Cortisol Parameters Research Articles

A randomized crossover study on the effects of a custom-made mouthguard on cardiopulmonary parameters and cortisol differences in a validated handball specific course.

The importance of mouthguards for handball players has been proven however, most players are reluctant to use it. The impact on physical capacity is assessed heterogeneously in the literature. This study aimed to investigate the influence of custom-made mouthguards (CMGs) under handball specific stress. This randomized crossover study used data from 15 youth professional handball players (age 17.0 ±0.5 years, weight 85.1±8.0 kg and height 191.2±6.9 cm) who performed a validated handball specific course and a lung function test. Pulmonary (spirometry), metabolic (blood lactate), and cortisol parameters were observed using a normal custom-made mouthguard without (nCMG) and with respiratory channels (CMGvent) in comparison to no mouthguard (Co). In resting spirometry, no differences in the parameter peak flow were observed using the CMGvent (9.57±1.59 l·s-1) and nCMG (9.17±1.03 l·s-1) in comparison to the Co (9.38±1.26 l·s-1). Under maximum stress, there were no differences in ventilation using CMGvent (151.2±15.64 L ·min-1), nCMG (148.6±12.51 l·min-1), and without mouthguard (145.8±14.32 l·min-1). Similar oxygen uptake was observed when using a CMGvent (45.51±4.14 L ·min-1·kg-1), nCMG (45.50±5.06 ml·min-1 ·kg-1), and without CMG (Co 43.90±4.02 mL ·min-1). The parameters of HR (CMGvent 185.2±11.63 bpm vs. Co 179.4±13.24 bpm p=0.46, nCMG 178.2±11.54 bpm vs. Co p=0.97; CMGvent vs. nCMG p=0.08) and in the blood lactate values (CMGvent: 9.66±2.3 mmol·l-1 vs. Co 9.07±2.1 mmol·l-1 p=0.63; nCMG 9.39±2.8 mmol·l-1 vs. Co p=0.87; CMGvent vs. nCMG p=0.91) displayed no differences. The cortisol production under stress showed no differences in the performance with the CMGvent (1.78±3.58 ng/ml), nCMG (0.74±4.52 ng/mL), and in the procedure without mouthguard (0.25. ±5.01 ng/ml). The results showed that under stress, there were no differences in the cortisol, ventilation, cardiac, and metabolic responses for all three conditions. Finally, the study shows that the use of a custom-made mouthguard does not negatively affect handball specific performance. Due to the preventive aspect of the mouthguard, the use of a custom-made mouthguard in handball is strongly recommended.

The utility of pre-test cortisol and other parameters in the prediction of short Synacthen test failure

The utility of pre-test cortisol and other parameters in the prediction of short Synacthen test failure

Cortisol reactivity in patients with anorexia nervosa after stress induction

There is a need of experimental studies on biomarkers in patients with anorexia nervosa (PAN), especially in the context of stress, in order to foster understanding in illness maintenance. To this end, the cortisol response to an acute stressor was investigated in n = 26 PAN (BMI: 19.3 ± 3.4 kg/m2), age, and gender matched to n = 26 healthy controls (HC; BMI: 23.08 ± 3.3 kg/m2). For this purpose, salivary cortisol parameters were assessed in two experimental conditions: (1) rest/no intervention and (2) stress intervention (TSST; Trier Social Stress Test). In addition, psychological indicators of stress were assessed (Primary Appraisal Secondary Appraisal, Visual Analogue Scale, and Trier Inventory for the assessment of Chronic Stress), as well as psychological distress, depression, and eating disorder (ED) symptoms. A 2 × 2 × 8 ANOVA demonstrated elevated cortisol levels in PAN in the resting condition. In the stress intervention no significant group effect in terms of cortisol (F (1, 50) = 0.69; p = 0.410; eta _p^2 = 0.014). A significant condition (F (1, 50) = 20.50; p = 0.000; eta _p^2 = 0.291) and time effect (F(2.71, 135.44) = 11.27; p = 0.000; eta _p^2 = 0.20) were revealed, as well as two significant interaction effects. First: Condition × group (F (1, 50) = 4.17, p = 0.046; eta _p^2 = 0.077) and second: Condition × time (F (2.71, 135.44) = 16.07, p = 0.000, eta _p^2 = 0.24.). In terms of AUCG, no significant differences between both groups were exhibited. Regardless, significant results were evinced in terms of an increase (AUCi: F(1, 50) = 20.66, p = 0.015, eta _p^2 = 0.113), baseline to peak (+20 min post-TSST: t5 = 16.51 (9.02), p = 0.029) and reactivity (MPAN = 0.73 vs. MHC = 4.25, p = 0.036). In addition, a significant correlation between AUCG and BMI: r (24) = −0.42, p = 0.027 was demonstrated, but not between AUCi and BMI (r (24) = −0.26, p = 0.20). Psychological indices suggested higher levels of chronic and perceived stress in PAN relative to HC. However, stress perception in the stress condition (VAS) was comparable. Additional analyses demonstrated that ED-symptoms are highly correlated with psychological distress and depression, but not with BMI. In addition, it could be demonstrated that reactivity is rather related to ED-symptoms and psychological burden than to BMI. In conclusion, PAN showed elevated basal cortisol levels at rest and exhibited a blunted cortisol reactivity to the TSST as evinced by salivary cortisol parameters. Further, it was shown that weight recovery influences reversibility of hypercortisolemia, i.e., cortisol levels normalize with weight gain. However, HPAA (hypothalamus–pituitary–adrenal axis) irregularities in terms of reactivity persist even at a BMI ≤ 19.3 (±3.4). Our data suggest that pronounced psychological burden in PAN, have a greater impact on the HPAA functionality (secondary to the ED) than BMI itself.

