Altered circadian patterns of salivary cortisol in low-functioning children and adolescents with autism

Is afternoon cortisol more reliable than waking cortisol in association studies of children with an ASD?

“…Confirming the Tordjman et al [72] and Bitsika et al [6] findings, a comment from a contemporary review of 53 studies of the HPA-axis DR in children and adolescents with an ASD was that "patterns of diurnal rhythm appear to be abnormal" ( [71], p. 208) in these children. It may be that, due to extraneous factors such as those reported above, the DR is not a reliable indicator of HPA-axis activity in children with an ASD.…”

“…All of the studies which used LF alone or a combination of HF + LF also reported altered cortisol DR. Of those studies which included HF participants, five reported some degree of variability or inconsistency in the cortisol DR compared to non-ASD children and two reported no significant differences in cortisol DR across ASD and non-ASD samples. Tordjman et al [72] commented that the overall outcome from these 11 studies was hampered by small sample sizes, level of cognitive functioning and whether serum or salivary cortisol was collected (the former might present a more stressful demand to children than the latter).…”

“…In response to those limitations in the previous literature, Tordjman et al [72] then examined the salivary cortisol DR in 55 LF (M IQ = 42, range 40-58) children and adolescents with ASD compared to 32 non-ASD children. Results indicated that these LF children with ASD had higher cortisol concentrations at all sampling times but flatter slopes across the day and night.…”

“…It is noteworthy that Tordjman et al [72] received parental reports that the process of saliva collection (via a dental cotton roll that was to be placed in the children's mouths for 1 min by their parents) was stressful for some children, as evidenced by screaming and attempts to escape by the children. It might be argued that this saliva collection procedure (repeated five times during the day: 8 am, 11 am, 4 pm, midnight and 8 am) represented a repeated stressor that these children did not understand or comply with, thus adding a potential extra factor to the data collected, which was acknowledged by Tordjman et al [72]. Thus, these data might properly be considered as representing salivary cortisol concentrations during 24 h of repeated stressor events, perhaps accounting for the elevated cortisol concentrations at all sampling points and the relative lack of the DR variation.…”

Relationship Between Oral Health-Related Quality of Life and Salivary Cortisol Levels in Children With Caries

“…If dental caries remain untreated, they can have an impact on a child's OHRQoL [4]. Moreover, the chronic inflammation caused by dental caries in children can trigger a salivary cortisol release in response to homeostasis [5].…”