Approaches to Salivary Cortisol Collection and Analysis in Infants

Salivary cortisol is becoming more commonly utilized as a biologic marker of stress in observational studies and intervention research. However, its use with infants (12 months of age or younger) is less widespread and poses some special challenges to researchers. In order to decide on the most suitable collection procedure for salivary cortisol in infants, a number of criteria should be considered. This article will aid investigators interested in integrating salivary cortisol measurement into their research studies by presenting (1) an overview of the patterns of cortisol secretion in infancy including the development of diurnal rhythm and response to stress; (2) a comparison of the most commonly used approaches for collecting salivary cortisol samples in infants including cotton rope, syringe aspiration technique, filter paper, hydrocellulose microsponge, and the Salimetrics children’s swab; (3) a discussion of the factors contributing to heightened cortisol variability in infancy and how these can be limited; (4) analytical issues associated with cortisol measurement; and (5) examples of criteria to consider when choosing a saliva sampling method and lab for conducting assays.

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Aerodynamic and Acoustic Voice Measures Before and After an Acute Public Speaking Stressor

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00252 ◽

2020 ◽

Vol 63 (10) ◽

pp. 3311-3325

Author(s):

Brittany L. Perrine ◽

Ronald C. Scherer

Keyword(s):

Fundamental Frequency ◽

Salivary Cortisol ◽

Public Speaking ◽

Stress System ◽

Before And After ◽

Subglottal Pressure ◽

Response To Stress ◽

System Activation ◽

Speaking Fundamental Frequency ◽

Pituitary Adrenal Axis

Purpose The goal of this study was to determine if differences in stress system activation lead to changes in speaking fundamental frequency, average oral airflow, and estimated subglottal pressure before and after an acute, psychosocial stressor. Method Eighteen vocally healthy adult females experienced the Trier Social Stress Test (TSST) to activate the hypothalamic–pituitary–adrenal axis. The TSST includes public speaking and performing mental arithmetic in front of an audience. At seven time points, three before the stressor and four after the stressor, the participants produced /pa/ repetitions, read the Rainbow Passage, and provided a saliva sample. Measures included (a) salivary cortisol level, (b) oral airflow, (c) estimated subglottal pressure, and (d) speaking fundamental frequency from the second sentence of the Rainbow Passage. Results Ten of the 18 participants experienced a hypothalamic–pituitary–adrenal axis response to stress as indicated by a 2.5-nmol/L increase in salivary cortisol from before the TSST to after the TSST. Those who experienced a response to stress had a significantly higher speaking fundamental frequency before and immediately after the stressor than later after the stressor. No other variable varied significantly due to the stressor. Conclusions This study suggests that the idiosyncratic and inconsistent voice changes reported in the literature may be explained by differences in stress system activation. In addition, laryngeal aerodynamic measures appear resilient to changes due to acute stress. Further work is needed to examine the influence of other stress systems and if these findings hold for dysphonic individuals.

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Impact of Trier Social Stress Test (TSST) on Salivary Cortisol Secretion

Acta Psychologica Sinica ◽

10.3724/sp.j.1041.2011.00403 ◽

2012 ◽

Vol 43 (4) ◽

pp. 403-409 ◽

Cited By ~ 4

Author(s):

Juan YANG ◽

Yan HOU ◽

Yu YANG ◽

Qing-Lin ZHANG

Keyword(s):

Salivary Cortisol ◽

Social Stress ◽

Stress Test ◽

Trier Social Stress Test ◽

Cortisol Secretion

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A FILTER PAPER SAMPLING METHOD FOR THE URIC ACID:CREATININE RATIO IN URINE

PEDIATRICS ◽

10.1542/peds.49.1.80 ◽

1972 ◽

Vol 49 (1) ◽

pp. 80-84

Author(s):

Roderick Mclnnes ◽

Peter Lamm ◽

Carol L. Clow ◽

Charles R. Scriver

Keyword(s):

Uric Acid ◽

Filter Paper ◽

Sampling Method ◽

Newborn Infants ◽

Postnatal Period ◽

Perinatal Complications ◽

Simple Method ◽

Automated Method ◽

The Mean ◽

Abnormal Ratio

A simple method is described for determining the uric acid: creatinine ratio (UA/C ratio) in urine collected on filter paper. Uric acid and creatinine can be eluted quantitatively from Schleicher and Schuell 903 filter paper in alkaline buffer; the eluate is analyzed for the two compounds simultaneously by an automated method. The mean UA/C ratio was defined in 820 newborn infants in the postnatal period of life. After the third day, the average is 1.49 ± 0.60 (mean ± 1SD), falling from a high value of 2.25 ± 0.85 on the second day. There is no significant sex difference or diurnal variation at this age and neither gestational age nor birth weight apparently affects the ratio. The technique can be used to screen population, particularly the neonate after the 3rd day of life, for disorders of purine metabolism. An abnormal ratio (i.e., above 3.29 or > 3SD above the mean) would indicate such a disorder. Transient high UA/C ratios can be anticipated in at least 0.5% of samples often because of acquired perinatal complications.

