Document Detail

Diagnostic Value of Salivary Cortisol in the CRH Stimulation Test in Premature Infants.
MedLine Citation:
PMID:  22259060     Owner:  NLM     Status:  Publisher    
Context:According to a recent nationwide survey in Japan, a significant proportion of very low birth weight infants (VLBWI) develop late-onset circulatory collapse after the first week of life. Small doses of glucocorticoid are very effective in these patients, and relative adrenal insufficiency is suspected to be the main cause of the condition. Although the CRH test is required to evaluate the hypothalamic-pituitary-adrenal axis, obtaining multiple blood samples is invasive.Objectives:The present study was carried out to validate the consistency of the cortisol profiles of matched serum and saliva samples collected as part of the CRH test from VLBWI.Subjects/Methods:In 23 VLBWI with a gestational age of less than 29 wk, we performed CRH tests at 2 wk after birth and at term. Their cortisol values were measured at the baseline and 30 min after the administration of a single dose of human CRH (1 μg/kg) using matched serum and saliva samples.Results:In 26 CRH tests in 19 infants, we were able to measure both serum and salivary cortisol. Significant correlations were detected between the infants' serum and salivary cortisol values (r = 0.78; P < 0.0001), the increases in these values induced in response to the CRH test (r = 0.81; P < 0.0001), and their peak serum and salivary cortisol values (r = 0.68; P = 0.0001).Conclusion:This study indicated that using salivary cortisol measurements for the CRH test could be a reliable method for evaluating the hypothalamic-pituitary-adrenal axis in VLBWI with gestational age of less than 29 wk.
Takashi Matsukura; Masahiko Kawai; Chieko Marumo; Kougoro Iwanaga; Kayo Yoshida; Minoru Shibata; Fusako Niwa; Takeshi Hasegawa; Toshio Heike
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-18
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  -     ISSN:  1945-7197     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
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