Urinary Cortisol Concentrations Research Articles

Oxytocin and cortisol concentrations in urine and saliva in response to physical exercise in humans

BackgroundWhile peripheral markers of endogenous oxytocin and glucocorticoid release are widely employed in psychological and behavioural research, there remains uncertainty regarding the effectiveness of saliva and urine samples in accurately capturing fluctuating hormone levels in response to relevant stimuli. In addition, it is unclear whether and under which conditions, urinary concentrations correlate with salivary levels of oxytocin and cortisol. MethodsIn the present study, two groups of healthy adult male and female participants (N=43) provided heart rate, saliva, and urine samples before and after exercising at different durations and intensities (3 ×10 min of running vs. 60 min of running). Effects of age, gender, cycle phase, and previous running experience were considered in the statistical analyses. Concentrations of oxytocin and cortisol were analysed in both saliva, and urine using validated assays. ResultsRunners of both groups had significantly increased oxytocin concentrations in urine and saliva after running than before. Oxytocin in saliva was elevated after 10 min and peaked after 30 min of running. Only participants of the long-running group showed an increase in urinary cortisol concentrations following exercise (and only after 90 min of stimulus onset), and neither group had a significant increase in salivary cortisol levels. Oxytocin rise in urine and saliva from basal to post-run was strongly and significantly correlated, as was cortisol rise from basal to post-rest, but no correlations between absolute hormone concentrations were found for oxytocin. ConclusionsOur results show that both urine and saliva are useful body fluids that can provide meaningful results when measuring oxytocin and cortisol concentrations after a physical stimulus. While temporal resolution may be better with salivary sampling as higher sampling frequency is possible, signal strength and robustness were better in urinary samples. Importantly, we report a strong correlation between the magnitude of change in oxytocin and cortisol concentrations in urine and saliva following physical exercise, but no correlations between absolute oxytocin concentrations in the two substrates.

Steroid Profiling and Circadian Cortisol Secretion in Patients with Mild Autonomous Cortisol Secretion: A Cross-Sectional Study.

Mild autonomous cortisol secretion (MACS) is diagnosed based on post-dexamethasone cortisol>1.8 mcg/dL. Scarce evidence exists on steroid circadian secretion and steroid metabolome in MACS. To characterize 24-hour (h) urine steroid metabolome in patients with MACS and determine circadian differences in urine steroid profiling and cortisol concentrations in patients with MACS versus referent subjects. Cross-sectional study, 2018-2023. Referral center. Patients with MACS and age-, sex-, BMI-, and menopausal status-matched referent subjects. Urine was collected over 24h period as separate day- and night-time collections. High-resolution mass spectrometry assay was used to measure 25 steroids. A subgroup of patients and referent subjects were admitted for every 2h serum measurements of free and total cortisol. Steroids, sums, and ratios. Patients with MACS (n=72) had lower mcg/24h median androgens (2084 vs 3283, P<0.001), higher glucocorticoids (15754 vs 12936, P<0.001), and higher glucocorticoid/androgen ratio (8.7 vs 3.9, P<0.001), compared to referent subjects. Patients also had lower steroid day/night ratios compared to referent subjects, reflecting a higher relative nocturnal steroid production in MACS. In a subgroup of 12 patients with MACS and 10 referent subjects, the 24-hour area under the curves for total and free cortisol were similar. However, evening mean total (5.3 vs 4.0 mcg/dL, P=0.056) and free (0.2 vs 0.1 mcg/dL, P=0.035) cortisol was higher in patients vs referent subjects. Patients with MACS demonstrate an abnormal urine steroid metabolome, with a high glucocorticoid to androgen ratio, and a higher nocturnal steroid production.