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Fathers' Heightened Stress Responses to Recounting their NICU Experiences Months after Discharge: A Mixed Methods Pilot Study

American Journal of Perinatology ◽

10.1055/s-0041-1731045 ◽

2021 ◽

Author(s):

Brittany J. Fronheiser ◽

Saher Ali ◽

Fumiyuki C. Gardner ◽

Alexia C. Hozella ◽

Gina M. Brelsford ◽

...

Keyword(s):

Pilot Study ◽

Thematic Analysis ◽

Stress Responses ◽

Salivary Cortisol ◽

Personal Narratives ◽

Stress Induction ◽

Stress Biomarkers ◽

Stress Responsivity ◽

Response To Stress ◽

And Coping

Objective The acute and traumatic events associated with having a newborn who requires admission to the neonatal intensive care unit (NICU) may elicit long-term concerns for parents postdischarge. Cognitive processing of taxing events influences recurring stress responses, which can be inferred via biomarkers such as salivary cortisol (sCort) and skin conductance (SC). In addition, personal narratives provide an important insight into individual perceptions and coping strategies. The current pilot study aimed to (1) test the hypotheses that fathers' sCort and SC would peak in response to stress induction and decrease during recovery, (2) examine associations among stress biomarkers and stress perceptions, (3) explore fathers' narratives using thematic analysis, and (4) integrate fathers' narrative themes with their stress responsivity. Study Design Using a convergent mixed methods approach, we enrolled 10 fathers of infants formerly cared for in NICU who underwent a Trier Social Stress Test including recounting their NICU experience months postdischarge. Stress responsivity was measured via sCort and SC, while stress perceptions were identified by using the Perceived Stress Scale and Distress Thermometer-Parent. Personal narratives were explored by using thematic analysis. Results The significant rise in fathers' sCort and SC in response to stress induction was reflected in narrative themes including loss, worry, and role strain. Subsequently, fathers' sCort and SC returned to baseline, which was illustrated by themes such as role strength, coping, and medical staff interactions. Fathers' stress measured by PSS was lower than that required for mental health referral, and did not correlate with stress biomarkers. Conclusion Salivary cortisol and skin conductance are useful biomarkers of paternal stress responsivity and recovery. Thematic analysis identified fathers' NICU stressors and coping strategies that mirrored their stress responsivity patterns. Further studies are needed to more broadly examine the sociodemographic variables that influence stress reactivity and perceptions in parents of infants formerly cared for in NICU. Key Points

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029-S: Patterns of Salivary Cortisol Secretion in Pregnancy and Implications for Assessment Protocols

American Journal of Epidemiology ◽

10.1093/aje/161.supplement_1.s8 ◽

2005 ◽

Vol 161 (Supplement_1) ◽

pp. S8-S8

Author(s):

E W Harville ◽

D A Savitz ◽

N Dole ◽

A H Herring ◽

J M Thorp

Keyword(s):

Salivary Cortisol ◽

Cortisol Secretion ◽

In Pregnancy

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Midnight salivary cortisol secretion and the use of antidepressants were associated with abdominal obesity in women with type 1 diabetes: a cross sectional study

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-019-0481-3 ◽

2019 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Eva Olga Melin ◽

Magnus Hillman ◽

Maria Thunander ◽

Mona Landin-Olsson

Keyword(s):

Type 1 Diabetes ◽

Logistic Regression ◽

Abdominal Obesity ◽

Salivary Cortisol ◽

Cross Sectional Study ◽

Cortisol Secretion ◽

Multiple Logistic Regression ◽

Sectional Study ◽

Cross Sectional

Abstract Background Abdominal obesity is a risk factor for cardiovascular disease. The aim was to explore the influence of midnight salivary cortisol (MSC), antidepressants and sex on abdominal obesity in type 1 diabetes (T1D). We controlled for physical inactivity, smoking, depression and alexithymia. Methods Cross sectional study of 190 T1D patients (86 women/104 men, 18–59 years, diabetes duration 1–55 years), consecutively recruited from one specialist diabetes outpatient clinic. Anthropometrics, blood pressure, saliva and blood samples were collected, supplemented with data from electronic medical records. Depression and alexithymia were assessed by self-report instruments. MSC (nmol/l) was categorised into 3 levels: high MSC: (≥ 6.7) (n = 64); intermediate MSC: ≥ 3.7− < 6.7) (n = 64); low MSC (< 3.7) (n = 62). Abdominal obesity was defined as waist circumference (meters) ≥ 0.88 for women and as ≥ 1.02 for men. Multiple logistic regression analyses (Backward: Wald) were performed. The Hosmer and Lemeshow test for goodness-of-fit and Nagelkerke R2 were used to evaluate each multiple logistic regression analysis model. Results The prevalence of abdominal obesity was three times higher in the women than in the men (24% versus 8%) (p = 0.002). Antidepressants were used by 10% of the women and by 4% of the men (p = 0.09). The prevalence of high MSC was 1.7 times higher in the women (43% versus 26%); the prevalence of both intermediate MSC (28% versus 38%) and low MSC (29% versus 36%) were lower in the women (p = 0.048). Significant associations with abdominal obesity were for all 190 patients: female sex (adjusted odds ratio (AOR) 3.4 (confidence interval (CI) 1.4–8.2)) and the use of antidepressants (AOR 4.3 (CI 1.2–14.8)); for the 86 women: high MSC (AOR 18.4 (CI 1.9–181)) and use of antidepressants (AOR 12.2 (CI 2.0–73.6)); and for the 104 men: alexithymia (AOR 5.2 (CI 1.1–24.9)). Conclusions Clear sex differences were demonstrated with a distinct higher prevalence of abdominal obesity, as well as a distinct higher prevalence of high midnight salivary cortisol in the women with type 1 diabetes. High midnight salivary cortisol secretion and the use of antidepressants were independent risk factors for abdominal obesity in the women.

