Evening Cortisol Research Articles

Exploring the interplay between control beliefs, cortisol levels and depression in old age: Is feeling in control always beneficial?

ObjectivesWe investigated the relationship between levels of mastery/conscientiousness and cortisol response in older adults, considering depression status. Based on former research we hypothesized that high and low and not intermediate levels of mastery/conscientiousness would correlate with high cortisol response, particularly in depressed individuals. MethodsData from the Netherlands Study of Depression in Older Persons (NESDO) were analyzed. Respondents were categorized into low, intermediate, and high mastery/conscientiousness groups. Regression analyses examined associations between mastery/conscientiousness and evening cortisol (N=412) and cortisol awakening response (N=370), stratified by depression status. Histograms were created to visualize the results. ResultsNo significant associations were found between mastery/conscientiousness and cortisol response, irrespective of depression status. ConclusionsOur findings do not suggest that low or high levels of mastery/conscientiousness increase stress in depressed older adults compared to those with intermediate levels, nor do they differ from non-depressed individuals.

Preclinical Online Sсreening for Stress-Associated Disorders in Combatants

Background: the need to improve standards, organizational methods and practical scientific approaches to the prevention and treatment of mental pathology and the restoration of mental health of military personnel involved in combat operations determines the importance of developing and implementing effective strategies for correcting the mental state of combatants. The aim: to analyze the results of preclinical online screening of stress-associated disorders in combatants to assess its effectiveness in conducting routine psychoprophylactic examinations of military personnel after returning from the combat zone. Subjects and methods: 176 male employees of the Russian Guard who returned after a business trip of up to 90 days in the combat zone were examined. All combatants underwent preclinical online screening for the detection of stress-associated mental disorders, including methods regulated by the Ministry of Health of the Russian Federation. After testing, the obtained data were processed using cluster analysis by the K-means method. Clinical and psychopathological examination and laboratory studies were conducted, including: the content of carbohydrate-deficient transferrin (CDT), testosterone and cortisol levels, processing of the data obtained using statistical methods. Results: the combination of high levels of evening cortisol and CDT in combatants may indicate a complex interaction of physical stress, psychological trauma and possible alcohol abuse, which may be the result of both specific conditions of military service and a way to cope with post-war stress and trauma. Conclusions: it was found that the data of preclinical screening testing are consistent with clinical and laboratory results. Online screening testing for the detection of stress-associated disorders in combatants, combined with the determination of testosterone, evening cortisol and CDT levels, can serve as markers of the presence of stress-associated disorders.

The cortisol awakening response is blunted in healthy women early postpartum

IntroductionThe dynamic capacity of the hypothalamic-pituitary-adrenal (HPA) axis supports healthy adaptions to stress and play a key role in maintaining mental health. Perinatal adaptations in the HPA-axis dynamics in terms of the Cortisol Awakening Response (CAR), may be involved in dysregulation of perinatal mental health. We aimed to determine if CAR and absolute evening cortisol early postpartum differed from non-perinatal women and evaluate the association between the CAR and maternal mental well-being. MethodsThe CAR was computed as the area under the curve with respect to increase from baseline from serial home-sampling of saliva across 0–60 minutes from awakening. We evaluated differences in CAR and absolute evening cortisol between postpartum women (N=50, mean postpartum days: 38, SD: ±11) and non-perinatal women (N=91) in a multiple linear regression model. We also evaluated the association between CAR and maternal mental well-being in a multiple linear regression model. ResultsWe found that healthy postpartum women had a blunted CAR (p<0.001) corresponding to 84% reduction and 80% lower absolute evening cortisol (p<0.001) relative to non-perinatal healthy women. In the postpartum group, there was a trend-level association between lower CAR and higher scores on the WHO Well-Being Index (WHO-5) (p=0.048) and lower Edinburgh Postnatal Depression Scale (EPDS) scores (p=0.04). ConclusionOur data emphasize the unique hormonal landscape during the postpartum period in terms of blunted CAR and lower absolute evening cortisol in healthy women early postpartum compared to non-perinatal. Our findings show a potential association between a reduced CAR and improved mental well-being during early motherhood, which suggests that reduced CAR might reflect healthy adjustment to early motherhood.

