Hansen Ase Marie, Garde Anne Helene, Persson Roger
National Research Centre for Working Environment, Copenhagen, Denmark.
Scand J Clin Lab Invest. 2008;68(6):448-58. doi: 10.1080/00365510701819127.
Salivary cortisol is often used in occupational field studies when measuring stress reactions. For purposes of precision and accuracy in measurement, and interpretation of results, it is crucial to know the sources of variability that exert systematic influence on sampling. Variability can be both biological and methodological in origin, and failure to identify its sources may induce erroneous interpretations of Type I and Type II. This review aims to increase our knowledge and provide an overview of the biological and methodological variations of relevance for field measurements of salivary cortisol. It is concluded that: (i) time of sampling has to be carefully registered and included in the statistical analysis; (ii) samples have to be collected at the same time of year in longitudinal designs; (iii) food intake has to be avoided in at least the 2 h before sampling; (iv) vigorous exercise has to be avoided in at least the 2 h, preferably longer, before saliva is collected for measurement of cortisol; (v) variation in results obtained by different laboratory techniques emphasizes use of the same, or otherwise made comparable, laboratory techniques; (vi) concentration of cortisol is dependent on the material of the tampon; (vii) despite the absence of hard evidence, it is recommended that information be collected and results possibly statistically controlled for alcohol consumption, medication, such as oral contraceptives, and treatment for mental diseases; (viii) saliva samples can be stored at -20 degrees C for at least 1 year; (ix) cross-comparisons of absolute concentrations across studies might be difficult and therefore the establishment of reference intervals for the population studied and method used is recommended.
在职业领域研究中测量应激反应时，唾液皮质醇常被使用。为了测量的精确性、准确性以及结果的解释，了解对采样产生系统性影响的变异性来源至关重要。变异性可能源于生物学和方法学两方面，未能识别其来源可能导致I型和II型错误解释。本综述旨在增加我们的知识，并概述与唾液皮质醇现场测量相关的生物学和方法学变异。得出以下结论：（i）采样时间必须仔细记录并纳入统计分析；（ii）在纵向设计中，样本必须在一年中的同一时间采集；（iii）至少在采样前2小时必须避免进食；（iv）在采集唾液测量皮质醇之前，至少在2小时内，最好更长时间，必须避免剧烈运动；（v）不同实验室技术获得的结果存在差异，这强调了使用相同的或其他可比的实验室技术；（vi）皮质醇浓度取决于棉塞的材质；（vii）尽管缺乏确凿证据，但建议收集关于酒精消费、药物（如口服避孕药）和精神疾病治疗的信息，并可能对结果进行统计控制；（viii）唾液样本可在-20摄氏度下储存至少1年；（ix）跨研究的绝对浓度交叉比较可能困难，因此建议为所研究的人群和所使用的方法建立参考区间。
