Correspondence between hair cortisol concentrations and 30-day integrated daily salivary and weekly urinary cortisol measures
Open accessAbstract
Characterization of cortisol production, regulation and function is of considerable interest and relevance given its ubiquitous role in virtually all aspects of physiology, health and disease risk. The quantification of cortisol concentration in hair has been proposed as a promising approach for the retrospective assessment of integrated, long-term cortisol production. However, human research is still needed to directly test and validate current assumptions about which aspects of cortisol production and regulation are reflected in hair cortisol concentrations (HCC). Here, we report findings from a validation study in a sample of 17 healthy adults (mean±SD age: 34±8.6 yrs). To determine the extent to which HCC captures cumulative cortisol production, we examined the correspondence of HCC, obtained from the first 1cm scalp-near hair segment, assumed to retrospectively reflect 1-month integrated cortisol secretion, with 30-day average salivary cortisol area-under-the curve (AUC) based on 3 samples collected per day (on awakening, +30min, at bedtime) and the average of 4 weekly 24-h urinary free cortisol (UFC) assessments. To further address which aspects of cortisol production and regulation are best reflected in the HCC measure, we also examined components of the salivary measures that represent: (1) production in response to the challenge of awakening (using the cortisol awakening response [CAR]), and (2) chronobiological regulation of cortisol production (using diurnal slope). Finally, we evaluated the test-retest stability of each cortisol measure. Results indicate that HCC was most strongly associated with the prior 30-day integrated cortisol production measure (average salivary cortisol AUC) (r=0.61, p=0.01). There were no significant associations between HCC and the 30-day summary measures using CAR or diurnal slope. The relationship between 1-month integrated 24-h UFC and HCC did not reach statistical significance (r=0.30, p=0.28). Lastly, of all cortisol measures, test-retest correlations of serial measures were highest for HCC (month-to-month: r=0.84, p<0.001), followed by 24-h UFC (week-to-week: r's between 0.59 and 0.68, ps<0.05) and then integrated salivary cortisol concentrations (week-to-week: r's between 0.38 and 0.61, p's between 0.13 and 0.01). These findings support the contention that HCC provides a reliable estimate of long-term integrated free cortisol production that is aligned with integrated salivary cortisol production measured over a corresponding one-month period.
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Stress is widely acknowledged for its pivotal role in the development of mental illnesses and stress-related disorders, yet the intricate biological mechanisms governing pathological stress regulation continue to challenge comprehension.
“Stress is widely acknowledged for its pivotal role in the development of mental illnesses and stress-related disorders, yet the intricate biological mechanisms governing pathological stress regulation continue to challenge our comprehension [55].”
From The Role of Cortisol in Chronic Stress, Neurodegenerative Diseases, and Psychological Disorders (2023) · cites this paper as [55]
The Introduction links long-term cortisol changes under chronic stress to increased risk of mental disease. It describes methodological difficulty in measuring long-term cortisol output, but does not say that the biological mechanisms governing pathological stress regulation remain poorly understood. (LLM, conf=0.86)
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- Authors
- Short, S. J., Stalder, T., Marceau, K., Entringer, S., Moog, N. K., Shirtcliff, E. A., Wadhwa, P. D., & Buss, C.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Brown University (US)
- University of California, Irvine (US)
- Charité – Universitätsmedizin Berlin (DE)
- Iowa State University (US)
- Corresponding author
- Buss, Claudia
- ORCID
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2016-09
- Volume
- 71
- Pages
- 12-18
- ISSN
- 0306-4530 (ISSN-L)
- PMC
- PMC4955743
- OpenAlex
- W2345786621
- Semantic Scholar
- a76d23de7a22b35ccddbf90385ba05cd6d9fed64
- Cited by
- 239
- References
- 68
- Citations by year
- 2026: 18 · 2025: 21 · 2024: 28 · 2023: 20 · 2022: 22 · 2021: 29 · 2020: 21 · 2019: 29 · 2018: 21 · 2017: 24 · 2016: 6
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- US PHS (R01 MH-091351)
- Iowa State University incentive-funding
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Veterinary › Small Animals › Animal Behavior and Welfare Studies
- Keywords
- hair cortisol, salivary cortisol, urinary free cortisol, cortisol awakening response, diurnal cortisol slope, test-retest reliability, cortisol regulation, biomarker validation, diurnal cycle, stress biomarkers, healthy adults, 24-hour urine collection
- MeSH terms
- Adult, Attention, Circadian Rhythm, Female, Hair, Humans, Hydrocortisone, Male, Middle Aged, Retrospective Studies, Saliva
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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