Academic stress through salivary biomarkers: A multivariate analysis of cortisol, IL-1β, CRP, and IgA levels and their variations as a function of sex

Abstract

Introduction: Academic stress can activate physiological changes mediated by the sympathetic nervous system (SNS) and the hypothalamic–pituitary–adrenal (HPA) axis, triggering the release of biomarkers such as cortisol and proinflammatory cytokines. Although physiological stress has been studied in relation to different inducers and diseases, there is still a gap regarding the association of academic stress with biological markers. Thus, this study aimed to associate the levels of academic stress against biological markers isolated from saliva from undergraduates' students. Materials and methods: 81 students (53 women and 28 men) were recruited and completed the SISCO inventory to determine the level of academic stress. The levels of cortisol, interleukin–1β (IL–1β), C-reactive protein (CRP) and immunoglobulin A (IgA) from saliva samples were determined by ELISA assays, and data were analyzed using ANOVA, Pearson correlation tests. A predictor model was estimated by lineal regression. Results: Stress categorization following the SISCO inventory showed that 37% of the students grouped in the low stress level (<48%), 35% grouped in the moderate stress level (>49% <60%), and 28% in high stress level (>61% <100%). The levels of salivary markers were similar across stress categories, however the trends identified–such as the decrease in cortisol and the increase in pro–inflammatory markers in male participants categorized in the high stress group–suggest a possible association between these biomarkers with academic stress gender–dependent. The multivariable model including the 4 biomarkers resulted in R2 = 0.14 with predictions that were roughly within ± 20% of stress levels. Conclusion: This research suggests a possible association between academic stress and salivary biomarkers and proposes a predictive tool for stress levels in college students. Further research will consider individual factors, longitudinal assessments, and the use of multiple psychometric tools to better define the interaction between academic stress and salivary biomarkers.