Urinary steroid profiling using liquid chromatography-tandem mass spectrometry for the diagnosis of canine Cushing’s syndrome

Serum cortisol measurements by chemiluminescence enzyme immunoassay (CLEIA) are widely used to diagnose hypercortisolism (HC) or Cushing’s syndrome in dogs. However, they are associated with problems such as the need for multiple blood collections under stressful conditions or cross-reactivity between hormones. Therefore, a less invasive and more accurate diagnostic method is required. This study aimed to develop a urinary steroid profile analysis method using liquid chromatography-tandem mass spectrometry (LC/MS/MS) and to evaluate its clinical usefulness. Sixty-five healthy dogs and 38 dogs with suspected HC were included in the study. Using LC/MS/MS, the levels of 11 steroid hormones in the urine were determined. We established the upper limit of the reference interval for each urinary steroid-to-creatinine ratio and evaluated their diagnostic performances. The levels of the five steroid hormones were significantly higher in the 14 dogs with HC than in the 24 dogs with mimicking HC and 65 healthy dogs. The urinary corticosterone-to-creatinine ratio showed the highest diagnostic accuracy (area under the curve, 0.96). A significant correlation was seen between urinary cortisol concentrations measured by LC/MS/MS and CLEIA (rs = 0.88, P <0.001), although the CLEIA measurements were significantly higher than the LC/MS/MS measurements (P <0.001). LC/MS/MS-based urinary steroid profiles are a promising tool for diagnosing canine HC.

Attachment-like behavioral expressions to humans in puppies are related to oxytocin and cortisol: A comparative study of Akitas and Labrador Retrievers

This study investigated the relationship between urinary hormone concentrations and attachment-related behaviors in two dog breeds, the Akitas and Labrador Retrievers, to elucidate the hormonal and behavioral mechanisms underlying domestication and interspecies attachment to humans. By measuring cortisol and oxytocin concentrations, and conducting the Strange Situation Test (SST), we aimed to investigate breed differences in endocrine secretions associated with domestication and how these differences influence dog behavior toward humans. Our results showed significant breed differences in urinary cortisol concentrations, with Akitas exhibiting higher levels than Labrador Retrievers. This suggests a breed-specific stress response related to genetic proximity to wolves. However, oxytocin concentrations did not differ significantly, which suggests a complex interplay between factors influencing the domestication process and the formation of attachment behaviors. Behavioral observations during the SST revealed breed-specific patterns, with Labrador Retrievers showing more playful and attachment-like behaviors and Akitas showing more exploratory and passive behaviors. The study found correlations between hormones and behaviors within breeds, particularly in Labrador Retrievers, where oxytocin concentrations were associated with attachment-like behaviors, and cortisol concentrations reflected individual differences in physical activity rather than stress responses to social situations. These findings contribute to the understanding of the evolutionary and adaptive processes underlying the ability of domestic dogs to form close relationships with humans while highlighting the role of hormonal mechanisms in mediating attachment behaviors and the influence of breed-specific genetic backgrounds on these processes.

Transition to a market economy and chronic psychosocial stress in northern Laos: An exploratory study of urinary free cortisol in rural residents.

The indigenous population in northern Laos has experienced a transition from self-sufficiency to a market-oriented economy, which may have brought about unprecedented chronic psychosocial stress. This study examined the association between the transition to a market economy and urinary free cortisol (UFC) concentration as a stress biomarker among rural residents of three villages with different degrees of integration into the market economy. An interview survey and urine sample collection were conducted in August 2018 and March 2019. We measured the UFC concentration in spot urine samples collected in the morning from participants aged 20-60 years (n = 168) using an enzyme-linked immunosorbent assay. Multiple linear regression analysis was performed to examine differences in UFC concentrations among villages by sex, with time of arrival for the survey, age, and body mass index included as covariates. The UFC concentration was higher in men living in the village with the highest degree of integration into the market economy than in those in the two villages with a lower dependence on cash, possibly linking increased stress levels with a change in employment type. This trend was not observed in women. Socioeconomic changes incidental to a transition to a market economy may increase the stress levels of men in northern Laos.

Features of hormonal homeostasis in women with functional hypothalamic amenorrhea and premature ovarian insufficiengy caused by posttraumatic stress disorder.

