Adrenal Gland Volume and Dexamethasone-Suppressed Cortisol Correlate with Total Daily Salivary Cortisol in African-American Women

[~MaryO~]

http://jcem.endojournals.org/cgi/content/abstract/92/4/1358

 

Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-2674

The Journal of Clinical Endocrinology & Metabolism Vol. 92, No. 4 1358-1363

Copyright ? 2007 by The Endocrine Society

 

Adrenal Gland Volume and Dexamethasone-Suppressed Cortisol Correlate with Total Daily Salivary Cortisol in African-American Women

 

Sherita Hill Golden, Saurabh Malhotra, Gary S. Wand, Frederick L. Brancati, Daniel Ford and Karen Horton Departments of Medicine (S.H.G., G.S.W., F.L.B., D.F.), Psychiatry (G.S.W.), and Radiology (K.H.), Johns Hopkins University School of Medicine, and Department of Epidemiology (S.H.G., F.L.B., D.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205; and Department of Medicine (S.M.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213

 

Address all correspondence and requests for reprints to: Dr. Sherita Hill Golden, Johns Hopkins University School of Medicine, Division of Endocrinology and Metabolism, 2024 East Monument Street, Suite 2-616, Baltimore, Maryland 21205. E-mail: sahill@jhmi.edu.

 

Context: Population-based studies of associations between subclinicalhypercortisolism and risk for disease states, such as type 2 diabetes mellitus, have been difficult to assess because ofimprecise measures of glucocorticoid exposure. Alternative measures(salivary cortisol and adrenal gland volume) have not been systematically compared with 24-h urine free cortisol (UFC) in a healthy population.

 

Objective: Our objectives were: 1) to determine whether 24-hUFC and total daily salivary cortisol correlated with each other,adrenal gland volume, and salivary cortisol after dexamethasone suppression and 2) to evaluate the association of adrenal gland volume with salivary cortisol after dexamethasone suppression.

 

Design, Setting, and Participants: This was a cross-sectionalstudy of 20 healthy, premenopausal African-American women aged 18?45 yr.

 

Main Outcome Measures: Salivary cortisol was assessed at sixtime points throughout the day simultaneous with 24-h UFC collection.Adrenal gland volume was measured by computed tomography scan. Dexamethasone-suppressed salivary cortisol was measured at 0800h after administration of 0.5 mg dexamethasone at 2300 h theprior evening.

 

Results: Dexamethasone-suppressed salivary cortisol levels correlatedstrongly with individual, timed salivary cortisol measurements, total daily salivary cortisol (r_s = 0.75; P = 0.0001; n = 20),and adrenal gland volume (r_s = 0.66; P = 0.004; n = 17). Totaldaily salivary cortisol and adrenal gland volume also correlated(r_s = 0.46; P = 0.04; n = 19). In contrast, 24-h UFC levelsdid not correlate with any of the other hypothalamic-pituitary-adrenalaxis measures.

 

Conclusion: A dexamethasone suppression test or adrenal glandvolume may be alternative measures for characterizing subtle subclinical hypercortisolism in healthy adults.