Sexual dimorphism in cortisol metabolism throughout pubertal development: a longitudinal study

ObjectiveSex differences in disease susceptibility might be explained by sexual dimorphism in hypothalamic-pituitary-adrenal axis activity, which has been postulated to emerge during puberty. However, studies conducted thus far lacked an assessment of Tanner pubertal stage. This study aimed to assess the contribution of pubertal development to sexual dimorphism in cortisol production and metabolism.MethodsParticipants (n = 218) were enrolled from a population-based Netherlands Twin Register. At the ages of 9, 12 and 17 years, Tanner pubertal stage was assessed and early morning urine samples were collected. Cortisol metabolites were measured with GC-MS/MS and ratios were calculated, representing cortisol metabolism enzyme activities, such as A-ring reductases, 11β-HSDs and CYP3A4. Cortisol production and metabolism parameters were compared between sexes for pre-pubertal (Tanner stage 1), early pubertal (Tanner stage 2–3) and late-pubertal (Tanner stage 4–5) stages.ResultsCortisol metabolite excretion rate decreased with pubertal maturation in both sexes, but did not significantly differ between sexes at any pubertal stage, although in girls a considerable decrease was observed between early and late-pubertal stage (P < 0.001). A-ring reductase activity was similar between sexes at pre- and early pubertal stages and was lower in girls than in boys at late-pubertal stage. Activities of 11β-HSDs were similar between sexes at pre-pubertal stage and favored cortisone in girls at early and late-pubertal stages. Cytochrome P450 3A4 activity did not differ between sexes.ConclusionsPrepubertally, sexes were similar in cortisol parameters. During puberty, as compared to boys, in girls the activities of A-ring reductases declined and the balance between 11β-HSDs progressively favored cortisone. In addition, girls showed a considerable decrease in cortisol metabolite excretion rate between early and late-pubertal stages. Our findings suggest that the sexual dimorphism in cortisol may either be explained by rising concentrations of sex steroids or by puberty-induced changes in body composition.

Three-year follow up of adrenal incidentalomas in a New Zealand centre.

