Can Salivary Cortisol be Used in Diagnosing Adrenal Insufficiency During the Acute and Subacute Phases of Traumatic Brain Injury?

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dc.contributor.authorUrhan, Emre
dc.contributor.authorElbuken, Gulsah
dc.contributor.authorKaraca, Zuleyha
dc.contributor.authorUnluhizarci, Kursad
dc.contributor.authorKula, Mustafa
dc.contributor.authorSelcuklu, Ahmed
dc.contributor.authorKelestimur, Fahrettin
dc.date.accessioned2025-04-06T12:23:51Z
dc.date.available2025-04-06T12:23:51Z
dc.date.issued2025
dc.departmentTekirdağ Namık Kemal Üniversitesi
dc.description.abstractIntroduction The diagnosis of adrenal insufficiency (AI) related to traumatic brain injury (TBI) remains a challenge. We investigated the basal and low-dose adrenocorticotropic hormone (ACTH)-stimulated serum cortisol and salivary cortisol (SaC) levels and the diagnostic utility of SaC levels during 28 days following TBI. Materials and Methods Blood samples were collected for basal levels [sequentially from day 1 (D1) to D7 and on D28)] and for peak serum cortisol and SaC responses to the low-dose ACTH stimulation test (on D1, D7, and D28). After the patient enrollment period was completed, patients were retrospectively categorized as AI or AS (adrenal sufficiency) for each day separately, based on a basal serum cortisol cut-off level of 11 mu g/dL, and data analysis was performed between the groups. Results Thirty-seven patients and 40 healthy controls were included. Median basal serum cortisol levels were higher in patients on D1 but were similar on other days. Median basal SaC levels were higher in patients on D1 and D2 but were similar on other days. Median peak serum cortisol and SaC levels were similar on D1 but were lower in patients on D7 and D28. Median basal SaC levels were higher in the AS group than in the AI group on all days. Discussion and Conclusions When evaluating AI during the course of TBI, the cut-off for basal SaC levels is 0.5-0.6 mu g/dL throughout the first week, except for 1.38 mu g/dL on D2. SaC levels may serve as a surrogate marker for accurately reflecting circulating glucocorticoid activity.
dc.description.sponsorshipErciyes University Council of Scientific Investigations [TSA-10-2909]
dc.description.sponsorshipErciyes University Council of Scientific Investigations | project code: TSA-10-2909
dc.identifier.doi10.1055/a-2444-4386
dc.identifier.endpage33
dc.identifier.issn0947-7349
dc.identifier.issn1439-3646
dc.identifier.issue1
dc.identifier.pmid39419287
dc.identifier.scopus2-s2.0-85216136087
dc.identifier.scopusqualityQ2
dc.identifier.startpage25
dc.identifier.urihttps://doi.org/10.1055/a-2444-4386
dc.identifier.urihttps://hdl.handle.net/20.500.11776/17213
dc.identifier.volume133
dc.identifier.wosWOS:001398982700001
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherGeorg Thieme Verlag Kg
dc.relation.ispartofExperimental and Clinical Endocrinology & Diabetes
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WOS_20250406
dc.subjectTraumatic brain injury
dc.subjectHPA axis
dc.subjectserum cortisol
dc.subjectsalivary cortisol
dc.subjectACTH stimulation test
dc.titleCan Salivary Cortisol be Used in Diagnosing Adrenal Insufficiency During the Acute and Subacute Phases of Traumatic Brain Injury?
dc.typeArticle

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