Assessment of salivary cortisol dynamics in an infantry training exercise: a pilot study

IntroductionMeasuring cortisol during military training offers insights into physiological responses to stress. We attempted precisely timed, cortisol awakening response (CAR) and pre-sleep cortisol (PSC), and diurnal slope (peak morning minus...

Sleep Quality and Evening Salivary Cortisol Levels in Association with the Psychological Resources of Parents of Children with Developmental Disorders and Type 1 Diabetes.

Sleep deprivation can decrease parental well-being and degrade mental and physical health in parents of children with chronic illness. The aim of this study was to explore the associations of sleep quality, psychological stress perception, and evening salivary cortisol concentration with self-esteem, optimism and happiness in parents of children with type 1 diabetes and developmental disorders compared to parents of healthy, typically developing children. We studied 196 parents of children with chronic conditions, including autistic spectrum disorder (N = 33), cerebral palsy (N = 18), Down syndrome (N = 33), and diabetes mellitus type 1 (N = 40) and parents of healthy children (N = 72). We evaluated parental sleep quality, evening salivary cortisol levels, self-esteem, optimism and happiness. Multiple linear regression models were used to assess associations between variables. Compared with those of the control group, the parents of children with autistic spectrum disorders had higher evening cortisol concentrations (β = 0.17; p = 0.038) and lower perceptions of happiness (β=-0.17; p = 0.017), while parents of children with type 1 diabetes had disrupted sleep quality (β = 0.25; p = 0.003). Optimism was negatively associated with the evening cortisol concentration (β=-0.18; p = 0.023) and sleep quality index (β=-0.20; p = 0.012). Public health programs aimed at lifestyle habit improvement, respite care, and relaxation for parents of children with chronic conditions would be useful for improving parental sleep quality, self-esteem, optimism and happiness.

Day-to-day variability of stress biomarkers during a music intervention in people living with dementia and their family caregivers.

Examination of the variability of stress biomarkers among people living with dementia and their family caregivers can provide evidence of stress reactions and corresponding self-regulation capacities, but no such research has been conducted to date. The aim of this study was to examine day-to-day variability patterns of salivary biomarkers in dyads of people living with dementia and their family caregivers and to investigate differences in variability patterns between music intervention and control groups. This study involved secondary analysis of data collected during a two-group, non-randomized open trial examining the effects of an 8-week music intervention on physiological stress markers. A total of 5791 salivary samples from 34 dyads were used to analyze the variability of morning and evening cortisol and of morning dehydroepiandrosterone sulfate (DHEA-S). The variability indices employed were the intra- and inter-individual standard deviation, coefficient of variation, and intra-class correlation coefficient. We found that family caregivers in the music intervention group had significantly greater coefficients of variation for all three biomarker endpoints than those in the control group. Our findings provide evidence that stress biomarkers in family caregivers with functional self-regulation capacities may be more likely to respond to music intervention. However, stress biomarkers in people living with dementia may not be responsive to music intervention, possibly due to their dysfunctional self-regulation capacities. Future stress biomarker studies involving dyads of people living with dementia and family caregivers should consider biomarker variability patterns in determining the effectiveness of behavioral interventions.

Biological and psychological predictors of cognitive function in breast cancer patients before surgery.

