What is the Origin of Diurnal Cortisol Slope?

This concept originates from psychoneuroendocrinology research, which established that the pattern of cortisol secretion throughout the day is a more sensitive biomarker of chronic stress and allostatic load than a single static morning measurement. The diurnal rhythm is an intrinsic circadian rhythm, crucial for synchronizing numerous physiological functions, including the sleep-wake cycle and immune surveillance. Its clinical utility has been significantly enhanced by reliable salivary and urinary hormone testing.

What is the Mechanism of Diurnal Cortisol Slope?

The mechanism is tightly controlled by the suprachiasmatic nucleus, the body's master clock, which orchestrates the rhythmic pulsatile release of ACTH and subsequent cortisol production. Following the morning Cortisol Awakening Response, the HPA axis utilizes a potent negative feedback loop, mediated by glucocorticoid receptors, to rapidly suppress further cortisol release. Chronic stress or inflammation can impair the sensitivity of these feedback receptors, preventing the essential evening decline and resulting in the pathologically blunted slope.

Diurnal Cortisol Slope

Meaning

The Diurnal Cortisol Slope is a precise clinical measurement representing the rate and magnitude of the decrease in the stress hormone cortisol concentration from its peak shortly after waking to its nadir late in the evening. A steep, pronounced slope is indicative of a well-regulated Hypothalamic-Pituitary-Adrenal axis and metabolic resilience, reflecting the body’s ability to efficiently downregulate stress responses. Conversely, a flattened slope, where evening cortisol remains inappropriately elevated, is often associated with chronic stress and increased cardiometabolic risk.

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