TY - JOUR

T1 - Reliability of three versus five saliva sampling times for assessing the cortisol awakening response

AU - Nasser, Arafat

AU - Ozenne, Brice

AU - Hogsted, Emma Sofie

AU - Jensen, Peter Steen

AU - Frokjaer, Vibe G.

PY - 2023

Y1 - 2023

N2 - The cortisol awakening response (CAR) describes the sharp increase in cortisol secretion within 60 min after awakening. A summary of the CAR, the area under the cortisol curve above the awakening cortisol value (AUCi) is a widely used biomarker in health research. Estimation of the AUCi rely on a number of collected salivary samples at fixed time intervals (i.e., 5 samples in 15 min intervals) starting from awakening. Little empirical work has been executed to investigate the impact of reducing sampling times on AUCi estimation, which could potentially improve participant compliance and reduce operational costs. This study aimed to assess the reli-ability and validity of using 3-sample AUCi versus 5-sample AUCi, i.e., systematic and random fluctuations based on a large dataset from healthy and case individuals (total n = 537). We showed that the ideal timing of 3 -sam-pling times was 0-30-60 min with a median difference in AUCi of -8 nmol*h/L and interquartile range of 65 nmol*h/L among healthy individuals, and -12 nmol*h/L and 78 nmol*h/L among case individuals. We sub-sequently validated the 3-sample AUCi by re-analyzing three published association studies. Overall, we obtained similar p-values with 3-sample AUCi when compared to 5-sample AUCi, while smaller effect sizes and standard errors were observed. In conclusion, despite a less precise estimation of the AUCi itself, our data support that the AUC measure of the CAR, based on three samples collected at 0-30-60 min from awakening, provides reliable results in association studies.

AB - The cortisol awakening response (CAR) describes the sharp increase in cortisol secretion within 60 min after awakening. A summary of the CAR, the area under the cortisol curve above the awakening cortisol value (AUCi) is a widely used biomarker in health research. Estimation of the AUCi rely on a number of collected salivary samples at fixed time intervals (i.e., 5 samples in 15 min intervals) starting from awakening. Little empirical work has been executed to investigate the impact of reducing sampling times on AUCi estimation, which could potentially improve participant compliance and reduce operational costs. This study aimed to assess the reli-ability and validity of using 3-sample AUCi versus 5-sample AUCi, i.e., systematic and random fluctuations based on a large dataset from healthy and case individuals (total n = 537). We showed that the ideal timing of 3 -sam-pling times was 0-30-60 min with a median difference in AUCi of -8 nmol*h/L and interquartile range of 65 nmol*h/L among healthy individuals, and -12 nmol*h/L and 78 nmol*h/L among case individuals. We sub-sequently validated the 3-sample AUCi by re-analyzing three published association studies. Overall, we obtained similar p-values with 3-sample AUCi when compared to 5-sample AUCi, while smaller effect sizes and standard errors were observed. In conclusion, despite a less precise estimation of the AUCi itself, our data support that the AUC measure of the CAR, based on three samples collected at 0-30-60 min from awakening, provides reliable results in association studies.

KW - Endocrinology

KW - Cortisol awakening response

KW - Cortisol measurement

KW - Cortisol indices

KW - Stress hormone

KW - Steroid hormone

KW - HPA-axis

KW - Positron Emission Tomography

KW - UNDER-THE-CURVE

KW - SEROTONIN TRANSPORTER

KW - RECEPTOR-BINDING

KW - BRAIN

KW - INDICATORS

KW - DEPRESSION

KW - REACTIVITY

KW - 5-HTTLPR

KW - WAKING

KW - MDMA

U2 - 10.1016/j.psyneuen.2022.105950

DO - 10.1016/j.psyneuen.2022.105950

M3 - Journal article

C2 - 36272363

VL - 147

JO - Psychoneuroendocrinology

JF - Psychoneuroendocrinology

SN - 0306-4530

M1 - 105950

ER -