Research suggests that cancer-related cognitive impairment (CRCI) can occur before breast cancer (BC) treatment. The limited extant evidence suggests the underlying mechanisms could be stress-related. Potential psychological and biological predictors of CRCI prior to any BC treatment were examined. 112 treatment-naïve women with BC and 67 healthy controls (HC) completed a neuropsychological test battery to assess cognitive impairment and a self-report battery to assess cognitive complaints, cancer-related stress, depressive and anxiety symptoms. Morning and evening cortisol and α-amylase were collected from saliva. Multilinear regressions were conducted. Treatment-naïve BC patients were more frequently impaired in verbal memory and processing speed and reported more cognitive complaints (all p < .001) than HC. BC patients and HC did not differ in overall cognitive impairment (p = .21). Steeper α-amylase, lower cancer-related stress and younger age was associated with better overall cognitive function in treatment-naïve BC patients. Higher depressive symptoms predicted higher levels of cognitive complaints in BC patients. Overall, these findings suggest that stress plays a role in CRCI. This study is the first to associate α-amylase with cognitive function in cancer patients, informing future research. The findings on impairment in processing speed and verbal memory among treatment-naïve BC highlight the need to screen for such impairments among BC patients and indicate that future studies on CRCI should include baseline assessments prior to BC treatment. If replicated, these findings could inform the development and testing of appropriate interventions to decrease CRCI among cancer patients. NCT04418856, date of registration: 06.05.2020.

Influence of the Antimycotic Drug Itraconazole on Plasma Cortisol Levels and Blood Pressure in a Patient with Burnout Syndrome

Burnout is a syndrome that is increasingly common nowadays. It is associated with reduced work efficiency and chronic exhaustion. The main cause of burnout is continuous stress at work and not enough rest. The main system involved in the pathogenesis of burnout is the hypothalamic–pituitary–adrenocortical axis with the final substrate of the glucocorticoid hormone cortisol. Therefore, in patients with burnout syndrome, the morning plasma cortisol levels are elevated, but there is no significant change in its evening values. This correlates with an increase in blood pressure, weight gain, muscle weakness, low immunity, etc. The following case report is about the unusual effect of the antifungal drug itraconazole on the circadian rhythm of the plasma cortisol levels, as well as on the blood pressure in patient with burnout syndrome. One month of peroral application of 100 mg itraconazole every day reduces the morning plasma cortisol levels to the greatest extent (by approximately 37%) rather than the evening cortisol levels (by circa 17.5%). The decrease in the mean ambulatory systolic and diastolic blood pressure is also not uniform (it is stronger in diastolic – 27% than in systolic – 17%).

Deciphering the Relationship between Salivary Cortisol Levels and Hypertension Using Enzyme-linked Immunosorbent Assay – An Observational Study

Abstract Background: Cortisol plays a major role in stress crises and is higher among patients with hypertension. Assessment of cortisol levels can serve as a predictor for the prevention of complications of hypertension. Aim: The study aimed to investigate the relationship between salivary cortisol levels and hypertension. Materials and Methods: Twenty hypertensive individuals (Group I) and 20 control subjects (Group II) participated in the study. Their blood pressure was measured, followed by the collection of morning and evening saliva samples. Salivary cortisol levels were estimated using an enzyme-linked immunosorbent assay kit. Unpaired Student’s t-test and Pearson’s correlation coefficient were done to statistically analyze the data using SPSS statistical analysis software. Results: Group I had mean morning cortisol levels that were higher (0.376–0.458 g/dL) than those in Group II (0.005–0.0001 g/dL). In Group I participants, there was a positive correlation between evening cortisol levels and pulse pressure (P = 0.05). Conclusion: In this study, we found high cortisol levels in patients with hypertension. Increased salivary cortisol levels could be an indicator of underlying cardiovascular complications.

