The 24-hour urinary cortisol in post-traumatic stress disorder: A meta-analysis

Autoři: Xiongfeng Pan aff001;  Atipatsa C. Kaminga aff001;  Shi Wu Wen aff003;  Zhipeng Wang aff001;  Xiaoli Wu aff001;  Aizhong Liu aff001
Působiště autorů: Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China aff001;  Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi aff002;  Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario, Canada aff003;  Ottawa Hospital Research Institute, Ottawa, Ontario, Canada aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227560



Previous studies found inconsistent results on the relationship between post-traumatic stress disorder (PTSD) and concentrations of 24-hour (24-h) urinary cortisol. This study performed a systematic review and meta-analysis to summarize previous findings on this relationship.


We searched in the databases of Web of Science, PubMed, Embase, and Psyc-ARTICLES for articles published before September 2018. We used the random-effects model with restricted maximum-likelihood estimator to synthesize the effect sizes by calculating the standardized mean difference (SMD) and assessing its significance.


Six hundred and nineteen articles were identified from the preceding databases and 20 of them were included in the meta-analysis. Lower concentrations of 24-h urinary cortisol were observed in patients with PTSD when compared with the controls (SMD = -0.49, 95%CI [-0.91; -0.07], p = 0.02). Subgroup analysis revealed that the concentrations of 24-h urinary cortisol were lower in PTSD patients than in the controls for studies that included female participants or studies that included participants from the United States of America.


Overall, decreased levels of 24-h urinary cortisol were linked with the pathophysiology of PTSD. Nonetheless, more studies should be conducted to validate the molecular underpinnings of urine cortisol degeneration in PTSD.

Klíčová slova:

Cortisol – Database searching – Metaanalysis – Post-traumatic stress disorder – Systematic reviews – United States – Urine – Radioimmunoassays


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