LC-MS/MS shown to be reliable in salivary cortisol evaluation. Obese individuals create special challenges with regards to coritsol levels, due to peripheral cortisol to cortisone conversion.
This study points out that saliva should not be used solely in the diagnosis of Cushing's syndrome due to unreferenced norms. That however, doesn't nullify salivary cortisol. It requires a look at the references. for those that are obese and being evaluated for cushing's. There is no perfect test. T
This study is a little misleading in its conclusion. Salivary testing is valid, but the reference ranges in the obese with suspected cushing's syndrome needs further evaluation: according to these authors.
Salivary cortisol testing shown to have sensitivity and specificity that exceeds 90%. Final Quote: "salivary cortisol will become routine in the evaluation of patients with disorders of the HPA axis
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Saliva is a wonderful marker of early disease detection that leads
to more effective treatment, risk assessment for future oral and
systemic disease, and a simple, non invasive alternative to blood and
urine tests
Psychological state was assessed by the current stress test, and chromogranin-A (CgA), cortisol, alpha-amylase, and beta-endorphin were measured in saliva