Abstract
The concentration of cortisol in the saliva reflects the activity of the hypothalamic-pituitary-adrenal axis (1), and an increased late-night salivary cortisol has >95% sensitivity and specificity for Cushing syndrome (1)(2). We compared a commonly used modification of a RIA for serum cortisol with a new enzyme immunoassay (EIA) specifically designed to measure salivary cortisol in 352 saliva samples. The first samples (n = 195) were sent to our laboratory to screen for Cushing syndrome; all were collected at 2300 from 90 patients (age range, 17–77 years; 74 women and 16 men). The second set of samples (n = 104) was obtained at 2300 and 0700 from healthy, elderly patients (n = 52; age range, 67–82 years; 21 women and 31 men) who were part of a large, longitudinal study (3). The third set of samples (n = 53) was obtained at 2300 and 0700 from a group of apparently healthy individuals (n = 27; age range, …
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