2025 · Analytical and Bioanalytical Chemistry · open access
Non-invasive assessment of free steroid hormones: a high-throughput LC-MS/MS method for salivary steroid quantification
Slettvoll et al.
The finding, in our words
Testosterone, androstenedione, cortisol and cortisone were measurable from 200 µL saliva, but estradiol fell below quantification and progesterone in under half of samples: only a subset of steroids is reliable in saliva, and not interchangeable with serum.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
A validated LC-MS/MS assay successfully measured 13 steroid hormones and two synthetic steroids in saliva, requiring only 50 microlitres, or down to 2 to 5 microlitres for nine analytes. This shows saliva's viability for non-invasive, patient-centric microsampling and decentralised monitoring in paediatric, neonatal and adult populations.
This study found that salivary 11-dehydrodexamethasone correlates strongly with serum dexamethasone, unlike salivary dexamethasone which shows poor agreement. This validation suggests patients could self-collect saliva samples at home to verify dexamethasone absorption for the overnight suppression test.
This study validated a lateral flow fluorescence assay using quantum dots for saliva and europium nanoparticles for serum to detect cortisol within physiological ranges. The test operates in 15 minutes with a handheld reader, supporting point-of-care and at-home monitoring without a cold chain.
Patient-centric microsampling of salivary cortisol shows a 12.6 nmol/L cutoff at 60 min post cosyntropin stimulation, 89% accuracy, 85% sensitivity and 90% specificity, for adrenal insufficiency diagnosis, but reproducibility in healthy volunteers was poor.
During ACTH stimulation, salivary cortisol correlated only weakly with serum and gave modest accuracy: saliva does not reliably replace serum cortisol for adrenal insufficiency. A concrete limit.