ReviewEuropean journal of epidemiology2011
Reliability of hypothalamic-pituitary-adrenal axis assessment methods for use in population-based studies.
Review in European journal of epidemiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
57 citing papers in PubMed, 1 synthesis or guideline pooled it.
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- Autonomic nervous system and endocrine system response to upper and lower cervical spine mobilization in healthy male adults: a randomized crossover trial.The Journal of manual & manipulative therapy · 2023Trial
- The Effects of Acceptance and Commitment Therapy (ACT) Intervention on Inflammation and Stress Biomarkers: a Randomized Controlled Trial.International journal of behavioral medicine · 2020Trial
- Reproducibility and utility of an overnight 0.25 mg dexamethasone suppression test as a marker for glucocorticoid sensitivity in children with asthma.Journal of endocrinological investigation · 2016Trial
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- MASSAG model: Towards an integrative neuroscience framework linking emotional trauma, pain, and mechanisms of force-based manipulations.Neuroscience and biobehavioral reviews · 2026Review
- Anterior insular co-activation patterns associated with stress markers in chronic primary pain.Brain communications · 2026Article
- Deep Learning-Based Adrenal Gland Volumetry for the Prediction of Diabetes.Endocrinology and metabolism (Seoul, Korea) · 2025Observational
- Physiological and cognitive reactivity to social exclusion among emerging adults with versus without a suicide attempt history.Psychiatry research communications · 2025Article
- Cortisol, DHEAS, and the cortisol/DHEAS ratio as predictors of epigenetic age acceleration.Biogerontology · 2025Article
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- Diurnal variability of cortisol in the Pennsylvania adult smoking study: Exploration of association with nicotine intake.International journal of psychophysiology : official journal of the International Organization of Psychophysiology · 2023Article
- Effects of Linpan nature therapy on health benefits in older women with and without hypertension.Frontiers in public health · 2023Article
- Advancing health equity through integrated biology and population health research: A community-based sample cortisol feasibility and exploratory study.Comprehensive psychoneuroendocrinology · 2022Article
- New Insights into the Role of Insulin and Hypothalamic-Pituitary-Adrenal (HPA) Axis in the Metabolic Syndrome.International journal of molecular sciences · 2022Review
- Review
- Virtual Reality Based Active Shooter Training Drill Increases Salivary and Subjective Markers of Stress.The Yale journal of biology and medicine · 2022Article
- Salivary Cortisol Reaction Norms in Zoo-Housed Great Apes: Diurnal Slopes and Intercepts as Indicators of Stress Response Quality.Animals : an open access journal from MDPI · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Population-based studies have been hampered in exploring hypothalamic-pituitary-adrenal axis (HPA) activity as a potential explanatory link between stress-related and metabolic disorders due to their lack of incorporation of reliable measures of chronic cortisol exposure. The purpose of this review is to summarize current literature on the reliability of HPA axis measures and to discuss the feasibility of performing them in population-based studies. We identified articles through PubMed using search terms related to cortisol, HPA axis, adrenal imaging, and reliability. The diurnal salivary cortisol curve (generated from multiple salivary samples from awakening to midnight) and 11 p.m. salivary cortisol had the highest between-visit reliabilities (r = 0.63-0.84 and 0.78, respectively). The cortisol awakening response and dexamethasone-suppressed cortisol had the next highest between-visit reliabilities (r = 0.33-0.67 and 0.42-0.66, respectively). Based on our own data, the inter-reader reliability (r(s)) of adrenal gland volume from non-contrast CT was 0.67-0.71 for the left and 0.47-0.70 for the right adrenal glands. While a single 8 a.m. salivary cortisol is one of the easiest measures to perform, it had the lowest between-visit reliability (R = 0.18-0.47). Based on the current literature, use of sampling multiple salivary cortisol measures across the diurnal curve (with awakening cortisol), dexamethasone-suppressed cortisol, and adrenal gland volume are measures of HPA axis tone with similar between-visit reliabilities which likely reflect chronic cortisol burden and are feasible to perform in population-based studies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.