Posttraumatic stress disorder can cause severe and prolonged amenorrhea in women. Since the beginning of the war in Ukraine, there has been an increased number of visits for the medical care of female military servicewomen and displaced women with this problem.The objective: to perform a comprehensive study of the characteristics of the hormonal levels of the hypothalamic-pituitary-ovarian axis and the stress hormone cortisol, as well as to analyze the presence of autoantibodies to ovarian tissue in women with secondary amenorrhea caused by posttraumatic stress disorder.Materials and methods. The levels of hypothalamic-pituitary-ovarian hormones (follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol, progesterone, free testosterone and anti-Mullerian hormone (AMH), as well as cortisol (urine), autoantibodies to ovarian tissue from 54 military servicewomen and displaced women with amenorrhea caused by posttraumatic stress disorder (main group). 35 (64.8%) women (the 1st subgroup) were diagnosed with functional hypothalamic amenorrhea (FHA), 19 (35.2%) patients (the 2nd subgroup) were diagnosed with premature ovarian failure (POF).The control group included 23 women of reproductive age (18–37 years), who were in a state of psychological comfort and had no menstrual cycle disorders.Results. As a result of the study, a significant (p&lt;0.05) decrease of all pituitary-ovarian hormones was found in women with FHA, except for free testosterone and AMH. In patients with POF, there was an increased concentration of pituitary hormones and a decreased amount of estradiol by 2.2 times, progesterone by 3.9 times, and AMH by 21.0 times compared to the control group.A 1.5-fold increase in prolactin level in patients with POF compared to the indicator of the control group is noteworthy. The presence of autoantibodies in the group with POF was detected in 26.3% of cases (in the group of women with FHA – only in 2.9% of cases; p&lt;0.05), which may be a manifestation of polyglandular autoimmune syndrome.In both examined subgroups of the main group, a probable increased cortisol concentration in daily urine was determined (by 2.0 times in the 1st subgroup and by 2.1 times in the 2nd subgroup compared to the control), which indicates a stressogenic dysfunction of the adrenal glands.Conclusions. Posttraumatic stress disorder can have an irreversible pathological effect on the reproductive system of women. In women with stressogenic functional hypothalamic amenorrhea there is a deep depression of the hypothalamic-pituitary-ovarian axis with preserving the follicular ovarian apparatus.In women with premature ovarian failure (POF) with long-term stress, there is a sharp depletion of the ovarian reserve. The presence of autoantibodies to ovarian tissue indicates the involvement of the immune system in the pathogenetic chain of development of amenorrhea, the severity of the lesion and the higher speed of the follicle atresia process by POF.

Prevalence and incidence of type 2 diabetes mellitus in patients with adrenal incidentalomas: a study of 709 cases.

To evaluate the prevalence and incidence of type 2 diabetes in patients with nonfunctioning adrenal incidentalomas (NFAI) or adrenal incidentalomas (AI) with autonomous cortisol secretion (ACS). In this single-center retrospective study, all patients with adrenal incidentalomas ≥1 cm and ACS or NFAI studied between 2013 and 2020 were included. ACS was defined by a post-dexamethasone suppression test (DST) serum cortisol concentration ≥1.8 μg/dl, in the absence of signs of hypercortisolism, and NFAI was defined as a DST < 1.8 μg/dl without biochemical evidence of hypersecretion of other hormones. Inclusion criteria were met by 231 patients with ACS and 478 with NFAI. At diagnosis, type 2 diabetes was present in 24.3% of patients. No differences were found in the prevalence of type 2 diabetes (27.7 vs. 22.6%, P = 0.137) between patients with ACS and NFAI. However, fasting plasma glucose values and glycated hemoglobin levels were significantly higher in patients with ACS than with NFAI (112 ± 35.6 vs. 105 ± 29 mg/dl, P = 0.004; and 6.5 ± 1.4 vs. 6.1 ± 0.9%, P = 0.005, respectively). Furthermore, patients with type 2 diabetes had higher urinary free cortisol (P = 0.039) and late-night salivary cortisol levels (P = 0.010) than those without type 2 diabetes. After a median follow-up of 28 months, no differences were found in the incidence of type 2 diabetes between the groups (HR 1.17, 95% 0.52-2.64). Type 2 diabetes was present in one fourth of our cohort. We found no differences in its prevalence or incidence between the groups. However, glycemic control might be worse among diabetic patients with ACS. Higher concentrations of urinary and salivary cortisol were found in patients with than without type 2 diabetes.

