Abstract

Salivary biomarkers have been widely used to help diagnose stress, anxiety, and/or depression. This study aimed to compare the responses of three commonly investigated salivary stress biomarkers that represent the hypothalamic-pituitary-adrenal activity (cortisol; sCort) and the sympathetic activity (alpha-amylase; sAA and chromogranin A; sCgA), using academic oral presentation as a model of stress. Twenty postgraduate dental students attended the seminar class as presenter and audience. The presenters’ performances were evaluated by the instructors suggesting more stress than the audience. The saliva was collected two times: before attending class and after an academic presentation (for presenters) or during the class (for audience). The pulse rates (PR) were also recorded. The results showed that the levels of all three biomarkers, as well as PR, were significantly higher in the presenter group compared with the audience group; however, the changes were most prominent with sCort and sAA (99.56 ± 12.76% for sCort, 93.48 ± 41.29% for sAA, 16.86 ± 6.42% for sCgA, and 15.06 ± 3.41% for PR). When compared between pre-post presentation, the levels of sCgA were not different, while those of sCort and sAA were significantly increased. These results suggest more sensitive reactivity to academic stress of sCort and sAA compared with sCgA and that the response of sCgA did not necessarily follow sAA pattern even though both are claimed to reflect the sympathetic activity. More studies are needed to elucidate the roles of sCgA in stress.

Highlights

  • Stress is a great topic of research interest because it can impact the quality of life and can lead to increased morbidity and mortality [1,2]

  • Various methods have been used for stress evaluation, e.g. collecting questionnaires [3,4], physical examination by evaluating heart rate, electrocardiogram, heart rate variability, skin conductance, or sweat production [5,6,7], and evaluation of biological markers indicating the physiological response to stress [8,9]

  • Examining the relationship between visual analog scale (VAS) scores and sleep duration to salivary cortisol (sCort), such as alpha-amylase (sAA), sCgA, and pulse rate responses revealed no significant correlations in the presenter group (S1 Fig)

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Summary

Introduction

Stress is a great topic of research interest because it can impact the quality of life and can lead to increased morbidity and mortality [1,2]. The body’s response to stress involves two major systems which are the hypothalamic-pituitaryadrenal (HPA) axis and the sympathetic-adrenal-medullary (SAM) system [10,11,12,13,14].

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