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Early morning salivary cortisol and cortisone, and adrenal responses to a simplified low dose short Synacthen test in children with asthma

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Early morning salivary cortisol and cortisone, and adrenal responses to a simplified low dose short Synacthen test in children with asthma. / Blair, J. C.; Lancaster, Gillian; Titman, Andrew et al.
In: Clinical Endocrinology, Vol. 80, No. 3, 03.2014, p. 376-383.

Research output: Contribution to Journal/Magazine › Journal article › peer-review

Harvard

Blair, JC, Lancaster, G, Titman, A, Peak, M, Newland, P, Collingwood, C, Chesters, C, Moorcroft, T, Wallin, N, Hawcutt, D, Gardner, C, Didi, M, Lacy, D & Couriel, J 2014, 'Early morning salivary cortisol and cortisone, and adrenal responses to a simplified low dose short Synacthen test in children with asthma', Clinical Endocrinology, vol. 80, no. 3, pp. 376-383. https://doi.org/10.1111/cen.12302

APA

Blair, J. C., Lancaster, G., Titman, A., Peak, M., Newland, P., Collingwood, C., Chesters, C., Moorcroft, T., Wallin, N., Hawcutt, D., Gardner, C., Didi, M., Lacy, D., & Couriel, J. (2014). Early morning salivary cortisol and cortisone, and adrenal responses to a simplified low dose short Synacthen test in children with asthma. Clinical Endocrinology, 80(3), 376-383. https://doi.org/10.1111/cen.12302

Vancouver

Blair JC, Lancaster G, Titman A, Peak M, Newland P, Collingwood C et al. Early morning salivary cortisol and cortisone, and adrenal responses to a simplified low dose short Synacthen test in children with asthma. Clinical Endocrinology. 2014 Mar;80(3):376-383. Epub 2013 Jul 29. doi: 10.1111/cen.12302

Author

Blair, J. C. ; Lancaster, Gillian ; Titman, Andrew et al. / Early morning salivary cortisol and cortisone, and adrenal responses to a simplified low dose short Synacthen test in children with asthma. In: Clinical Endocrinology. 2014 ; Vol. 80, No. 3. pp. 376-383.

Bibtex

@article{1fbc78a914bd466d91d09a52d6269add,
title = "Early morning salivary cortisol and cortisone, and adrenal responses to a simplified low dose short Synacthen test in children with asthma",
abstract = "ObjectiveTo examine serum cortisol responses to a simplified low dose short Synacthen test (LDSST) in children treated with inhaled corticosteroids (ICS) for asthma and to compare these to early morning salivary cortisol (EMSC) and cortisone (EMSCn) levels.DesignEMSC and EMSCn samples were collected for three consecutive days. On day three Synacthen 500ng/1.73m2 was administered intravenously. Samples were collected at 0, 15, 25, 35 minutes.Results269 subjects (160 M: 109F), median (range) age 10.0 (5.1 – 15.2) years were studied. Peak cortisol in the LDSST was <500nmol/L in 101 subjects (37.5%) and <350nmol/L in 12 subjects (4.5%). Basal cortisol correlated with peak cortisol: r=0.55, (95% CI: 0.46, 0.63, p<0.0001). Time at which peak cortisol concentration was achieved was significantly related to the value of peak cortisol (p<0.0001), with higher cortisol peaks occurring later in the test and lower cortisol peaks occurring earlier. EMSC and EMSCn had no predictive value for the identification of patients with a peak cortisol <500nmol/L. EMSCn was superior to EMSC in identifying patients with a peak cortisol < 350nmol/L: a minimum EMSCn cut-off value of 12.5 nmol/L gave a negative predictive value of 99.2% and positive predictive value of 30.1%.ConclusionOur data illustrate that basal measures of cortisol are likely to be of value in screening populations for patients at greatest risk of adrenal crisis. EMSCn shows promise as a screening tool for the identification of patients with severe adrenal insufficiency.",
author = "Blair, {J. C.} and Gillian Lancaster and Andrew Titman and M. Peak and P. Newland and C. Collingwood and C. Chesters and T. Moorcroft and N. Wallin and D. Hawcutt and C. Gardner and M. Didi and D. Lacy and J. Couriel",
year = "2014",
month = mar,
doi = "10.1111/cen.12302",
language = "English",
volume = "80",
pages = "376--383",
journal = "Clinical Endocrinology",
issn = "0300-0664",
publisher = "Wiley-Blackwell",
number = "3",

}

RIS

TY - JOUR

T1 - Early morning salivary cortisol and cortisone, and adrenal responses to a simplified low dose short Synacthen test in children with asthma

AU - Blair, J. C.