Effect of external sleep disturbance on sleep architecture in perimenopausal and postmenopausal women

Objective This study aimed to use external sleep disturbance as a model to evaluate sleep architecture in climacteric women before and after menopausal hormone therapy (MHT). Methods Seventeen perimenopausal and 18 postmenopausal women underwent a polysomnography protocol: an adaptation night, a reference night and a sleep disturbance night with one hand loosely tied to the bed for blood sampling. The sleep architecture of the reference and disturbance nights were compared. The 24-h urinary free cortisol concentration (UFC) was measured. The procedure was repeated after 6 months on MHT or placebo. Results Fifteen perimenopausal and 17 postmenopausal women completed the study. The perimenopausal and postmenopausal groups were combined. During external sleep disturbance, sleep was shorter and more fragmented; with less stage 2, slow-wave and rapid eye movement (REM) sleep and more wake time and awakenings, both at baseline and after the treatment period. Compared to the placebo group, sleep disturbance was minor for women on MHT: sleep was not shortened and the amount of slow-wave sleep did not decrease. Increased 24-h UFC was observed only during MHT. Conclusions Sleep in climacteric women is easily disturbed, leading to shorter and more fragmented sleep with less deep sleep and REM sleep. Six months of MHT attenuates the observed sleep disturbance.

Cushing's syndrome is associated with altered adipokine profile.

Adipokines are signaling molecules involved in the integration of metabolism. Changes in their concentrations were observed in obesity, metabolic syndrome, diabetes mellitus and cardiovascular diseases, as well as endocrine disorders. Cushing's syndrome is associated with metabolic dysregulation, but the significance of adipokines in this entity and related complications is largely unknown. The aim of our study was to determine the concentrations of adipokines: fetuin A, fatty acid binding protein 4 (FABP4) and retinol binding protein 4 (RBP4) in Cushing's syndrome and to assess their relation to established cardiovascular and diabetes risk markers. We examined 21 subjects with Cushing's syndrome and 24 healthy controls in a cross-sectional manner. Venous blood samples were analysed for adipokines, cortisol, adrenocorticotrophin, glucose, insulin, glycated haemoglobin (HbA1c), triglycerides, cholesterol fractions, thyrotropin and free thyroid hormones concentrations. Patients' body mass index (BMI) was evaluated, homeostatic model assessment-insulin resistance and Systematic Coronary Risk Evaluation (SCORE) were calculated. We found that the concentration of fetuin A was lower, while FABP4 and RBP4 concentrations were higher in Cushing's syndrome compared to controls [156.4 ± 60.0 µg/ml vs 260.7 ± 49.6 µg/ml; 79.8 (35.2-156.1) ng/ml vs 27.9 (17.1-36.7) ng/ml and 34 (30-37.7) mg/l vs 25.8 (23.6-27.7) mg/l, respectively]. Fetuin A correlated inversely, while FABP4 and RBP4 positively, with the concentrations of urinary free cortisol and adrenocorticotrophin. Fetuin A was positively related to LDL-cholesterol, and negatively to SCORE and HbA1c. FABP4 was associated positively with BMI, HbA1c and triglycerides, while RBP4 correlated positively with triglycerides and systolic blood pressure. Adipokines' concentrations change in hypercortisolism. Further research is needed to ascertain whether adipokines are involved in the development of metabolic complications accompanying Cushing's syndrome or secondarily reflect metabolic dysregulation.

Urinary oxytocin and cortisol concentrations vary by group type in male western lowland gorillas (Gorilla gorilla gorilla) in North American zoos.

