BMB Rep. 2015; 48(4): 209-216  
Technical and clinical aspects of cortisol as a biochemical marker of chronic stress
Do Yup Lee1, Eosu Kim2,* & Man Ho Choi3,*
1Department of Bio and Fermentation Convergence Technology, Kookmin University, Seoul 136-702, 2Department of Psychiatry, Institute of Behavioral Science in Medicine, Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul 120-752, 3Future Convergence Research Division, Korea Institute of Science and Technology, Seoul 136-791, Korea
Correspondence to: Eosu Kim, Tel: +82-2-2228-1620; Fax: +82-2-318-0891; E-mail:, Man Ho Choi, Tel: +82-2-958-5081, Fax: +82-2-958-5059, E-mail:
Received: October 17, 2014; Published online: April 30, 2015.
© Korean Society for Biochemistry and Molecular Biology. All rights reserved.

Stress is now recognized as a universal premorbid factor associated with many risk factors of various chronic diseases. Acute stress may induce an individual’s adaptive response to environmental demands. However, chronic, excessive stress causes cumulative negative impacts on health outcomes through “allostatic load”. Thus, monitoring the quantified levels of long-term stress mediators would provide a timely opportunity for prevention or earlier intervention of stressrelated chronic illnesses. Although either acute or chronic stress could be quantified through measurement of changes in physiological parameters such as heart rate, blood pressure, and levels of various metabolic hormones, it is still elusive to interpret whether the changes in circulating levels of stress mediators such as cortisol can reflect the acute, chronic, or diurnal variations. Both serum and salivary cortisol levels reveal acute changes at a single point in time, but the overall long-term systemic cortisol exposure is difficult to evaluate due to circadian variations and its protein-binding capacity. Scalp hair has a fairy predictable growth rate of approximately 1 cm/month, and the most 1 cm segment approximates the last month’s cortisol production as the mean value. The analysis of cortisol in hair is a highly promising technique for the retrospective assessment of chronic stress.
Keywords: Allostasis, Cortisol, Hair, Mass spectrometry, Metabolomics, Stress

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