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Reliability of three versus five saliva sampling times for assessing the cortisol awakening response.
Psychoneuroendocrinology. 2023 Jan; 147:105950.P

Abstract

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 reliability 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-sampling 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 subsequently 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.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Nasser A
Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 6-8 Inge Lehmanns Vej, Copenhagen 2100, Denmark. Electronic address: Arafat.nasser@nru.dk.
Ozenne B
Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 6-8 Inge Lehmanns Vej, Copenhagen 2100, Denmark; Department of Public Health, Section of Biostatistics, University of Copenhagen, 5 Øster Farimagsgade, Copenhagen 1014, Denmark. Electronic address: Brice.ozenne@nru.dk.
Høgsted ES
Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 6-8 Inge Lehmanns Vej, Copenhagen 2100, Denmark. Electronic address: Emma.hoegsted@nru.dk.
Jensen PS
Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 6-8 Inge Lehmanns Vej, Copenhagen 2100, Denmark. Electronic address: Peter.steen.jensen@nru.dk.
Frokjaer VG
Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 6-8 Inge Lehmanns Vej, Copenhagen 2100, Denmark; Mental Health Services Capital Region Denmark, Psychiatric Center Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. Electronic address: vibe.frokjaer@nru.dk.

MeSH

HumansHydrocortisoneSalivaReproducibility of ResultsWakefulnessCircadian Rhythm

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36272363

Citation

Nasser, Arafat, et al. "Reliability of Three Versus Five Saliva Sampling Times for Assessing the Cortisol Awakening Response." Psychoneuroendocrinology, vol. 147, 2023, p. 105950.
Nasser A, Ozenne B, Høgsted ES, et al. Reliability of three versus five saliva sampling times for assessing the cortisol awakening response. Psychoneuroendocrinology. 2023;147:105950.
Nasser, A., Ozenne, B., Høgsted, E. S., Jensen, P. S., & Frokjaer, V. G. (2023). Reliability of three versus five saliva sampling times for assessing the cortisol awakening response. Psychoneuroendocrinology, 147, 105950. https://doi.org/10.1016/j.psyneuen.2022.105950
Nasser A, et al. Reliability of Three Versus Five Saliva Sampling Times for Assessing the Cortisol Awakening Response. Psychoneuroendocrinology. 2023;147:105950. PubMed PMID: 36272363.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reliability of three versus five saliva sampling times for assessing the cortisol awakening response. AU - Nasser,Arafat, AU - Ozenne,Brice, AU - Høgsted,Emma Sofie, AU - Jensen,Peter Steen, AU - Frokjaer,Vibe G, Y1 - 2022/10/07/ PY - 2022/07/04/received PY - 2022/10/04/revised PY - 2022/10/04/accepted PY - 2022/10/23/pubmed PY - 2022/12/1/medline PY - 2022/10/22/entrez KW - Cortisol awakening response KW - Cortisol indices KW - Cortisol measurement KW - Endocrinology KW - HPA-axis KW - Positron Emission Tomography KW - Steroid hormone KW - Stress hormone SP - 105950 EP - 105950 JF - Psychoneuroendocrinology JO - Psychoneuroendocrinology VL - 147 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 reliability 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-sampling 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 subsequently 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. SN - 1873-3360 UR - https://www.unboundmedicine.com/medline/citation/36272363/Reliability_of_three_versus_five_saliva_sampling_times_for_assessing_the_cortisol_awakening_response_ DB - PRIME DP - Unbound Medicine ER -