Evaluating how primates in human care function within their social environment is important for understanding and optimizing their management and welfare. The neuroendocrine hormone oxytocin is associated with affiliation and bonding, suggesting it can be used to evaluate the affiliative nature of social groupings. When paired with cortisol concentrations, social stressors can simultaneously be assessed, providing a more complete picture of primate social environments than if measuring either hormone independently. Here, we measured both oxytocin and cortisol in urine within a large subset of male western lowland gorillas (Gorilla gorilla gorilla; n = 71) living in North American zoos. Both endocrine measures were compared between social group types, with an emphasis on comparing bachelor and mixed-sex groupings to understand how these broad management practices affect male gorillas in zoos. Oxytocin concentrations were greater in bachelor group males than mixed-sex group males and singly housed males, providing physiological evidence that males in bachelor groups form comparatively stronger affiliative relationships than males in other group types. Cortisol concentrations did not differ between bachelor and mixed-sex group males and males in both group types had lower cortisol concentrations than singly housed males. These results indicate that males are similarly capable of coping with group-specific social stressors, and single management may expose males to additional stressors for which further study is needed. These data contribute to a larger body of research highlighting the value of bachelor groups from both a population management and individual welfare perspective.

Physiological Assessment of the Health and Welfare of Domestic Cats-An Exploration of Factors Affecting Urinary Cortisol and Oxytocin.

Physiological samples are beneficial in assessing the health and welfare of cats. However, most studies have been conducted in specialized environments, such as shelters or laboratories, and have not focused on cats living in domestic settings. In addition, most studies have assessed physiological stress states in cats based on cortisol, and none have quantified positive indicators, such as oxytocin. Here, we collected urine samples from 49 domestic cats and quantified urinary cortisol, oxytocin, and creatinine using ELISA. To identify factors influencing hormone levels, owners responded to questionnaires regarding their housing environment, individual cat information, and the frequency of daily interactions with their cats. Using principal component analysis, principal component scores for daily interactions were extracted. These results showed that the frequency of tactile and auditory signal-based communication by owners was positively correlated with the mean concentration of oxytocin in the urine. Additionally, this communication was more frequent in younger cats or cats that had experienced a shorter length of cohabitation with the owner. However, no factors associated with urinary cortisol concentration were identified. Our study indicates that interactions and relationships with the owner influence the physiological status of cats and suggests that oxytocin is a valuable parameter for assessing their health and welfare.

Diagnostic effectiveness of stress biomarkers in cats with feline interstitial and bacterial cystitis.

Although bacterial cystitis (BC) and feline interstitial cystitis (FIC) are categorized under feline lower urinary tract disease (FLUTD) due to their similar clinical manifestations, stress is an important factor for FIC. Therefore, the investigation of stress biomarkers might be important in the differentiation and elucidation of these conditions. We aimed to evaluate the diagnostic effectiveness of serum and urine cortisol, serotonin, and dopamine concentrations and their relationship with stress in cats with FIC and BC. Twelve healthy cats (Control group) and 24 cats with FLUTD were used. The cats with FLUTD were divided into FIC and BC groups. Multimodal environmental modification (MEMO) scores were found to be higher in the FIC group than in the BC and Control groups (P < .001). Urine serotonin concentrations were higher in cats with FIC and BC compared with those in the Control group. Based on ROC analyses, the sensitivity, specificity, and accuracy of urine serotonin and dopamine were found to be statistically significant in being able to differentially diagnose cats in the FIC group vs the Control group. The sensitivity, specificity, and accuracy of serum dopamine were also found to be statistically significant for the differential diagnosis of FIC and BC. High urine serotonin concentrations were found in cats with FLUTD compared with healthy controls and interpreted as the presence of stress not only in cats with FIC but also in cats with BC. Also, based on the ROC-based diagnostic performance evaluation of these stress biomarkers, urine serotonin, and dopamine concentrations can be used to diagnose FIC, and serum dopamine concentrations can be used to differentiate FIC and BC in cats.

