Alpha amylase as a salivary biomarker of acute stress of venepuncture from periodic medical examinations

Abstract

Periodic occupational health examinations often require venepuncture. Acute psycholog-ical and physical stressors during such procedure result in sympathetic stimulation and increased salivary protein secretion, including salivary ?-amylase (SAA). We studied SAA response to venepuncture during such examination. Fifty-eight healthy males undergoing periodic medical examination reported perceived stress level (PSL) scores (on a five-point scale) and provided passive drool saliva samples at 15-min (T1) and 1-min before (T2); and 1-min (T3) and 15-min after venepuncture (T4). A subset of 33 participants available for repeat examination on a control day when there was no venepuncture provided saliva samples at the corresponding times for comparison. Saliva SAA activity levels were analyzed using a SAA assay kit (Salimetrics LLC, USA). Among 58 participants, mean SAA increased from T1 (89.95U/L) to T2 (109.5U/L) and T3 (116.9U/L). SAA remained elevated 15min after venepuncture (121.0U/L). A positive trend in the difference of SAA betweenT3 andT1 was noted among subjects with increasing mean PSL scores. T3-T1 values were 0.6 (among those with PSL?1, nD24), 11.3 (among those with PSL between 1 and 1.5, nD18), and 78.9 (among those with PSL>1.5, nD16). SAA increment over four-time points was signif-icantly higher on the venepuncture compared to the control day (P D0.021). SAA increases in response to the acute stress of venepuncture during a periodic medical examination, and remains elevated 15min after the procedure. In comparison, such fluctuations in SAA were not seen on a control day. During venepuncture, increase in SAA from baseline is higher among those who reported greater self-perceived stress during the procedure. © 2014 Koh, Ng and Naing .