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Area Under the Curve and Other Summary Indicators of Repeated Waking Cortisol Measurements

From the Biostatistics and Epidemiology Branch (D.B.F., M.E.A., C.M.B., T.A.H., L.E.C.), Toxicology and Molecular Biology Branch (D.B.M.), Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia; Department of Social and Preventive Medicine (J.M.V.), School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, New York.

View larger version (18K): [in this window] [in a new window]   Figure 1. Plot of repeated measurements indicating magnitude of response or intensity (I1, I2, and I3) at each time point, changes in the response over time or sensitivity (S1 and S2) (A) and the three forms of AUC (B). AUC = area under the curve.

View larger version (16K): [in this window] [in a new window]   Figure 2. Pattern of four repeated measurements taken at 15-minute intervals where all subsequent measurements are larger than the baseline value. AUCI is the area under the curve above the referent baseline measurement (shaded region).

View larger version (12K): [in this window] [in a new window]   Figure 3. Pattern of four repeated measurements taken at 15-minute intervals where the value of the last sample is less than the baseline measurement. AUCI is the difference of two areas: area under the curve above the baseline value (AT1 + AT2 + AR2 + AT3) minus area above the curve below the baseline value (AT5).

View larger version (16K): [in this window] [in a new window]   Figure 4. (A–H). Various time courses of salivary cortisol and the sign and magnitude of AUCI associated with each profile. AUCI = area under the curve with respect to increase.