Investigation of the urine cortisol to creatinine ratio for the diagnosis of hypoadrenocorticism in dogs.

To evaluate the urine cortisol-to-creatinine ratio (UCCR) for the diagnosis of hypoadrenocorticism (HA) in dogs and to determine whether the method of urine cortisol measurement affects results. 41 dogs with naturally occurring HA and 107 dogs with nonadrenal illness. Urine samples were prospectively collected from dogs undergoing testing for HA. Urine cortisol concentrations were measured at a veterinary diagnostic laboratory using either a radioimmunoassay (RIA) or a chemiluminescent immunoassay (CLIA). Receiver operating characteristic (ROC) curves were constructed to assess UCCR performance by both methods for HA diagnosis. Sensitivities, specificities, accuracies, and predictive values were calculated for various cutpoints. The areas under the ROC curves for UCCR diagnosis of HA were 0.99 (95% CI, 0.98 to 1.00) and 1.00 (95% CI, 1.00 to 1.00) when urine cortisol was determined by RIA and CLIA, respectively. An RIA UCCR of ≤ 2 was 97.2% sensitive, 93.6% specific, and 94.7% accurate for HA diagnosis, whereas a CLIA UCCR of ≤ 10 was 100% sensitive, specific, and accurate. An RIA UCCR > 4 and a CLIA UCCR of > 10 had negative predictive values of 100%. The UCCR was an accurate diagnostic test for HA in this study population, although equivocal results are possible. Case characteristics, method of cortisol measurement, and laboratory-specific cutpoints must be considered when interpreting results.

Validation study of canine urine cortisol measurement with the Immulite 2000 Xpi cortisol immunoassay.

We report here validation of the Immulite 2000 Xpi cortisol immunoassay (Siemens; with kit lot numbers <550) for measurement of urine cortisol in dogs, with characterization of the precision (CV), accuracy (spiking-recovery [SR] bias), and observed total error (TEo = bias + 2CV) across the reportable range. Linearity assessed by simple linear regression was excellent. Imprecision, SR bias, and TEo increased markedly with decreasing urine cortisol concentration. Interlaboratory comparison studies determined range-based (RB) bias and average bias (AB). The 3 biases (SR, RB, and AB) and resulting TEo differed markedly. At 38.6 and 552 nmol/L (1.4 and 20 μg/dL), between-run CVs were 10% and 4.5%, respectively, and TEoRB were ~30% and 20%, respectively, similar to observations in serum in another validation study. These analytical performance parameters should be considered for urine cortisol:creatinine ratio (UCCR) result interpretation, given that, for any hypothetical errorless urine creatinine measurement, the error % on UCCR mirrors the error % on urine cortisol. Importantly, there is no commonly used interpretation threshold for UCCR, given that UCCR varies greatly depending on measurement methods and threshold computation. To date, there is no manufacturer-provided quality control material (QCM) with target values for urine cortisol with an Immulite; for Liquicheck QCM (Bio-Rad), between-run imprecision was ~5% for both QCM levels. Acceptable QC rules are heavily dependent on the desired total allowable error (TEa) for the QCM system, itself limited by the desired clinical TEa.

Influence of a Maximal Incremental Test Until Exhaustion on the Urinary Excretion of Steroid Hormones in Trained Cyclists.

This study aimed to assess the effect of a maximum incremental stress test through urinary concentrations of steroid hormones in trained cyclists. Twenty male cyclists participated in the study (23.83 ± 2.3 years; 1.76 ± 0.03 m; 66.94 ± 3.59 kg; training volume: 20.50 ± 2.35 h/week). Athletes performed a maximum incremental test until exhaustion on a cycle ergometer and urine samples were collected at three different time points: before, immediately after, and 48 h after the test. Lactate, creatinine and urinary concentrations of testicular and adrenal androgens were obtained as well as urinary concentrations of glucocorticoid hormones. An increase in lactate was observed after the test (p < 0.01). There were decreases in the urinary excretion of androgenic hormones after the test, which were significant in testosterone, androsterone, androstenedione, total adrenal androgen and total testicular androgen (p < 0.05). The values were restored after 48 h (p < 0.05). Urinary cortisol concentrations decreased after the test (p < 0.05). A decrease was also observed in the ratio of anabolic/catabolic hormones (p < 0.05) increasing 48 h after the test (p < 0.05). Increased acute physical exercise until exhaustion causes variations in the urinary excretions of steroid hormones which were restored 48 h after exercise. Urinary excretion of steroid hormones could be a valid method of monitoring training loads.