The international guidelines for management of adrenal incidentalomas (AI) are becoming more conservative. These changes are based on the growing body of evidence suggesting that non-functioning adenomas have a low likelihood of becoming functional or malignant over time. To follow up at least 100 patients for 3 years who were originally found to have benign adrenal adenomas which were non-functional or had subclinical Cushing syndrome (SCS). This study prospectively evaluated consecutive patients aged 18 years or older with benign adrenal incidentalomas (AI), not treated with adrenalectomy, which were non-functioning or had SCS. The initial and follow-up evaluation, including clinical assessment, hormonal investigations and imaging were coordinated via a standardised nurse-led AI clinic. Of 233 patients referred to the AI clinic, 101 patients met the inclusion criteria and completed 3-year follow up. Most of those excluded were due to incomplete initial or follow-up evaluation or were not true AI. Most AI either remained stable or decreased in size on repeat imaging, while 5% of patients had AI enlargement of >5 mm diameter. No patient developed features suggesting adrenal carcinoma. Ninety-two patients had an initial diagnosis of non-functioning adenoma and nine patients had SCS. After 3 years (range 2.9-4.7 years), five of the nine patients with SCS showed normalisation of cortisol parameters (44%), and five of the 92 non-functional AI patients developed SCS (5%). After 3 years of follow up, approximately half of patients with SCS normalised, while 5% of patients with initially non-functioning adenomas developed biochemical evidence of SCS. This study found a low likelihood of progressive hormonal excess with no evidence of malignancy developing on follow-up evaluation, providing support for the shift towards the more conservative approach to management of AI recommended in recent guidelines.

Dysregulation of Hypothalamic-Pituitary-Adrenal Axis Explain the Dynamic Association Between Glucose Fluctuation and Cognitive

Objective—Type 2 diabetes mellitus is a risk factor for cognitive dysfunction. However, the underlying mechanism of cognitive decline in patients with type 2 diabetes mellitus is still elusive. Dysregulation of HPA axis is related to cognitive impairment. The present study aims to calculate explanation of the association between glucose fluctuation and cognitive function by HPA axis in type 2 diabetes mellitus patients. Methods—The mean amplitude of glycemic excursion (MAGE) was analyzed by a continuous glucose monitoring system (CGMS) for 3 days in 330 elderly type 2 diabetes mellitus patients. All the subjects received a set of neuropsychological test battery for cognitive assessment. The diurnal rhythm of cortisol was also analyzed. Linear multivariate regression analysis was performed to explore the relationship between glucose fluctuation, cortisol parameters and cognitive parameters. Results—MAGE was observed to be associated with diurnal cortisol fall but with neither cortisol awakening response (CAR) nor overall mean cortisol levels (t = –2.195, P = 0.030). Linear multivariate regression analysis displayed that MAGE and average diurnal cortisol fall were uniquely associated with some cognitive parameters, such as AVLT trial, FAS, and TMT (P &lt; 0.05). Conclusion—Glucose fluctuation was strongly associated with cognitive impairment in elderly type 2 diabetes mellitus patients. Especially in executive function, attention and processing speed. Dysregulation of HPA axis was probably the cause of cognitive dysfunction in these patients.

Diurnal Cortisol Secretion Is Not Related to Multiple Sclerosis-Related Fatigue.

Some evidence supports the involvement of the hypothalamic–pituitary–adrenal axis (HPA axis) with multiple sclerosis (MS)-related fatigue. In this study, we determined the relation of HPA-axis function with primary fatigue in MS patients in the longitudinal treating fatigue in a MS cohort. MS patients from the TREeating FAtigue in MS (TREFAMS) research program that consists of three randomized controlled trials to study the effects of aerobic training, energy conservation management, and cognitive behavioral therapy on MS-related fatigue were included. The HPA-axis functioning was determined at baseline, the end of treatment (16 weeks) and after 52 weeks. The cortisol awakening response (CAR) and night-time cortisol levels were analyzed. Fatigue was measured with the fatigue subscale of the Checklist Individual Strength (CIS20r fatigue). There was no relationship between CAR and night-time cortisol parameters with CIS20r fatigue scores. Neither of the treatments influenced CAR and night-time cortisol parameters, with the exception of an effect in the energy conservation management treatment group on the CAR surge increase over 52 weeks (β = −114.8, p = 0.007, 95% CI = −197.6, −31.9). Our data suggest that the diurnal cortisol secretion is not associated with MS-related fatigue. This indicates that MS-related fatigue is not attributed to diurnal cortisol secretion and is likely caused by other disease mechanisms.

