculty of Medicine, Ankara, Turkey. semcetinkaya@gmail.com

Hormone Research
|March 6, 2007
PubMed

Insights

Salivary cortisol (SC) measurement is a valuable tool for diagnosing adrenal insufficiency (AI) in children. It correlates well with serum cortisol and can help differentiate patients with AI during initial evaluations.

Area of Science:

  • Pediatric Endocrinology
  • Endocrinology
  • Clinical Chemistry

Background:

  • Salivary cortisol (SC) levels may reflect plasma free cortisol.
  • Measuring SC is a simple method, particularly useful in pediatric patients.
  • Adrenal insufficiency (AI) requires accurate diagnostic methods, especially in children.

Purpose of the Study:

  • To evaluate the diagnostic value of salivary cortisol (SC) measurement in pediatric patients with suspected adrenal insufficiency (AI).
  • To assess the correlation between salivary cortisol and serum cortisol levels.
  • To determine the efficacy of SC in differentiating individuals with and without AI.

Main Methods:

  • Fifty-one pediatric patients investigated for AI were included.
  • Adrenal function was assessed using a low-dose ACTH stimulation test.
  • Salivary cortisol samples were collected simultaneously with serum samples during the test (0-40 min).

Main Results:

  • Basal SC showed a significant correlation with basal serum cortisol (r=0.64, p<0.001).
  • A SC cut-off of 0.94 microg/dl differentiated subjects with AI from normal individuals with 80% sensitivity and 77% specificity.
  • A peak SC below 0.62 microg/dl identified AI with 100% specificity but 44% sensitivity.

Conclusions:

  • Salivary cortisol measurement is a viable method for evaluating adrenal insufficiency (AI).
  • SC measurements correlate well with serum cortisol levels.
  • Peak SC during a low-dose ACTH test can aid in the initial differentiation of AI in suspected cases.
Abstract

More Related Videos

Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers08:25

Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers

Published on: December 18, 2013

Related Concept Videos

Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...
Cushing Syndrome I: Introduction01:26

Cushing Syndrome I: Introduction

Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
Hormones of the Adrenal Glands01:31

Hormones of the Adrenal Glands

Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and corticosterone...
Anatomy of the Adrenal Glands01:17

Anatomy of the Adrenal Glands

The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct regions...
Hypothalamic-Pituitary Axis01:37

Hypothalamic-Pituitary Axis

The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.