{
  "abstract": "Globally, university students face substantial psychological pressures, and stress-related mental health disorders are recognized as major public health concerns. While biomarkers such as cortisol have been extensively studied, integrated analyses of neuroendocrine-immune-circadian interactions remain limited. In this cross-sectional study with two complementary components, psychometric assessments of 637 undergraduates revealed that 90.4% experienced moderate-to-high perceived stress. These stress levels correlated with fatigue (r = 0.41, p < 0.01) and poor sleep quality (r = 0.35, p < 0.01). A second component involved laboratory-based diurnal biomarker profiling of 33 high-stress and low-stress participants, revealing stress-dependent physiological patterns. Specifically, high stress was associated with sympathetic activation (α-amylase↑), HPA axis dysregulation (altered diurnal cortisol patterns), circadian disruption (melatonin↑), and mucosal immune activation (IgA ↑ , lysozyme↑). The coupling of α-amylase and lysozyme suggested neuro-immune coordination (r = 0.52, p < 0.001). These findings indicate that salivary biomarker profiles are associated with perceived stress. Sleep quality and fatigue warrant further investigation as potential intervention targets in future longitudinal studies.",
  "abstract_shown": true,
  "affiliations": [
    "College of Science and Technology, Wenzhou-Kean University, Wenzhou, Zhejiang, China",
    "Dorothy and George Hennings College of Science, Mathematics and Technology, Kean University, Union, New Jersey, United States of America",
    "Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China",
    "The Key Laboratory of Aerospace Medicine, Ministry of Education, Fourth Military Medical University, Xi'an, Shaanxi, China",
    "Department of Neurosurgery, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hongyu Xu"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhiqiang Yan"
    },
    {
      "affs": [
        2
      ],
      "name": "Xinyi Kong"
    },
    {
      "affs": [
        3
      ],
      "name": "Shuang Wu"
    },
    {
      "affs": [
        4
      ],
      "name": "Fei Shi"
    },
    {
      "name": "Qiong Ye"
    },
    {
      "name": "Zijin Li"
    },
    {
      "name": "Jia Lu"
    },
    {
      "name": "Juan Fang"
    },
    {
      "name": "Kexin Chen"
    },
    {
      "name": "Jiajun Bao"
    },
    {
      "name": "Yiyao Huang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/exjpyr4pwpc5a.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pmen.0000717",
  "fulltext_url": "https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000717",
  "id": "exjpyr4pwpc5a",
  "issns": [
    "2837-8156"
  ],
  "landing_url": "https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000717",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2802|Stress Responses and Cortisol"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Biomarkers"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Enzymology/Enzymes/Lysozyme"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Hormones/Lipid hormones/Cortisol"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Hormones/Melatonin"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Hormones/Steroid hormones/Cortisol"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Proteins/Enzymes/Lysozyme"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Physiological processes/Sleep"
    ],
    [
      "plos",
      "/Biology and life sciences/Psychology/Psychological stress"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Fatigue"
    ],
    [
      "plos",
      "/Medicine and health sciences/Mental health and psychiatry"
    ],
    [
      "plos",
      "/Medicine and health sciences/Mental health and psychiatry/Psychological stress"
    ],
    [
      "plos",
      "/Social sciences/Psychology/Psychological stress"
    ]
  ],
  "openalex": "W7213276388",
  "pdf_url": "https://journals.plos.org/mentalhealth/article/file?id=10.1371/journal.pmen.0000717&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-15",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/exjpyr4pwpc5a.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:49Z",
      "native_id": "10.1371/journal.pmen.0000717",
      "source": "plos",
      "url": "https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000717"
    }
  ],
  "subjects": [
    {
      "field": "biochemistry",
      "origin": "plos:enzymology",
      "subfield": "enzymology-metabolism"
    },
    {
      "field": "medicine",
      "origin": "plos:physiology",
      "subfield": "physiology"
    },
    {
      "field": "medicine",
      "origin": "plos:mental health and psychiatry",
      "subfield": "psychiatry"
    }
  ],
  "title": "The hidden burden of college life: Stress, sleep, and salivary biomarkers in students—A cross-sectional study",
  "title_text": "The hidden burden of college life: Stress, sleep, and salivary biomarkers in students—A cross-sectional study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:49Z",
  "url": "https://research.draconitic.com/paper/exjpyr4pwpc5a",
  "venue": "PLOS Mental Health",
  "versions": []
}