Acute supplementation with an amino acid mixture suppressed the exercise-induced cortisol response in recreationally active healthy volunteers: a randomized, double-blinded, placebo-controlled crossover study

BackgroundFew studies have demonstrated the suppressive effects of amino acids (AAs) on the level of cortisol during exercise in humans. We hypothesized that an AA mixture containing arginine, which promotes lipid metabolism, valine, which effectively decreases the level of glucocorticoid, and serine, a substrate in the production of phosphatidylserine that is reported to blunt increases in cortisol, would suppress the exercise-induced cortisol response by combining the positive effects of the AAs synergistically.MethodsA randomized, double-blinded, placebo-controlled crossover trial was conducted. Twenty healthy recreationally active males ingested either an AA mixture containing 1.8 g of arginine, 1.1 g of valine, and 0.1 g of serine or a placebo. Thirty minutes after ingestion, subjects performed an exercise trial on a cycle ergometer for 80 min at 50% maximal oxygen consumption. Plasma cortisol and other blood parameters immediately before and after the exercise were evaluated.ResultsPlasma cortisol concentrations after exercise were significantly higher than those before exercise in the placebo condition (9.51 ± 0.85 vs 14.39 ± 2.15, p < 0.05), while there was no significant difference in the AA condition (9.71 ± 0.93 vs 9.99 ± 1.23, p = 0.846). In addition, the increase in plasma cortisol before and after exercise was significantly lower in the AA condition than in the placebo condition (0.28 [− 2.75, 3.31] vs 4.87 [0.89, 8.86], p < 0.05). For the level of adrenocorticotropin, there was a significant difference between before and after exercise only in the placebo condition (24.21 ± 2.91 vs 53.17 ± 6.97, p < 0.01) but not in the AA condition (27.33 ± 3.60 vs 46.92 ± 10.41, p = 0.057). Blood glucose, plasma lactate, plasma ammonia, serum creatine phosphokinase, serum total ketone body, and serum free fatty acid were also significantly changed by the exercise load in both conditions, but no significant differences were observed between the two conditions.ConclusionsThe present study demonstrated that the AA mixture suppressed the cortisol response during exercise without affecting exercise-related biological parameters such as glucose or lipid metabolism.Trial registrationUMIN Clinical Trials Registry, UMIN000023587. Registered 19 August 2016.

Application of Sigma Metrics for Evaluating the Analytical Performance of Thyroid Profile and Cortisol in Clinical Biochemistry Laboratory

Introduction: Now-a-days quality is the key aspect of clinical laboratory services. The six sigma metrics is an important quality measurement method for evaluating the performance of the clinical laboratory. Aim: To assess the analytical performance of clinical biochemistry laboratory by utilising thyroid profile and cortisol parameters from Internal Quality Control (IQC) data and to calculate sigma values. Materials and Methods: Study was conducted at Clinical Biochemistry Laboratory, Dhiraj General Hospital, Piparia, Gujarat, India. Retrospectively, IQC data of thyroid profile and cortisol were utilised for six subsequent months (July to December 2019). Coefficient of Variation (CV%) and bias were calculated from IQC data, from that the sigma values were calculated. The sigma values &lt;3, &gt;3 and &gt;6 were indicated by poor performance procedure, good performance and world class performance, respectively. Results: The sigma values were estimated by calculating mean of six months. The mean sigma value of Thyroid Stimulating Hormone (TSH) and Cortisol were &gt;3 for six months which indicated the good performance. However, sigma value of Triiodothyronine (T3), Tetraiodothyronine (T4) were found to be &lt;3 which indicated poor performance. Conclusion: Six sigma methodology applications for thyroid profile and cortisol was evaluated, it was generally found as good. While T3 and T4 parameters showed low sigma values which requires detailed root cause analysis of analytical process. With the help of six sigma methodology, in clinical biochemistry laboratories, an appropriate Quality Control (QC) programming should be done for each parameter. To maintain six sigma levels is challenging to quality management personnel of laboratory, but it will be helpful to improve quality level in the clinical laboratories.

Mindfulness-based focused attention training versus progressive muscle relaxation in remitted depressed patients: Effects on salivary cortisol and associations with subjective improvements in daily life

