Impact of exogenous glucocorticoid use on salivary cortisol measurements among adults with asthma and rhinitis

Umesh Masharani, Stephen Shiboski, Mark D. Eisner, Patricia P. Katz, Susan L. Janson, Douglas A. Granger, Paul D. Blanc

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

The diurnal rhythm of cortisol secretion in chronic disease can reflect the interactions between exogenous and endogenous factors. Exogenous glucocorticoid use may impact salivary cortisol measurements, but this has not been well-studied in ambulatory settings. In this report salivary cortisol levels were used to evaluate aspects of the diurnal rhythm of cortisol secretion within an ambulatory population of patients with asthma and allergic rhinitis. 183 persons with asthma with or without concomitant rhinitis and 34 persons with rhinitis alone were asked to collect at home, two saliva samples, 30 min after awakening and 12 h later. The salivary cortisol levels were quantified by enzyme immunoassay. The recent use of glucocorticoids in the study group was determined by interview and direct examination of medications. We report that the median salivary cortisol levels 30 min post-awakening significantly differed by exogenous steroid status: no glucocorticoid use (n=91), 10.1 nmol/l; nasal gluco-corticoid use alone (n=25), 11.4 nmol/l; inhaled glucocorticoids (with or without concomitant nasal glucocorticoids; n=76), 9.0 nmol/l; systemic glucocorticoids (n=17), 4.0 nmol/l; (P=0.02). 12-h post-awakening salivary cortisol values among the groups were similar (P=0.85). The median 30-min post-awakening cortisol differed significantly by type and amount of inhaled steroid used: non-fluticasone users (n=21), 11.5 nmol/l; lower dose fluticasone (<800 μg per day, n=35); 9.2 nmol/l; and higher dose fluticasone (≥800 μg, n=20), 5 nmol/l; (P=0.01). We conclude that in an ambulatory setting, exogenous glucocorticoid use can decrease the 30 min post-awakening but not the 12-h post-awakening salivary cortisol levels, an effect that should be taken into account in assessing the effects of other potential determinants on cortisol secretion.

Original languageEnglish (US)
Pages (from-to)744-752
Number of pages9
JournalPsychoneuroendocrinology
Volume30
Issue number8
DOIs
StatePublished - Sep 2005
Externally publishedYes

Fingerprint

Rhinitis
Glucocorticoids
Hydrocortisone
Asthma
Circadian Rhythm
Nose
Steroids
Immunoenzyme Techniques
Saliva
Adrenal Cortex Hormones
Chronic Disease
Interviews

Keywords

  • Asthma
  • Diurnal rhythm
  • Salivary cortisol

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Endocrine and Autonomic Systems
  • Psychology(all)

Cite this

Masharani, U., Shiboski, S., Eisner, M. D., Katz, P. P., Janson, S. L., Granger, D. A., & Blanc, P. D. (2005). Impact of exogenous glucocorticoid use on salivary cortisol measurements among adults with asthma and rhinitis. Psychoneuroendocrinology, 30(8), 744-752. https://doi.org/10.1016/j.psyneuen.2005.03.003

Impact of exogenous glucocorticoid use on salivary cortisol measurements among adults with asthma and rhinitis. / Masharani, Umesh; Shiboski, Stephen; Eisner, Mark D.; Katz, Patricia P.; Janson, Susan L.; Granger, Douglas A.; Blanc, Paul D.

In: Psychoneuroendocrinology, Vol. 30, No. 8, 09.2005, p. 744-752.

Research output: Contribution to journalArticle

Masharani, U, Shiboski, S, Eisner, MD, Katz, PP, Janson, SL, Granger, DA & Blanc, PD 2005, 'Impact of exogenous glucocorticoid use on salivary cortisol measurements among adults with asthma and rhinitis', Psychoneuroendocrinology, vol. 30, no. 8, pp. 744-752. https://doi.org/10.1016/j.psyneuen.2005.03.003
Masharani, Umesh ; Shiboski, Stephen ; Eisner, Mark D. ; Katz, Patricia P. ; Janson, Susan L. ; Granger, Douglas A. ; Blanc, Paul D. / Impact of exogenous glucocorticoid use on salivary cortisol measurements among adults with asthma and rhinitis. In: Psychoneuroendocrinology. 2005 ; Vol. 30, No. 8. pp. 744-752.
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