Uncorrected Proof Trends in Med Sci. 2022 May; 2(2):e129845. Published online 2022 August 6. doi: 10.5812/tms-129845. Research Article Eﬀect of Competition on the Salivary Cortisol Level in Elite Boy Swimmers Farhang Hooshmand 1 , Karamatollah Rahmanian 2 , Vahid Rahmanian 2 , Masihollah Shakeri 1 and Abdolreza Sotoodeh Jahromi 1, * 1 Research Center for Noncommunicable Diseases, Jahrom University of Medical Science, Jahrom, Iran 2 Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran * Corresponding author: Research Center for Noncommunicable Diseases, Jahrom University of Medical Science, Jahrom, Iran. Email: sotoodehj2002@yahoo.com Received 2022 July 15; Revised 2022 July 20; Accepted 2022 July 20. Abstract Background: The eﬀect of exercise on serum and salivary cortisol levels depends on the intensity of sports. So far, no study has evaluated the eﬀect of acute exercise on cortisol levels. Objectives: This study aimed to determine and compare the salivary cortisol concentration two weeks and 30 minutes before com- petition in elite adolescent boy swimmers. Also, we determined the association between anxiety and salivary cortisol levels. Methods: We included 14 elite boy swimmers aged 10 - 13 years old. Anxiety was assessed using the Sports Competition Anxiety Test (SCAT) 30 minutes before the competition. Saliva samples were measured two weeks and 30 minutes before the swimming competition. The enzyme-linked immunosorbent assay (ELISA) technique was used to assess salivary cortisol levels. Using paired t-test, we compared salivary cortisol levels 30 minutes and two weeks before the competition. Also, we used linear regression to examine the eﬀect of anxiety on salivary cortisol levels before the competition. Results: Our results showed a signiﬁcantly elevated cortisol level 30 minutes before the competition compared to two weeks before the competition (5.24 ± 1.97 vs. 3.47 ± 1.03 μg/dL, P = 0.007). However, pre-competition salivary cortisol levels were not signiﬁcantly related to SCAT, somatic, and cognitive anxiety (P > 0.05). Conclusions: According to the results of this study, swimming competition inﬂuenced salivary cortisol response before the com- petition. Keywords: Cortisol, Saliva, Anxiety, Swimming, Exercise 1. Background Cortisol, the principal glucocorticoid in humans, is known to play a major role in metabolism and immune function (1, 2). There are conﬂicting data on the eﬀect of acute exercise on cortisol levels (3). Salivary cortisol con- centration may be more appropriate to evaluate the activ- ity of glucocorticoids than their serum concentration (3, 4). Competition can cause acute stress, and studies showed that acute exercise can raise cortisol levels in saliva (5, 6). Also, among female soccer players, saliva cortisol concen- trations were higher ten minutes before the match com- pared to immediately after the match (5). Similarly, an el- evated cortisol level was identiﬁed among young female gymnasts (7) and bicyclists (8). Previous studies reported that exercise had no eﬀect or negative eﬀect on salivary cortisol levels. Talebi et al. (9) re- ported that resistance or powerful exercise signiﬁcantly re- duced the salivary cortisol levels in swimmers. On the con- trary, Adesola (3) stated that salivary cortisol concentration did not change signiﬁcantly among male children after ex- ercise. A study on male soccer players in Iran showed a rise in salivary cortisol levels after the ﬁrst and second half of the competition compared to two hours before the match (10). Another study on female football players showed that cor- tisol decreased after the match and throughout the tour- nament, independently of the match outcome (11). Athletes’ anxiety is a physiological reaction to an imag- inary or real threat. A positive stress is essential to attain the desired task. Upper levels of anxiety physically inhibit acts by creating muscle tension and impairing activity or- ganization. However, the low performance of athletes was related to higher stress (12). Anxiety can increase corticos- teroid hormones. In another study, pre-match cortisol con- centrations were signiﬁcantly associated with anxiety (13). Copyright © 2022, Trends in Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.