Mekanik ventilasyon modlarının prematüre bebeklerin tükürük kortizol düzeylerine etkisi

Purpose: The aim of this study was to examine the relationship between mechanical ventilation modes and stress levels by measuring salivary cortisol levels in preterm infants.&#x0D; Materials and Methods: The study group comprised 65 preterm infants on respiratory support and 43 control preterm infants. The Neonatal Infant Pain Scale (NIPS) was used to evaluate pain. To determine the stress level, salivary cortisol levels were studied in saliva samples taken in the morning and evening on the 4th postnatal day.&#x0D; Results: In the study group, morning and evening cortisol levels of the infants were measured 8.33±5.7 ng/ml and 8.05±5.6 ng/ml, respectively. In the control group, morning and evening cortisol values of the infants were measured 1.50±0.7 ng/ml and 1.48±0.7 ng/ml, respectively. The morning and evening salivary cortisol levels of the infants in the study group were significantly higher than those of the infants in the control group. In the invasive mechanical ventilation group infants, morning and evening cortisol levels of the infants were measured 12.46±5,3 ng/ml and 12.0±5,2 ng/ml, respectively. In the non-invasive mechanical ventilation group, morning and evening cortisol values were measured 4.57±2.7 ng/ml and 4.41±2.7 ng/ml, respectively. Both morning and evening salivary cortisol levels of infants on invasive mechanical ventilation were higher than those of infants on non-invasive mechanical ventilation. &#x0D; Conclusion: Increased salivary cortisol levels in invasive modes indicate that intubation causes pain and stress in newborns.

A population-based study of children suggests blunted morning cortisol rhythms are associated with alterations of the systemic inflammatory state

BackgroundIn children, digital media, lifestyle, and the COVID pandemic have impacted sunlight exposure, exercise, and diet patterns - cues that entrain the circadian clock. We hypothesized that low morning cortisol reflects a weak circadian clock, impacting the pro-inflammatory state. The primary objective was to test relationships between diurnal cortisol fluctuations and the inflammatory state in children as a means of providing indirect support for this hypothesis. MethodsThe Cardiovascular Health Intervention Program (CHIP) was a population-based cross-sectional and longitudinal study of circadian health in public elementary school children in Southern Maine, USA (recruitment period 2012–2017). Participants were 689 students in 4th grade (baseline; age=9.2 ± 0.4 years), and 647 students in 5th grade (age=10.5 ± 0.5 years). Nine salivary cortisol measures per child (2 awakening and 1 prior to bed for 3 sequential days) (n = 1336 child phenotype days; n = 7987 cortisol assays), 10 cytokines measured in morning and evening saliva samples (n = 202 child phenotype days), and lipids were measured. Clinical outcomes were blood pressure, weight and height (body mass index [BMI]; BMI = kg/m2), among others. FindingsUpon-waking cortisol levels were 0.28 ± 0.13 µg/dL, 30-minute post-waking 0.33 ± 0.15 µg/dL, and evening 0.08 ± 0.10 µg/dL. Salivary cytokine levels (n = 202) showed interleukins (IL) IL-1β and IL-8 were highest in early morning (upon awakening; AM), and IL-6 and tumor necrosis factor (TNF) TNF-α highest before bed (PM) (IL-1β AM > PM [−4.02 fold; p < 0.001]; IL-8 AM > PM [−1.36 fold; p < 0.001]; IL-6 AM < PM [+1.49 fold; p < 0.001]; TNF-α AM < PM [+1.73 fold; p = 0.03]. Regression modeling showed high morning cortisol was associated with high morning IL-1β (p = 3.82 ×10−6), but low evening IL-1β (p = 6.27 ×10−4). Regression modeling of BMI z-score as the response variable showed the expected significant relationships to high density lipoprotein (HDL) (negative; p < 0.001), mean arterial pressure (positive; p < 0.001), and morning cortisol (negative; p = 0.01) but only weak relationships to either evening cortisol (p = 0.1) or cytokine (positive; p = 0.02; from the model with smallest Rsquared) levels. InterpretationWe provide preliminary data on diurnal fluctuations of inflammatory cytokines in saliva in a population-based cohort of children. Correlation of morning and evening cortisol levels with inflammatory cytokines in the same saliva samples showed that high morning cortisol was associated with high morning IL-1β and low evening IL-1β. Future studies may test the hypothesis that strong diurnal cycling of IL-1β may serve as a homeostatic mechanism keeping the immune system in check, and that low morning cortisol (possible circadian misalignment) may lead to less stringent control of inflammatory networks.

