Salivary cortisone, as a biomarker for psychosocial stress, is associated with state anxiety and heart rate

Yoon Ju Bae; Janis Reinelt; Jeffrey Netto; Marie Uhlig; Anja Willenberg; Uta Ceglarek; Arno Villringer; Joachim Thiery; Michael Gaebler; Juergen Kratzsch

doi:10.1016/j.psyneuen.2018.10.015

Salivary cortisone, as a biomarker for psychosocial stress, is associated with state anxiety and heart rate

Psychoneuroendocrinology. 2019 Mar:101:35-41. doi: 10.1016/j.psyneuen.2018.10.015. Epub 2018 Oct 28.

Authors

Affiliations

¹ Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Strasse 13-15, 04103, Leipzig, Germany.
² Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Stephanstraße 1a, 04103, Leipzig, Germany.
³ Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Stephanstraße 1a, 04103, Leipzig, Germany; Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany; Mind Brain Body Institute at the Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Luisenstraße 56, 10117, Berlin, Germany.
⁴ Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Strasse 13-15, 04103, Leipzig, Germany. Electronic address: Juergen.Kratzsch@medizin.uni-leipzig.de.

PMID: 30408721
DOI: 10.1016/j.psyneuen.2018.10.015

Abstract

Background: Stress activates the central nervous, the autonomic nervous, and the endocrine system. This study aimed to (1) test the usability of salivary cortisone in a standardized psychosocial stressor, (2) create a comprehensive profile of hormonal responses to determine laboratory parameters with high discriminatory power, and (3) analyze their association with psychometric and autonomic stress measures.

Methods: Healthy young men (18-35 years) completed either the Trier Social Stress Test (TSST) (n = 33) or a Placebo-TSST (n = 34). Blood and saliva were collected at 14 time points along with state-anxiety (STAI) and heart rate. Serum steroids (cortisol*, cortisone*, dehydroepiandrosterone-sulfate, androstenedione*, progesterone*, 17-hydroxyprogesterone*, testosterone, estradiol*, aldosterone*), salivary cortisol* and cortisone*, copeptin*, adrenocorticoptropic hormone*, corticosteroid-binding globulin, and salivary alpha-amylase* were analyzed. We used mixed-design ANOVAs to test group differences, receiver operator characteristic (ROC) curve analyses to assess the discriminatory power of each measure, and Spearman correlation analyses to probe the association between measures.

Results: The largest area under the ROC curve was observed in salivary cortisone at 20 min after the end of the TSST (AUC = 0.909 ± 0.044, p < 0.0001). Significant time-by-group interactions were found in the parameters marked with * above, indicating stress-induced increases. The peak response of salivary cortisone was significantly associated with those of STAI (rho = 0.477, p = 0.016) and heart rate (rho = 0.699, p < 0.0001) in the TSST group.

Conclusion: Our study found salivary cortisone to be a stress biomarker with high discriminatory power and significant correlations with subjective and autonomic stress measures. Our results can inform future stress studies of sampling time for different laboratory parameters.

Keywords: Heart rate; Salivary cortisone; State trait anxiety inventory; Stress biomarker; Temporal dynamics; Trier Social Stress Test.

MeSH terms

Adult
Anxiety / physiopathology
Anxiety Disorders
Area Under Curve
Biomarkers
Heart Rate / physiology*
Humans
Hydrocortisone / analysis*
Male
ROC Curve
Risk Factors
Saliva / chemistry
Steroids / analysis
Steroids / blood
Stress, Physiological / physiology
Stress, Psychological / physiopathology*
Young Adult

Substances

Biomarkers
Steroids
Hydrocortisone