Reliability of hypothalamic–pituitary–adrenal axis assessment methods for use in population-based studies

May 3, 2011European journal of epidemiology

Reliability of methods measuring stress hormone system activity in large population studies

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Abstract

The diurnal salivary cortisol curve and 11 p.m. salivary cortisol exhibited high reliability with between-visit correlations of r = 0.63-0.84 and 0.78, respectively.

  • Chronic cortisol exposure may be better assessed using multiple salivary samples taken throughout the day.
  • The cortisol awakening response and dexamethasone-suppressed cortisol showed moderate reliability with between-visit correlations of r = 0.33-0.67 and 0.42-0.66, respectively.
  • Inter-reader reliability for adrenal gland volume measured by non-contrast CT ranged from r = 0.67-0.71 for the left adrenal gland and 0.47-0.70 for the right gland.
  • A single 8 a.m. salivary cortisol sample, while easily obtainable, had the lowest reliability with correlations of R = 0.18-0.47.
  • Multiple measures of salivary cortisol and adrenal gland volume are feasible and may effectively reflect HPA axis activity in population-based studies.

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