Neutrophil-Lymphocyte Ratio as an Initial Screening Biomarker for Differential Diagnosis of Cushing's Syndrome from Nonfunctional Adenoma in Patients with an Adrenal Mass.

Objective Assessing excess adrenal hormones is important in patients with adrenal mass. Current screening tests for excess cortisol hormones are complex, so it cannot be done sometimes due to the limited medical resources. The aim of the study was to evaluate whether the neutrophil-lymphocyte ratio (NLR) can be used as an initial screening biomarker for Cushing's syndrome (CS) in patients with an adrenal mass. Methods This retrospective study included a total of 185 patients with CS and 185 patients with nonfunctional adrenal adenoma (matched 1 : 1 by sex, body mass index, and discharge date). The NLR was compared between the two groups. The association between NLR and serum and urinary cortisol concentrations was analyzed, and an NLR cut-off value for CS screening was calculated. Results NLR (3.38 (2.33, 5.45) vs. 2.13 (1.74, 3.00), P < 0.001) was significantly higher in the CS group than in the nonfunctional adenoma group. In CS patients, the NLR was positively associated with serum cortisol concentrations at 8 am, with 24-hour urine free cortisol and with serum cortisol after a 1 mg dexamethasone suppression test (P < 0.001 each). An NLR cut-off of 2.2 had a sensitivity of 80.0% and a specificity of 54.05%. The weighted Youden index for the NLR was similar to that of the 24-hour urine free cortisol and late-night serum cortisol tests, which are recommended initial tests for CS diagnosis. Conclusion The NLR may be useful for initial screening for CS among patients with an adrenal mass as an easy and convenient marker.

Hair Cortisol Concentration as a Biomarker of Sleep Quality and Related Disorders

Cortisol is the end product of the hypothalamic-pituitary-adrenal (HPA) axis, and its production is increased mainly in stressful situations or in chronic disorders accompanied by stress enhancement. Altered cortisol concentrations have been reported in a number of neuropsychiatric diseases and sleep disorders. Cortisol concentrations have been measured using several methods, and in several matrixes, such as blood, saliva, and urine. However, lately, hair cortisol, for several reasons, has emerged as a promising biomarker of long-term retrospective HPA activation. Several experimental approaches for cortisol measurement with the corresponding concentration reference ranges and a summary of findings from scientific literature on this field are presented. There is evidence of a close relationship between HPA functional alteration and the development of neuropsychiatric disorders. Sleep disorders are the most common manifestation in several neuropsychiatric conditions, and have also been associated to cortisol alterations in both adults and children. Many studies indicate that hair cortisol constitutes a valuable tool for further contributing to existing data on salivary, plasma, or urinary cortisol concentrations in patients with sleep disorders.

Effects of physiological changes and social life events on adrenal glucocorticoid activity in female zoo-housed Asian elephants (Elephas maximus).

