EFFECT OF ACADEMIC STRESS ON ENDOCRINE PROFILE AMONG MALE MBBS STUDENTS OF A MEDICAL COLLEGE

Background: The effect of academic stress on the endocrine system is very complex but very few studies emphasize the association between the hormonal status with different grades of stress. Aims: The study was done to establish the serum level of Cortisol, Prolactin, freeT4(fT4) and Thyroid Stimulating Hormone (TSH) as the biomarkers for academic stress. Settings and Design: Cross-sectional descriptive study. Methods and Material: Serum Cortisol, Prolactin, TSH and fT4 were measured in 123 male medical students during pre- examination, considered as a high stress period and post examination as a low stress period. Perceived Stress Scale (PSS) was provided to assess the level of stress among the participants at both time points. Statistical analysis used: Differences in mean values, Correlation and ROC curve analysis done to formulate the diagnostic accuracy of each of the endocrinal parameters. Results: All three parameters including Cortisol, Prolactin and fT4 except TSH were significantly increased with the increasing grade of stress. The ROC curve analysis illustrated a significant area under the curve (AUC) for Cortisol, Prolactin and fT4 with optimal threshold cut off value with high sensitivity and specificity. Conclusions: These combined assays of serum Cortisol, Prolactin, and fT4 can be established as a diagnostic endocrine profile to assess the severity of academic stress This is probably one of the novel approaches to compare the diagnostic accuracy with the threshold cut off value of the individual parameter and the combination profile of the stress parameters (Prolactin, fT4 & Cortisol) with severity levels of stress.