Sialochemistry and cortisol levels in patients with Sjogren's syndrome

Oral Dis. 2012 Apr;18(3):255-9. doi: 10.1111/j.1601-0825.2011.01866.x. Epub 2011 Nov 4.


Objectives: (i) To determine whether salivary cortisol and electrolyte levels differ between patients with Sjogren's syndrome (SjS) and healthy individuals. (ii) To assess correlations between whole-saliva cortisol and some clinical manifestations in patients with SjS.

Methods: A total of 24 healthy women (mean age 49.3±9.8) served as controls (C) vis-à-vis 17 patients with SjS (mean age 55.5±15.7). Salivary cortisol concentration was determined, and sialochemistry analysis was performed.

Results: Significantly lower saliva flow rates and higher salivary chloride (Cl(-) ), potassium (K(+) ), and Ca(2+) levels were found in the SjS group. No significant differences or correlations were found in other parameters, including sodium (Na(+) ), magnesium (Mg(2+) ), phosphate ((-) ), urea (U), and salivary cortisol levels.

Conclusion: Increased whole-salivary output of Cl(-) and K(+) in SjS may reflect release from apoptotic rests of acinar cells after secondary necrosis. Normal levels of salivary Na(+) , Mg(2+) , and (-) argue against concentration effect, deranged tubular function or cortisol (mineralocorticosteroid) effect as the cause for these findings. Increased salivary Ca(2+) levels probably reflect leakage of plasma Ca(2+) through the injured oral mucosa in SjS. In spite of disease-associated stress, salivary cortisol, a stress biomarker, was not increased, suggesting insufficient hypothalamus-pituitary-adrenal (HPA) axis response and/or local consumption of cortisol by lymphocyte infiltrates.

Publication types

  • Comparative Study

MeSH terms

  • Acinar Cells / metabolism
  • Apoptosis / physiology
  • Calcium / analysis
  • Case-Control Studies
  • Chlorides / analysis
  • Electrolytes / analysis
  • Female
  • Humans
  • Hydrocortisone / analysis*
  • Magnesium / analysis
  • Middle Aged
  • Phosphates / analysis
  • Potassium / analysis
  • Saliva / chemistry*
  • Saliva / metabolism
  • Secretory Rate
  • Sjogren's Syndrome / metabolism*
  • Sodium / analysis
  • Urea / analysis


  • Chlorides
  • Electrolytes
  • Phosphates
  • Urea
  • Sodium
  • Magnesium
  • Potassium
  • Calcium
  • Hydrocortisone