Endocrinology and Metabolism

Review Article

Adrenal Gland
Clinical and Technical Aspects in Free Cortisol Measurement: Man Ho Choi; Endocrinol Metab. 2022;37(4):599-607. Published online August 19, 2022; DOI: https://doi.org/10.3803/EnM.2022.1549

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Accurate measurement of cortisol is critical in adrenal insufficiency as it reduces the risk associated with misdiagnosis and supports the optimization of stress dose. Comprehensive assays have been developed to determine the levels of bioactive free cortisol and their clinical and analytical efficacies have been extensively discussed because the level of total cortisol is affected by changes in the structure or circulating levels of corticoid-binding globulin and albumin, which are the main reservoirs of cortisol in the human body. Antibody-based immunoassays are routinely used in clinical laboratories; however, the lack of molecular specificity in cortisol assessment limits their applicability to characterize adrenocortical function. Improved specificity and sensitivity can be achieved by mass spectrometry coupled with chromatographic separation methods, which is a cutting-edge technology to measure individual as well as a panel of steroids in a single analytical run. The purpose of this review is to introduce recent advances in free cortisol measurement from the perspectives of clinical specimens and issues associated with prospective analytical technologies.

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Highly Responsive Bioassay for Quantification of Glucocorticoids
Mathias Flensted Poulsen, Martin Overgaard, Christian Brix Folsted Andersen, Andreas Lodberg
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An LC-MS/MS Method for the Simultaneous Quantification of Insulin, Cortisol, Glucagon-like Peptide 1, Ghrelin, and Osteocalcin
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Determination of cortisol cut-off limits and steroid dynamics in the ACTH stimulation test: a comparative analysis using Roche Elecsys Cortisol II immunoassay and LC-MS/MS
Sema Okutan, Nanna Thurmann Jørgensen, Lars Engers Pedersen, Stina Willemoes Borresen, Linda Hilsted, Lennart Friis Hansen, Ulla Feldt-Rasmussen, Marianne Klose
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Advancements in Cortisol Detection: From Conventional Methods to Next-Generation Technologies for Enhanced Hormone Monitoring
Visesh Vignesh, Bernardo Castro-Dominguez, Tony D. James, Julie M. Gamble-Turner, Stafford Lightman, Nuno M. Reis
ACS Sensors.2024; 9(4): 1666. CrossRef
Comparative analysis of salivary cortisol measurements using different assay methods in relation to serum-free cortisol measurement
Anna Lee, Sooah Jang, Sanghoo Lee, Hyun-Kyung Park, In-Young Kim, Ryunsup Ahn, Jeong-Ho Seok, Kyoung-Ryul Lee
Practical Laboratory Medicine.2024; 40: e00393. CrossRef
A dilute and shoot method for urinary free cortisol analysis by LC-MS/MS
Ying Shen, Xia Luo, Qing Guan, Liming Cheng
Journal of Chromatography B.2024; 1239: 124127. CrossRef
Osteopathic Manipulation as a Method of Cortisol Modification: A Systematic Review
Dylan Thibaut, Valentine Santarlas, Joseph Hoppes, Alejandra Vásquez-Castillo, Alexa Morrow, Eddie Oviedo, James Toldi
Cureus.2023;[Epub] CrossRef
Pitfalls in the Diagnosis and Management of Hypercortisolism (Cushing Syndrome) in Humans; A Review of the Laboratory Medicine Perspective
Kade C. Flowers, Kate E. Shipman
Diagnostics.2023; 13(8): 1415. CrossRef
Electrochemical sensors for cortisol detection: Principles, designs, fabrication, and characterisation
Gopi Karuppaiah, Min-Ho Lee, Shekhar Bhansali, Pandiaraj Manickam
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The role of the hypothalamic-pituitary-adrenal axis in depression across the female reproductive lifecycle: current knowledge and future directions
Liisa Hantsoo, Kathleen M. Jagodnik, Andrew M. Novick, Ritika Baweja, Teresa Lanza di Scalea, Aysegul Ozerdem, Erin C. McGlade, Diana I. Simeonova, Sharon Dekel, Sara L. Kornfield, Michelle Nazareth, Sandra J. Weiss
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РІВЕНЬ СТРЕСУ В ДІТЕЙ ШКІЛЬНОГО ВІКУ З COVID-19
Г. А. Павлишин, О. І. Панченко
Здобутки клінічної і експериментальної медицини.2023; (4): 119. CrossRef
Corticotropin-stimulated steroid profiles to predict shock development and mortality in sepsis: From the HYPRESS study
Josef Briegel, Patrick Möhnle, Didier Keh, Johanna M. Lindner, Anna C. Vetter, Holger Bogatsch, Dorothea Lange, Sandra Frank, Ludwig C. Hinske, Djillali Annane, Michael Vogeser, Michael Bauer, Thorsten Brenner, Patrick Meybohm, Markus Weigand, Matthias Gr
Critical Care.2022;[Epub] CrossRef

Original Article

Clinical Study
Stimulated Salivary Cortisol as a Noninvasive Diagnostic Tool for Adrenal Insufficiency: Yoon Ji Kim, Jung Hee Kim, A Ram Hong, Kyeong Seon Park, Sang Wan Kim, Chan Soo Shin, Seong Yeon Kim; Endocrinol Metab. 2020;35(3):628-635. Published online September 22, 2020; DOI: https://doi.org/10.3803/EnM.2020.707

