Diurnal and day-to-day biological variation of salivary cortisol and cortisone

Elisa Danese; Andrea Padoan; Davide Negrini; Elisa Paviati; Matteo De Pastena; Alessandro Esposito; Giuseppe Lippi; Martina Montagnana

doi:10.1515/cclm-2024-0196

Diurnal and day-to-day biological variation of salivary cortisol and cortisone

Clin Chem Lab Med. 2024 May 9. doi: 10.1515/cclm-2024-0196. Online ahead of print.

Authors

Elisa Danese¹, Andrea Padoan², Davide Negrini¹, Elisa Paviati¹, Matteo De Pastena³, Alessandro Esposito³, Giuseppe Lippi¹, Martina Montagnana¹

Affiliations

¹ Section of Clinical Biochemistry, Department of Engineering for Innovation Medicine, 19051 University of Verona , Verona, Italy.
² Department of Medicine - DIMED, University of Padova, Padova, Italy.
³ General and Pancreatic Surgery Unit, Pancreas Institute, 19051 University of Verona , Verona, Italy.

PMID: 38721806
DOI: 10.1515/cclm-2024-0196

Abstract

Objectives: There is a growing interest in the relevance of salivary cortisol and cortisone concentrations in stress-related research. To correctly attribute the magnitude of salivary cortisol and cortisone variation as an effect of a stressful event, a coherent understanding of the day-to-day intra-individual and inter-individual variability across the diurnal cycle of the two steroids is required. However, such information is currently lacking.

Methods: This study aimed to overcome these existing limitations by performing an investigation of the biological variation (BV) of salivary cortisol and cortisone within one day and between five days using an LC-MS/MS method. Saliva samples were collected from 20 healthy volunteers immediately after waking up, at 8:00, 12:00, 15:00, 19:00 and 23:00 on each day over five days. All samples were analyzed in duplicate in one run. Nested ANOVA was used to calculate the sums of squares for analytical and biological components of variation.

Results: The within-subject BV of salivary cortisol and cortisone (CV_I) ranged from a minimum of 29.3 and 19.0 % to a maximum of 56.5 and 49.1 %, respectively, while the between-subject biological variation (CV_G) ranged from 29.7 and 29.0 % to 51.6 and 43.6 %. The reference change values (RCVs) ranged from 96 to 245 % for cortisol and from 55 to 194 % for cortisone. A medium index of individuality was observed for both compounds at all time points.

Conclusions: This study provides updated BV estimates and RCVs for different times of day that can be used to assess the magnitude of change in biomarkers in future stress-related research.

Keywords: biological variation; cortisol; cortisone; saliva.