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Published on: December 18, 2013
Salivary Steroid Collection in Children Under Conditions Replicating Home Sampling
Joseph J Tonge1, Brian G Keevil2, Jessica N Craig1
1Academic Unit of Medical Education, Medical School, University of Sheffield, S10 2RX Sheffield, UK.
Insights
Salivary glucocorticoid measurements are stable during home collection using Salivette, passive drool, and SalivaBio methods. The SaliPac device is well-tolerated for young children's salivary sampling.
Area of Science:
- Endocrinology
- Biochemistry
- Pediatrics
Background:
- Salivary glucocorticoids are used for adrenal function testing.
- Current home collection methods have limitations, especially for young children.
Purpose of the Study:
- Compare salivary collection methods for glucocorticoids.
- Assess glucocorticoid stability under home collection conditions.
- Evaluate the SaliPac device for pediatric salivary sampling.
Main Methods:
- Adults used Salivette, passive drool, and SalivaBio for 5 days.
- Children tested SalivaBio and SaliPac.
- Samples stored at 4°C, room temp, and 50°C for up to 1 week.
- Salivary cortisol and cortisone measured by mass spectrometry.
Main Results:
- No significant differences in glucocorticoid concentrations across the three adult methods.
- Salivary cortisol and cortisone remained stable for 72 hours at 4°C and room temperature.
- SaliPac and SalivaBio were well-tolerated and efficient for children under 6.
Conclusions:
- Salivette, passive drool, and SalivaBio provide comparable, stable salivary glucocorticoid measurements for home collection.
- The SaliPac device is an acceptable and effective option for pediatric salivary sampling.
Context:
Measurement of salivary glucocorticoids is an accepted method for testing adrenal function but there are few data on stability during home collection. Current salivary collection techniques require active participation or present a choking hazard and are unsuitable for young children.
Objective:
We sought to compare different salivary collection methods; assess the stability of salivary glucocorticoids under conditions replicating home collection; and assess patient tolerability and caregiver acceptability of a salivary collection device for young children, a swab encased in an infant pacifier (SaliPac).
Methods:
Six healthy adults collected salivary samples using a Salivette Cortisol, passive drool, and SalivaBio at night, waking, and 3 Pm for five days. Time to collect 1-mL saliva using the SalivaBio and SaliPac and caregiver acceptability were assessed in 30 children younger than 6 years. Saliva was stored at 4 °C, room temperature (RT), and 50 °C for 24, 48, 72 hours and 1 week to replicate potential postage conditions. Salivary cortisol and cortisone concentrations were measured by mass spectrometry.
Results:
There was no difference in salivary glucocorticoid concentrations using the 3 collection methods. Salivary cortisol and cortisone were stable for 72 hours at RT and 4 °C, and repeated freeze-thaw cycles did not cause significant degradation. In children younger than 6 years the SalivaBio and SaliPac were well tolerated and collected sufficient saliva for salivary steroid analysis in less than 4 minutes.
Conclusion:
Salivette, passive drool, and SalivaBio collect samples with comparable salivary cortisol and cortisone concentrations, which are stable under conditions replicating home collection. SaliPac is an acceptable device for salivary sampling in young children.