Major Depression is a stress-related disorder characterized by altered hypothalamic-pituitary-adrenal axis function. Mindfulness-based interventions have shown to improve subjective parameters of stress and to reduce relapse rates in depressed patients. However, research on their effects on diurnal patterns of cortisol and associations with subjective outcomes is lacking.The present Ambulatory Assessment study investigated possible changes in daily rhythm cortisol parameters (cortisol awakening response (CAR), daily slope, total cortisol) in currently remitted individuals with recurrent depression who were randomized to a four-week mindfulness-based focused attention training (MBAT, n = 39) or a progressive muscle relaxation training (PMR, n = 39). A second aim was to investigate whether changes in cortisol were linked to improvements in affective and cognitive daily life states. On three weekdays before and after the intervention, seven saliva cortisol samples per day were collected. For analysis, multilevel models were applied. Results revealed no group-specific or general change in CAR and daily slopes from pre- to postintervention. In contrast, total cortisol increased across groups, which was however moderated by group and subjective improvement status. While cortisol increased irrespective of subjective improvement in PMR participants, MBAT participants with larger reductions in negative affect and rumination maintained their initial cortisol levels, whereas those with lower improvement paralleled the PMR group. Thereby, MBAT appeared to buffer an increase in overall cortisol secretion over time, but only in patients showing marked improvements in those affective and cognitive states that constitute core elements for depressive relapses in the vulnerability model of mindfulness-based cognitive therapy.

Impact of Cognitive Behavioral Therapy on Resting Cardiac Parameters and Cortisol in Patients with Post-Traumatic Stress Disorder: A Pilot Randomized Clinical Trial

Post-Traumatic Stress Disorder (PTSD) has been associated with changes in psychophysiological and neuroendocrinal parameters. Cognitive Behavioral Therapy (CBT) is considered the treatment of choice for PTSD and is able to regularize altered neurobiological parameters; however, little is known about its effects on these parameters when measured during the therapeutic process. This pilot study aimed to evaluate the impact of CBT on cortisol and cardiac parameters measured at rest during the treatment of PTSD with comorbid major depression. 14 patients were randomized to four months of CBT or a waiting list. As expected, the experimental group had a greater reduction in PTSD symptoms and a large effect size. There was a reduction in the low frequency component of heart rate variability, which achieved borderline statistical significance and a large effect size. Salivary cortisol tended to track the progress of therapy, rising in the period of exposure and decreasing by the end of treatment. Despite the small sample size, this study opens the way for further research into the impact of CBT on the different biological markers of PTSD during the therapeutic process. This can hopefully help to optimize and personalize therapeutic studies while providing clues about modifications in bio behavioral pathological manifestations.

Association of occupational stress with waking, diurnal, and bedtime cortisol response in police officers.

Police officers have higher rates of cardiovascular disease (CVD) morbidity and mortality than the U.S. general population. Officers are exposed to conventional and unexpected workplace stressors. The hypothalamic-pituitary-adrenal (HPA) axis plays a major role responding to stressor exposure by releasing cortisol. Prolonged release or excessive levels may result in disease. Our study investigated cross-sectional associations between self-reported work stress and various salivary cortisol parameters. A total of 285 police officers (76.5% male) from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study (2004-2009) completed the Spielberger Police Stress Survey, reporting frequency and severity of work events during the past month and year to calculate stress indices. Officers provided saliva samples to measure levels of cortisol secretion. Linear regression assessed associations between stress indices and various cortisol parameters, adjusted for age, gender, race/ethnicity, abdominal height, and smoking status. Significant positive associations were observed between stress indices (overall stress, physical danger stress, and past-month lack of support) and diurnal cortisol (AUCg: total area under the curve). Administrative, overall, and physical danger stress in the past year were significantly associated with the diurnal slope. Overall, administrative, and physical danger stress were significantly associated with bedtime levels. There were no significant associations between the stress indices and the awakening cortisol parameters. Higher stress ratings were related to blunted diurnal decline in cortisol, suggesting conventional and unexpected police stressors may result in HPA axis dysfunction. Future studies investigating possible associations between elevated cortisol and subclinical CVD are needed.

Simplified model for diagnosis of secondary adrenal insufficiency using non-fasting cortisol and clinical parameters

Simplified model for diagnosis of secondary adrenal insufficiency using non-fasting cortisol and clinical parameters

Meta-analysis of blood cortisol levels in individuals with first-episode psychosis