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Abstract PDF PubReader ePub

Background
Salivary cortisol is routinely used as a diagnostic test for Cushing syndrome. The diagnostic use of salivary cortisol for adrenal insufficiency (AI), however, is less established. We aimed to investigate the utility of morning basal and adrenocorticotropic hormone-stimulated salivary cortisol in diagnosing AI in Korean adults.
Methods
We prospectively included 120 subjects (female, n=70) from Seoul National University Hospital. AI was defined as a stimulated serum cortisol level of <496.8 nmol/L during the short Synacthen test (SST). Serum and saliva samples were drawn between 8:00 AM and 10:00 AM. Salivary cortisol levels were measured using an enzyme immunoassay kit.
Results
Thirty-four patients were diagnosed with AI according to the SST results. Age, sex, body mass index, serum albumin levels, and serum creatinine levels did not significantly differ between the normal and AI groups. Basal and stimulated salivary cortisol levels were positively correlated with basal (r=0.538) and stimulated serum cortisol levels (r=0.750), respectively (all P<0.001). Receiver operating characteristic curve analysis yielded a cutoff level of morning basal salivary cortisol of 3.2 nmol/L (sensitivity, 84.9%; specificity, 73.5%; area under the curve [AUC]=0.822). The optimal cutoff value of stimulated salivary cortisol was 13.2 nmol/L (sensitivity, 90.7%; specificity, 94.1%; AUC=0.959). Subjects with a stimulated salivary cortisol level above 13.2 nmol/L but a stimulated serum cortisol level below 496.8 nmol/L (n=2) had lower serum albumin levels than those showing a concordant response.
Conclusion
The diagnostic performance of stimulated salivary cortisol measurements after the SST was comparable to serum cortisol measurements for diagnosing AI.

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European Journal of Endocrinology.2024; 190(1): R10. CrossRef
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The Reliability of Salivary Cortisol Compared to Serum Cortisol for Diagnosing Adrenal Insufficiency with the Gold Standard ACTH Stimulation Test in Children
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РІВЕНЬ СТРЕСУ В ДІТЕЙ ШКІЛЬНОГО ВІКУ З COVID-19
Г. А. Павлишин, О. І. Панченко
Здобутки клінічної і експериментальної медицини.2023; (4): 119. CrossRef
Secondary adrenal suppression related to high doses of inhaled corticosteroids in patients with severe asthma
Mariana Lobato, João Gaspar-Marques, Pedro Carreiro-Martins, Paula Leiria-Pinto
Annals of Allergy, Asthma & Immunology.2022; 128(4): 464. CrossRef
Clinical and Technical Aspects in Free Cortisol Measurement
Man Ho Choi
Endocrinology and Metabolism.2022; 37(4): 599. CrossRef
Continuous biomarker monitoring with single molecule resolution by measuring free particle motion
Alissa D. Buskermolen, Yu-Ting Lin, Laura van Smeden, Rik B. van Haaften, Junhong Yan, Khulan Sergelen, Arthur M. de Jong, Menno W. J. Prins
Nature Communications.2022;[Epub] CrossRef
Reversible Immunosensor for the Continuous Monitoring of Cortisol in Blood Plasma Sampled with Microdialysis
Laura van Smeden, Annet Saris, Khulan Sergelen, Arthur M. de Jong, Junhong Yan, Menno W. J. Prins
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Case Report

A Case Report of Symptomatic Salivary Gland Rest within the Pituitary Gland.: Tae Ho Kim, Tae Jin Park, Hae Jin Kim, Dae Jung Kim, Yoon Sok Chung, Kwan Woo Lee, Tae Hi Lee, Ho Sung Kim, Kyung Gi Cho; J Korean Endocr Soc. 2007;22(6):436-439. Published online December 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.6.436

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Abstract PDF

Although salivary gland tissues in the posterior pituitary are occasionally observed in microscopic examination at autopsy, these tissues are considered clinically silent. Only three examples of symptomatic salivary tissues in the pituitary have been previously reported. We report a case of symptomatic salivary gland rest within the pituitary gland. A 19-year-old woman complained of headache for 2 months, and dizziness, nausea, blurred vision for 1 week. Magnetic resonance imaging revealed a 1.8 cm-sized mass in sella turcica with hyperintensity on T1-weighted images. Basal hormone levels and combined pituitary stimulation test were normal. The trans-sphenoidal approach of tumor removal was performed and a pathological examination confirmed salivary gland rest without any evidence of a pituitary adenoma. The symptoms had disappeared, except for post-operative diabetes insipidus.

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Symptomatic salivary gland choristoma of the pituitary gland
Pedro Iglesias, Cecilia Fernández-Mateos, Eva Tejerina
Endocrinología, Diabetes y Nutrición.2022; 69(7): 544. CrossRef
Symptomatic salivary gland choristoma of the pituitary gland
Pedro Iglesias, Cecilia Fernández-Mateos, Eva Tejerina
Endocrinología, Diabetes y Nutrición (English ed.).2022; 69(7): 544. CrossRef
Salivary gland tissues and derived primary and metastatic neoplasms: unusual pitfalls in the work-up of sellar lesions. A systematic review
T. Feola, F. Gianno, M. De Angelis, C. Colonnese, V. Esposito, F. Giangaspero, M.-L. Jaffrain-Rea
Journal of Endocrinological Investigation.2021; 44(10): 2103. CrossRef
Intrasellar Symptomatic Salivary Gland Rest with Inflammations
Yusuke Tanaka, Atsuhiko Kubo, Junichi Ayabe, Masahide Watanabe, Masahiro Maeda, Yukio Tsuura, Yoshihide Tanaka
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Intracranial Salivary Gland Choristoma within Optic Nerve Dural Sheath: Case Report and Review of the Literature
Eric B. Hintz, Gabrielle A. Yeaney, Glenn K. Buchberger, G. Edward Vates
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