Comparative Study between Serum and Salivary Cortisol Levels to Assess Adrenal Cortisol Insufficiency in Patients with Cirrhosis

Title: Comparative Study between Serum and Salivary Cortisol Levels to Assess Adrenal Cortisol Insufficiency in Patients with Cirrhosis

Authors: Amr A.bdel Moety, Amal R.Mansour, Eman Zaki Azzam, Rehab Ali Elsayed

DOI: http://dx.doi.org/10.18535/jmscr/v4i1.21

Abstract

The reduction in the synthetic function of the liver in patients with liver cirrhosis makes measuring of total serum cortisol invalid because of the prevalence of hypoalbuminemia and the decreased level of cortisol binding globulin in these patients. Salivary cortisol concentrations accurately reflect the free cortisol level in non cirrhotic patients because the unbound portion of cortisol in the blood freely diffuse into saliva which represent the fraction which diffuses to the target tissues of the body.

Aims: To study the correlation between salivary, serum total cortisol and calculated free cortisol. The prevalence of cortisol insufficiency using salivary and serum assays. Parameters associated with the discrepancy between both tests in cirrhotic patients.

Methods: Fasting serum cortisol was assessed using ADVIA Centur Autoanalizer together with salivary cortisol using Salimetrics Salivary assay kit cat. #1-3002 5pk 1—32002-5-USA at 8 AM. Pituitary hypoadrenalism will be excluded in patients with total cortisol level less than 4 µg/ dl.

Results: Salivary cortisol and calculated free cortisol are significantly correlated to adrenal function in cirrhotic patients more than serum total cortisol.

Conclusion: Salivary cortisol levels are the most accurate to asses adrenal cortical function in cirrhotic patients.

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Corresponding Author

Rehab Ali

Department of Internal Medicine (Hepatology Unit), University of Alexandria, Egypt

Phone:+201004643869, Fax: 002034862506

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