ObjectiveSchizophrenia is associated with abnormal neuroimmunoendocrine function. There is evidence for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in individuals with first-episode psychosis (FEP). However, some previous meta-analyses have focused on heterogeneous sample sources and patient populations. We performed a meta-analysis of baseline (i.e., one sample) blood cortisol levels in individuals with FEP and minimal exposure to antipsychotics. MethodArticles were identified by searching PubMed, PsycInfo, Web of Science, and Science Direct, and the reference lists of these studies. ResultsTwenty-six studies (comprising twenty-seven samples) met the inclusion criteria. Blood cortisol levels were significantly increased in individuals with FEP compared to controls with a small-to-medium effect size (standard mean difference [SMD] = 0.37, 95% CI 0.16-0.57, p < 0.001). In meta-regression analyses, geography was a significant moderator of this association, with larger effects seen in studies conducted in Asia versus the Middle East. ConclusionWe found elevated blood cortisol levels in individuals with FEP, providing additional, complementary evidence for abnormal HPA axis function in this disorder. This finding, which does not inform on mechanism, is consistent with the “neural diathesis-stress” model of psychosis. Given the immunomodulatory effects of cortisol, methodologically rigorous longitudinal studies of cortisol parameters, inflammatory markers, and psychopathology in this patient population are warranted.

Rigor and Reproducibility: A Systematic Review of Salivary Cortisol Sampling and Reporting Parameters Used in Cancer Survivorship Research.

Salivary cortisol is a commonly used biomarker in cancer survivorship research; however, variations in sampling protocols and parameter reporting limit comparisons across studies. Standardized practices to provide rigor and reproducibility of diurnal salivary cortisol sampling and reporting are not well established. Previous systematic reviews examining relationships between diurnal salivary cortisol and clinical outcomes have resulted in mixed findings. It remains unclear which sampling protocols and reporting parameters offer the greatest utility for clinical research. This review examines diurnal salivary cortisol sampling protocols and reporting parameters to evaluate whether a standardized approach is recommended. A comprehensive search of intervention studies among adult cancer survivors including diurnal salivary cortisol resulted in 30 articles for review. Sampling protocols ranged from 1 to 4 days with the majority of studies sampling cortisol for 2 days. Sampling instances ranged from 2 to 7 times per day, with the majority collecting at 4 time points per day. Diurnal cortisol slope and cortisol awakening response (CAR) were the most commonly reported parameters associated with clinical outcomes. Flattened cortisol slopes, blunted CARs, and elevated evening cortisol concentrations were associated with poorer psychosocial and physiological outcomes. Based on our review, we propose that a rigorous, standardized diurnal salivary cortisol sampling protocol should include sampling at key diurnal times across ≥3 consecutive days to report diurnal cortisol parameters (i.e., CAR and slope) and objective measures of participant protocol adherence. Diminishing budgetary resources and efforts to minimize participant burden dictate the importance of standardized cortisol sampling protocols and reporting parameters.

Diurnal Cortisol in a Sample of Socioeconomically Disadvantaged Chinese Children: Evidence for the Shift-and-Persist Hypothesis.

Low socioeconomic status (SES) is one of the most well-established social determinants of health. However, little is known about what can protect the health of individuals (especially children) living in low-SES circumstances. This study explored whether the psychological strategy of "shift-and-persist" protects low-SES children from stress-related physiological risks, as measured through blunted (unhealthy) diurnal cortisol profiles. A sample of 645 children (aged 8-15 years) from low-SES backgrounds and having at least one HIV-positive parent completed a battery of psychological scales. Diurnal cortisol assessments included collection of saliva samples four times a day for 3 days, from which three cortisol parameters (cortisol at awakening, cortisol awakening response, and cortisol slope) were derived. Higher levels of shift-and-persist, considered as a single variable, were associated with higher cortisol at awakening (B = 0.0119, SE = 0.0034, p < .001) and a steeper cortisol slope (B = -0.0007, SE = 0.0003, p = .023). These associations remained significant after adjusting for covariates and did not vary by age. In supplementary analyses, where shifting and persisting were treated as separate variables, the interaction between these two coping strategies significantly predicted cortisol at awakening (B = 0.0250, SE = 0.0107, p = .020) and the cortisol slope (B = -0.0022, SE = 0.0011, p = .040), suggesting that the combination of shift-and-persist is important for predicting diurnal cortisol profiles. Our findings demonstrate that shift-and-persist is associated with healthier diurnal cortisol profiles among socioeconomically disadvantaged children and introduce the possibility that this coping strategy is protective against other stressors, such as those uniquely faced by children in our study (i.e., being affected by parental HIV).

