Evaluating salivary cortisol and alpha-amylase as candidate biomarkers in anorexia nervosa: a systematic review and meta-analysis

• Takahiro Seura ^[1] ; Yuuna Nanba ^[1]
  1. [1] Hokkaido University of Education

     Hokkaido University of Education

     Chūō-ku, Japón

     
• Localización: EJIHPE: European Journal of Investigation in Health, Psychology and Education, ISSN 2174-8144, ISSN-e 2254-9625, Vol. 15, Nº. 12, 2025, págs. 260-260
• Idioma: inglés
• DOI: 10.3390/ejihpe15120260
• Enlaces
  • Texto completo
• Resumen

  • Objectives: This systematic review and meta-analysis investigated whether salivary cortisol and alpha-amylase levels differ between patients with anorexia nervosa (AN) and healthy controls. Methods: A systematic literature search was conducted in PubMed, ScienceDirect, SpringerLink, and Scopus for relevant studies published up to December 2024. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Statistical heterogeneity was assessed using Cochran’s Q and the I2 statistic. Results: Data on salivary alpha-amylase were extracted from six studies including 218 patients with AN and 220 healthy controls. No significant group difference was observed (SMD = −0.48; 95% CI, −1.05 to 0.10; I2 = 86%), though sensitivity analysis indicated significantly lower levels in AN (SMD = −1.12; 95% CI, −2.16 to −0.09; I2 = 82%). Salivary cortisol was assessed in 24 reports from 17 studies (517 patients with AN, 672 controls), revealing significantly higher levels in AN (SMD = 0.69; 95% CI, 0.54–0.85; I2 = 30%). Sensitivity analyses showed stable effect sizes. Meta-regression indicated that neither age nor body mass index significantly moderated the results. Conclusions: Salivary cortisol may serve as a reliable, noninvasive biomarker for AN, with potential utility in early identification and prevention of disease progression.

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