{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T19:21:54Z","timestamp":1789413714459,"version":"build-2803163510"},"reference-count":31,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T00:00:00Z","timestamp":1538524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004963","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["281654"],"award-info":[{"award-number":["281654"]}],"id":[{"id":"10.13039\/501100004963","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Population studies frequently measure cortisol as a marker of stress, and excess cortisol is associated with increased mortality. Cortisol has a circadian rhythm, and frequent blood sampling is impractical to assess cortisol exposure. We investigated measuring salivary cortisone and examined the sampling frequency required to determine cortisol exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Serum and saliva with cortisol and cortisone were measured by liquid chromatography\u2013tandem mass spectrometry in independent cohorts. The relationship between serum cortisol and salivary cortisone was analyzed in cohort 1 using a linear mixed effects model. The resulting fixed effects component was applied to cohort 2. Saliva cannot easily be collected when a patient is sleeping, so we determined the minimum sampling required to estimate cortisol exposure [estimated area under the curve (eAUC)] using 24-hour cortisol profiles (AUC24) and calculated the relative error (RE) for eAUC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>More than 90% of variability in salivary cortisone could be accounted for by change in serum cortisol. A single serum cortisol measurement was a poor estimate of AUC24, especially in the morning or last thing at night (RE &amp;gt;68%); however, three equally spaced samples gave a median RE of 0% (interquartile range, \u221215.6% to 15.1%). In patients with adrenal incidentalomas, eAUC based on three serum cortisol samples showed a difference between those with autonomous cortisol secretion and those without (P = 0.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Accepting that most people sleep 7 to 8 hours, \u223c8-hourly salivary cortisone measurements provide a noninvasive method of estimating 24-hour cortisol exposure for population studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jc.2018-01172","type":"journal-article","created":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T14:22:28Z","timestamp":1538576548000},"page":"765-772","source":"Crossref","is-referenced-by-count":27,"title":["Salivary Cortisone to Estimate Cortisol Exposure and Sampling Frequency Required Based on Serum Cortisol Measurements"],"prefix":"10.1210","volume":"104","author":[{"given":"Robert F","family":"Harrison","sequence":"first","affiliation":[{"name":"Faculties of Medicine and Engineering, The University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Debono","sequence":"additional","affiliation":[{"name":"Faculties of Medicine and Engineering, The University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin J","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Faculties of Medicine and Engineering, The University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian G","family":"Keevil","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Newell-Price","sequence":"additional","affiliation":[{"name":"Faculties of Medicine and Engineering, The University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9222-9678","authenticated-orcid":false,"given":"Richard J","family":"Ross","sequence":"additional","affiliation":[{"name":"Faculties of Medicine and Engineering, The University of Sheffield, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2018,10,3]]},"reference":[{"key":"2020071622281945900_B1","doi-asserted-by":"crossref","first-page":"e4800","DOI":"10.1136\/bmj.e4800","article-title":"Shift work and vascular events: systematic review and 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