Ensuring good health and welfare is an increasingly important consideration for conservation of endangered species and includes breeding of individuals managed under human care. Understanding how factors in the captive environment affect individual animal wellbeing can be aided by long-term monitoring of biological functioning. This study involved longitudinal assessments (4 to 28 years) of reproductive and adrenal hormones in zoo-housed female Asian elephants (Elephas maximus) (age range 4 to ~71 years) to elucidate patterns in adrenal glucocorticoid (GC) activity in association with reproductive and demographic factors, and examine individual response to major social changes. Concentrations of serum and urinary cortisol covaried more consistently with physiological changes (ovarian cycle phase, puberty, pregnancy, lactational anestrus, and age) than with social life events (births, deaths, and facility transfers). Cortisol fluctuated across the ovarian cycle with mean concentrations being higher in the follicular than in the luteal phase, and concentrations were highest in lactational anestrous compared to all other reproductive states. The elephants in this study exhibited substantial individuality in adrenal GC response to major social change, reinforcing the need to assess welfare on an individual basis and to consider factors influencing the impact of perceived stressors, such as social relationships, social support, temperament, and life history. Outcomes from this study deepen our understanding of Asian elephant physiology and highlight the importance of taking intrinsic patterns of hormone secretion into account when evaluating the impact of external factors. Finally, a better understanding of the impact of social change and resiliency in response to real and perceived stressors allows us to improve social management to enhance welfare in both captive settings and free-ranging environments.

DYNAMICS OF TRAINING DISTRESS, PERFORMANCE, AND EXCRETION OF CORTISOL AND CORTISONE IN URINE DURING SIX WEEKS OF TRAINING IN ELITE SWIMMERS

Aim. Optimal balance between training intensity and recovery is of particular importance for elite swimmers in order to improve their results. The aim of this study was to record the dyna­mics of training distress, performance, and excretion of cortisol and cortisone in urine during six weeks of training in elite swimmers. Materials and Methods. Twenty-four participants (10 women and 14 men) from the national swimming team of Bulgaria took part in this study, with an average age of 18.7 ± 3.78 years. Training distress (TDS) and urine concentration of cortisol and cortisone were evaluated every two weeks. In total, the measurements were taken on the 1-st (T1), 14-th (T2), 28-th (T3) and 42-nd days (T4). Anthropometric measurements were also taken at T1 and T4, and body fat percentage and muscle mass percentage were calculated by skinfold methods. Results. The TDS score at T4 (6.92 ±7.15) was significantly lower than this at T1 (14.96 ± 10.63) and T2 (15.21 ± 12.44). The concentrations of cortisol at T3 (35.9 ± 47.7) and T4 (35.0 ± 24.2) were also significantly lower than that registered at T1 (82.7 ± 62.8). The concentration of cortisone did not show any significant differences across T1 to T4, but the sum of cortisol and cortisone urine concentration was significantly lower in T3 and T4 vs T1. Conclusion. The significantly reduced cortisol concentration in urine in T4, as well as the sum of the concentrations of cortisol and cortisone, were in line with the reduction of the TDS score in T4.

A randomized cross-over trial assessing salivary and urinary cortisol concentrations after alfaxalone and propofol administration in healthy cats

The aim of this study was to assess the effects of commonly used anaesthetics alfaxalone and propofol on salivary and urinary cortisol in healthy cats. Fifteen male castrated research-purposed cats received randomly intravenous continuous rate infusions of 8 mg/kg/h of alfaxalone, 12 mg/kg/h of propofol and 2 ml/kg/h of Lactated Ringer's solution for 30 min, with intervals of 6 days between treatments. Saliva samples were collected for 24 h before each infusion and for 24 h from the start of each infusion. Urine was collected as single pooled samples over each 24 h period. Mean integrated saliva cortisol responses in cats treated with alfaxalone were greater than responses of cats treated with propofol (P = 0.034) and controls (P = 0.017). Integrated responses in cats treated with propofol did not differ from controls. The mean urinary cortisol/creatinine ratio (UCCR) was higher on the day of treatment than the day before treatment in cats treated with alfaxalone (P < 0.0001) and in cats treated with propofol (P = 0.0168) and did not differ between days in cats treated with lactated Ringer's solution. The mean UCCR was higher in cats treated with alfaxalone than in cats treated with lactated Ringer's solution (P = 0.0020) on the day of treatment. Mean total urinary cortisol over 24 h was greater in cats treated with alfaxalone than controls (P = 0.0267). In conclusion, alfaxalone increased short-term salivary and urinary cortisol concentrations in healthy cats as compared to propofol and a control group of non-anesthetised cats.