OR-016 Inflammatory responses associated with cortisol and CK after intensive endurance exercise

OR-016 Inflammatory responses associated with cortisol and CK after intensive endurance exercise

The effects of six-day SSRI administration on diurnal cortisol secretion in healthy volunteers

RationaleHyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis has been widely reported in depression, and evidence suggests that selective serotonin reuptake inhibitors (SSRIs) might exert their therapeutic effects through altering cortisol secretion.ObjectiveThis study assessed the effects of SSRI administration on diurnal cortisol secretion in healthy volunteers.MethodsSixty-four healthy men and women were randomised to receive either 10 mg escitalopram or placebo for six days in a double-blind fashion. On day six of medication, saliva samples were obtained at home for measurement of diurnal cortisol parameters (cortisol slope, cortisol awakening response, total daily cortisol output).ResultsWomen receiving escitalopram had significantly steeper cortisol slopes across the day compared with those receiving placebo (F(1, 36) = 7.54, p = 0.009). This alteration in cortisol slope was driven by increases in waking cortisol levels (F(1, 35) = 9.21, p = 0.005). Escitalopram did not have any significant effect on the cortisol awakening response or the total daily cortisol output.ConclusionsFlattened cortisol slopes have been seen in depression. The results of this study suggest that escitalopram might exert its therapeutic effect in women in part through correction of a flattened diurnal cortisol rhythm.

Microaggressions and Diurnal Cortisol: Examining Within-Person Associations Among African-American and Latino Young Adults

PurposeWe examined the relations between African-American and Latino young adults’ microaggressions and subsequent changes in weekly diurnal cortisol parameters (i.e., cortisol awakening responses, overall cortisol output (AUC), and diurnal slopes). MethodsYoung adults (N = 53, Mage = 20years, SD = .90; 72% female) participated in a 4-week diary study in which they reported their weekly experiences of microaggressions and completed 2 days ofsaliva samples each week. Saliva samples were obtained at waking, 30-minutes after waking, and bedtime on each sampling day (six samples each week; 24 samples total). In line with an idiographic approach to stress, young adults’ increases and decreases in microaggressions (relative to their own average) were linked to changes in cortisol parameters the following week. ResultsIncreases in microaggressions predicted greater AUC the subsequent week, controlling for gender, race, parental education, prior week's AUC, and weekly behavioral controls. Follow-up analyses of specific types of microaggressions indicated that experiences centered around criminality and second-class citizenship also related to increases in young adults’ cortisol awakening responses the subsequent week. Microaggressions were unrelated to changes in diurnal slopes. ConclusionsMicroaggressions were linked to subsequent changes in diurnal cortisol among African-American and Latino young adults. Given the rigorous within-person design, findings point to the importance and impact of subtle forms of discrimination on young adults’ hypothalamic-pituitary-adrenal axis activity, which is theorized to underlie health and well-being.

Effort-reward imbalance in police work: associations with the cortisol awakening response.

We hypothesized that effort-reward imbalance (ERI) is associated with an atypical cortisol response. ERI has been associated with higher job stress. Stress triggers cortisol secretion via the hypothalamic-pituitary-adrenal (HPA) axis, and significant deviation from a typical cortisol pattern can indicate HPA axis dysfunction. 176 police officers participated from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study. ERI was the exposure variable. Outcome variables were saliva-based peak and mean cortisol values, total area under the curve ground (AUCG) and baseline (AUCI); linear regression line fitted to log-transformed cortisol. Regression analyses were used to examine linear trend between ERI and cortisol parameters. Repeated measures analysis examined whether the pattern of cortisol over time differed between low ERI (< median) and high ERI (≥ median). Mean age was 46years (SD = 6.6). After adjustment for potential confounders, there was a significant inverse association between ERI and peak cortisol (β = - 0.20, p = 0.009), average cortisol (β = - 0.23, p = 0.003), and total area under the curve (β = - 0.21, p = 0.009). ERI was not significantly associated with AUCI (β = - 0.11, p = 0.214); slope of the regression line fitted to the cortisol profile (β = - 0.009, p = 0.908). Repeated measures analyses showed that the cortisol pattern did not vary significantly between high and low ERI using the median as a cut point (interaction p value = 0.790). ERI was inversely associated with the magnitude of awakening cortisol over time, indicating HPA axis dysregulation and potential future health outcomes.