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SOCIAL AND BEHAVIORAL FACTORS IN COGNITIVE AGING: APPLYING THE CAUSAL INFERENCE FRAMEWORK IN OBSERVATIONAL STUDIES

Innovation in Aging ◽

10.1093/geroni/igz038.1178 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S323-S323

Author(s):

Anja K Leist

Keyword(s):

Machine Learning ◽

Cognitive Decline ◽

Causal Inference ◽

Cognitive Aging ◽

Behavioral Interventions ◽

Observational Studies ◽

Intervention Research ◽

Learning Approaches ◽

Behavioral Factors

Abstract Rationale: There is an urgent need to better understand how to maintain cognitive functioning at older ages with social and behavioral interventions, given that there is currently no medical cure available to prevent, halt or reverse the progression of cognitive decline and dementia. However, in current models, it is still not well established which factors (e.g. education, BMI, physical activity, sleep, depression) matter most at which ages, and which behavioral profiles are most protective against cognitive decline. In the last years, advances in the fields of causal inference and machine learning have equipped epidemiology and social sciences with methods and models to approach causal questions in observational studies. Method: The presentation will give an overview of the causal inference framework and different machine learning approaches to investigate cognitive aging. First, we will present relevant research questions on the role of social and behavioral factors in cognitive aging in observational studies. Second, we will introduce the causal inference framework and recent methods to visualize and compute the strength of causal paths. Third, promising machine learning approaches to arrive at robust predictions are presented. The 13-year follow-up from the European SHARE survey that employs well-established cognitive performance tests is used to demonstrate the usefulness of the approach. Discussion: The causal inference framework, combined with recent machine learning approaches and applied in observational studies, provides a robust alternative to intervention research. Advantages for investigations under the new framework, e.g., fewer ethical considerations compared to intervention research, as well as limitations are discussed.

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Cortisol secretion pattern in overweight/obese and normal-weight infants: a cross-sectional study

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0273 ◽

2020 ◽

Vol 33 (2) ◽

pp. 241-246

Author(s):

Ana Cristina Resende Camargos ◽

Pedro Henrique Scheidt Figueiredo ◽

Sueli Ferreira da Fonseca ◽

Mariana Aguiar de Matos ◽

Katherine Simone Caires Oliveira ◽

...

Keyword(s):

Salivary Cortisol ◽

Area Under The Curve ◽

Cross Sectional Study ◽

Normal Weight ◽

Control Group ◽

Cortisol Secretion ◽

Cross Sectional ◽

Increased Risk ◽

Highly Sensitive ◽

Cortisol Levels

AbstractBackgroundThe salivary circadian diurnal cortisol plays an important role in growth and development. Inappropriate levels may induce changes associated with an increased risk of obesity later in life. It is unknown if there are differences in cortisol secretion pattern between overweight/obese infants when compared with theirs peers in infancy. Thus, this study aimed to compare the salivary cortisol secretion pattern in overweight/obese and normal-weight infants.MethodsThirty-three (overweight/obese = 17 and normal weight = 16) infants between 6 and 24 months of age had saliva samples collected upon awakening (T1), 30 min after waking (T2), at 12:00 am or before the baby’s meal (T3), and prior to bedtime (T4). Highly sensitive enzyme immunoassays were used for cortisol analyses.ResultsSalivary cortisol levels were similar between the groups: T1 (p = 0.22; 95% confidence interval [CI]: −5.65, 1.37), T2 (p = 0.24; 95% CI: −8.23, 2.17), T3 (p = 0.95; 95% CI: −3.16, 2.96), and T4 (p = 0.81; 95% CI: −1.39, 1.08); and no differences were observed between area under the curve (AUC) (p = 0.80; 95% CI: −4.58–13.66). The cortisol level reduced in T4 (95% CI: 1.35–2.96) compared to T1 (95% CI: 5.15–8.49) and T2 in the overweight/obese group (p < 0.001; 95% CI: 6.02–11.04). In the normal-weight group, the cortisol reduced in T3 (95% CI: 2.86–8.18) compared to T1 (95% CI: 5.64–12.28) and decreased until T4 (p = 0.001; 95% CI: 1.25–3.37).ConclusionsThe overweight/obese infant group presented a different pattern of cortisol secretion, although cortisol levels did not differ between the control group.

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