AU - Lancaster, Gillian

AU - Titman, Andrew

AU - Peak, M.

AU - Newland, P.

AU - Collingwood, C.

AU - Chesters, C.

AU - Moorcroft, T.

AU - Wallin, N.

AU - Hawcutt, D.

AU - Gardner, C.

AU - Didi, M.

AU - Lacy, D.

AU - Couriel, J.

PY - 2014/3

Y1 - 2014/3

N2 - ObjectiveTo examine serum cortisol responses to a simplified low dose short Synacthen test (LDSST) in children treated with inhaled corticosteroids (ICS) for asthma and to compare these to early morning salivary cortisol (EMSC) and cortisone (EMSCn) levels.DesignEMSC and EMSCn samples were collected for three consecutive days. On day three Synacthen 500ng/1.73m2 was administered intravenously. Samples were collected at 0, 15, 25, 35 minutes.Results269 subjects (160 M: 109F), median (range) age 10.0 (5.1 – 15.2) years were studied. Peak cortisol in the LDSST was <500nmol/L in 101 subjects (37.5%) and <350nmol/L in 12 subjects (4.5%). Basal cortisol correlated with peak cortisol: r=0.55, (95% CI: 0.46, 0.63, p<0.0001). Time at which peak cortisol concentration was achieved was significantly related to the value of peak cortisol (p<0.0001), with higher cortisol peaks occurring later in the test and lower cortisol peaks occurring earlier. EMSC and EMSCn had no predictive value for the identification of patients with a peak cortisol <500nmol/L. EMSCn was superior to EMSC in identifying patients with a peak cortisol < 350nmol/L: a minimum EMSCn cut-off value of 12.5 nmol/L gave a negative predictive value of 99.2% and positive predictive value of 30.1%.ConclusionOur data illustrate that basal measures of cortisol are likely to be of value in screening populations for patients at greatest risk of adrenal crisis. EMSCn shows promise as a screening tool for the identification of patients with severe adrenal insufficiency.

AB - ObjectiveTo examine serum cortisol responses to a simplified low dose short Synacthen test (LDSST) in children treated with inhaled corticosteroids (ICS) for asthma and to compare these to early morning salivary cortisol (EMSC) and cortisone (EMSCn) levels.DesignEMSC and EMSCn samples were collected for three consecutive days. On day three Synacthen 500ng/1.73m2 was administered intravenously. Samples were collected at 0, 15, 25, 35 minutes.Results269 subjects (160 M: 109F), median (range) age 10.0 (5.1 – 15.2) years were studied. Peak cortisol in the LDSST was <500nmol/L in 101 subjects (37.5%) and <350nmol/L in 12 subjects (4.5%). Basal cortisol correlated with peak cortisol: r=0.55, (95% CI: 0.46, 0.63, p<0.0001). Time at which peak cortisol concentration was achieved was significantly related to the value of peak cortisol (p<0.0001), with higher cortisol peaks occurring later in the test and lower cortisol peaks occurring earlier. EMSC and EMSCn had no predictive value for the identification of patients with a peak cortisol <500nmol/L. EMSCn was superior to EMSC in identifying patients with a peak cortisol < 350nmol/L: a minimum EMSCn cut-off value of 12.5 nmol/L gave a negative predictive value of 99.2% and positive predictive value of 30.1%.ConclusionOur data illustrate that basal measures of cortisol are likely to be of value in screening populations for patients at greatest risk of adrenal crisis. EMSCn shows promise as a screening tool for the identification of patients with severe adrenal insufficiency.

U2 - 10.1111/cen.12302

DO - 10.1111/cen.12302

M3 - Journal article

C2 - 23895277

VL - 80

SP - 376

EP - 383

JO - Clinical Endocrinology

JF - Clinical Endocrinology

SN - 0300-0664

IS - 3

ER -