Salivary cortisol and DHEA levels in the Korean population: age-related differences, diurnal rhythm, and correlations with serum levels.
Salivary cortisol and DHEA levels in the Korean population: age-related differences, diurnal rhythm, and correlations with serum levels.
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DOI：
10.3349/ymj.2007.48.3.379
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发表时间：
2007-06-30
影响因子：
2.4
通讯作者：
Chun SI
中科院分区：
文献类型：
--
作者：
Ahn RS;Lee YJ;Choi JY;Kwon HB;Chun SI
本研究的主要目的是研究基础皮质醇和脱氢表雄酮水平的变化，在唾液和血清中存在的年龄，并确定唾液和血清之间的类固醇浓度的相关系数。次要目的是获得一个标准的昼夜节律的唾液皮质醇和脱氢表雄酮在韩国人口。对于第一个目标，在上午10点至11点之间从359名年龄在21岁至69岁之间的志愿者（167名男性和192名女性）中收集唾液和血液样本。对于第二个目标，从78名志愿者（42名女性和36名男性）中收集了一天中的四个唾液样本（觉醒后，上午11点，下午4点和睡前），年龄从20岁到40岁不等。皮质醇和DHEA水平使用放射免疫测定法（RIA）测量。早晨皮质醇和脱氢表雄酮水平，以及与年龄相关的类固醇下降模式在两种性别中相似。血清皮质醇水平在40岁左右显著下降（p < 0.001，与20多岁的人相比），线性回归分析显示随着年龄的增长呈显著下降模式（斜率=-2.29，t =-4.297，p < 0.001）。然而，唾液皮质醇水平并没有随着年龄的增长而显著变化，但显示出下降的趋势（斜率=-0.0078，t =-0.389，p = 0.697）。血清/唾液皮质醇的相对比值为3.4-4.5%，随年龄增长而增加（斜率= 0.051，t = 3.61，p < 0.001）。唾液（斜率=-0.007，t =-3.76，p < 0.001）和血清（斜率= -0.197，t =-4.88，p < 0.001）中DHEA水平也随年龄增长而下降。特别是，唾液和血清中的DHEA水平直到40岁才开始显著下降，但随后在50岁（与40岁年龄组相比，p < 0.001）和60岁（与50岁年龄组相比，p < 0.001）时进一步显著下降。血清与唾液的相对DHEA比率在所检查的年龄段中是相似的（slop = 0.0016，t = 0.344，p = 0.73）。唾液皮质醇和DHEA水平与血清皮质醇和DHEA水平的相关系数分别为0.59和0.86，P < 0.001。最高的唾液皮质醇水平出现在刚醒来时（约为上午11点水平的两倍），全天下降，并在睡前达到最低水平（与下午皮质醇水平相比，p < 0.001）。最高唾液DHEA水平也出现在觉醒后（约为11 AM水平的1.5倍），并在11 AM时下降（p < 0.001）。DHEA水平在就寝前没有进一步降低（与PM DHEA水平相比，p = 0.11）。本研究表明，唾液和血清中皮质醇和脱氢表雄酮（DHEA）水平随年龄变化，且DHEA的负斜率比皮质醇的负斜率大。唾液中皮质醇和脱氢表雄酮的水平反映了血清中皮质醇和脱氢表雄酮的水平，因此唾液中类固醇水平的测定为评价肾上腺功能提供了一个有用和实用的工具，这对于临床诊断是必不可少的。
The primary objective of this study was to examine the changes of basal cortisol and DHEA levels present in saliva and serum with age, and to determine the correlation coefficients of steroid concentrations between saliva and serum. The secondary objective was to obtain a standard diurnal rhythm of salivary cortisol and DHEA in the Korean population. For the first objective, saliva and blood samples were collected between 10 and 11 AM from 359 volunteers ranging from 21 to 69 years old (167 men and 192 women). For the second objective, four saliva samples (post-awakening, 11AM, 4PM, and bedtime) were collected throughout a day from 78 volunteers (42 women and 36 men) ranging from 20 to 40 years old. Cortisol and DHEA levels were measured using a radioimmunoassay (RIA). The morning cortisol and DHEA levels, and the age-related steroid decline patterns were similar in both genders. Serum cortisol levels significantly decreased around forty years of age (p < 0.001, when compared with people in their 20s), and linear regression analysis with age showed a significant declining pattern (slope = -2.29, t = -4.297, p < 0.001). However, salivary cortisol levels did not change significantly with age, but showed a tendency towards decline (slope = -0.0078, t = -0.389, p = 0.697). The relative cortisol ratio of serum to saliva was 3.4-4.5% and the ratio increased with age (slope = 0.051, t = 3.61, p < 0.001). DHEA levels also declined with age in saliva (slope = -0.007, t = -3.76, p < 0.001) and serum (slope = -0.197 t = -4.88, p < 0.001). In particular, DHEA levels in saliva and serum did not start to significantly decrease until ages in the 40s, but then decreased significantly further at ages in the 50s (p < 0.001, when compared with the 40s age group) and 60s (p < 0.001, when compared with the 50 age group). The relative DHEA ratio of serum to saliva was similar throughout the ages examined (slop = 0.0016, t = 0.344, p = 0.73). On the other hand, cortisol and DHEA levels in saliva reflected well those in serum (r = 0.59 and 0.86, respectively, p < 0.001). The highest salivary cortisol levels appeared just after awakening (about two fold higher than the 11 AM level), decreased throughout the day, and reached the lowest levels at bedtime (p < 0.001, when compared with PM cortisol levels). The highest salivary DHEA levels also appeared after awakening (about 1.5 fold higher than the 11AM level) and decreased by 11AM (p < 0.001). DHEA levels did not decrease further until bedtime (p = 0.11, when compared with PM DHEA levels). This study showed that cortisol and DHEA levels change with age and that the negative slope of DHEA was steeper than that of cortisol in saliva and serum. As the cortisol and DHEA levels in saliva reflected those in serum, the measurement of steroid levels in saliva provide a useful and practical tool to evaluate adrenal functions, which are essential for clinical diagnosis.