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

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Article

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 and Martina Montagnana

Published/Copyright: May 9, 2024

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From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 62 Issue 11

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

Corresponding author: Prof.ssa Martina Montagnana, Section of Clinical Biochemistry, Department of Engineering for Innovation Medicine, University of Verona, P.le LA Scuro, Verona, 37134, Italy, E-mail: martina.montagnana@univr.it

Giuseppe Lippi and Martina Montagnana share senior authorship.

Research ethics: University Hospital of Verona; SOPAV-1; protocol no. 971CESC.
Informed consent: Informed consent was obtained from all individuals included in this study.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: The authors state no conflict of interest.
Research funding: None declared.
Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2024-02-09

Accepted: 2024-05-02

Published Online: 2024-05-09

Published in Print: 2024-10-28

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Articles in the same Issue

https://doi.org/10.1515/cclm-2024-0196

Keywords for this article

biological variation; cortisol; cortisone; saliva