Short-term cortisol adaption to discrimination and Mexican-origin adolescents' mental and sleep health.

Discrimination experiences are a salient contributor to the health disparities facing Latina/x/o youth. The biopsychosocial model of minority health posits that discrimination influences health through wear and tear on the biological stress responses, including the hypothalamic-pituitary-adrenal (HPA) axis, which is a primary stress response system in the body. Emerging evidence suggests that discrimination alters the secretion of cortisol, the end product of the HPA axis, yet, whether the daily processes between discrimination and diurnal cortisol response influence mental and sleep health remains unanswered. This study integrated daily diary and post-diary survey data to examine whether daily diurnal cortisol responses to discrimination influence adolescents' mental (depressive symptoms, anxiety) and sleep (sleep quality, duration) health in a sample of Mexican-origin youth (N = 282; M age = 17.10; 55% female). Results showed that adolescents who experienced more discrimination across the four-day diary period exhibited steeper diurnal cortisol slopes and lower evening cortisol; however, such physiological responses tended to be associated with poorer adolescents' mental and sleep health. The current study underscores the potential adaptation cost associated with short-term cortisol adaptation in the face of discrimination.

Diurnal Cortisol Change Moderates the Associations Between Bedtime Parenting Sensitivity and Young Children's Executive Functioning and Emotion Regulation

Abstract: The present study examined children's diurnal cortisol as a moderator of the association between parenting sensitivity at bedtime and young children's executive functioning and emotion regulation. Fifty-one children ( M age = 4.47 years) and their families participated. Parenting sensitivity was assessed from video recordings of child bedtime. Average child morning and evening cortisol levels were measured from saliva across 3 days. A greater decline in cortisol from morning to evening reflected healthy diurnal patterning. Children's executive functioning was measured objectively, and parents reported on children's emotion regulation. Regression analyses showed that lower parenting sensitivity at bedtime was associated with lower executive functioning and more labile and less adaptive emotion regulation only for children who showed less cortisol decline from morning to evening, suggesting that adaptive cortisol patterning may be protective in the context of low parenting sensitivity. The findings identify children at greatest risk and inform interventions targeting children's developmental outcomes.

ОЦЕНКА УРОВНЯ СТРЕССА У ВРАЧЕЙ-СТОМАТОЛОГОВ НА ОСНОВАНИИ СОДЕРЖАНИЯ КОРТИЗОЛА В СЛЮНЕ

Aim. Based on the cortisol content in the oral fluid and the assessment of emotional stress, determine the stress level of dentists.&#x0D; Materials and methods. The group consisted of 25 healthy volunteers, dentists (8 men and 17 women aged 24 to 60 years) with various work experience. Participants filled in an adapted scale of the level of emotional stress before the start of the work shift. On the same day, oral fluid was collected to assess cortisol levels in the morning and evening.&#x0D; Results. There were no statistically significant differences in the level of emotional stress among dentists, depending on gender. The level of emotional stress in general increases with increasing work experience. With an experience of more than 20 years, emotional stress is significantly (p = 0.026) higher compared to colleagues who have been in the profession for less than 10 years, the indicator was 16.43 (±3.20) and 19.00 (±1.10) points, respectively. The level of evening cortisol in the oral fluid has a statistically significant relationship of noticeable strength with the level of emotional tension only in participants with a high level of tension (18–20 points).&#x0D; Conclusions. The level of emotional stress increases with increasing work experience as a dentist. To assess the level of stress, the level of evening cortisol is more indicative than in the morning, and the interpretation of the results should be carried out in conjunction with the assessment of emotional stress, as well as considering the somatic status of the subject.

The developmental trajectory of diurnal cortisol in autistic and neurotypical youth.

Increasing age and puberty affect the hypothalamic pituitary adrenal (HPA) axis maturation, which is likely associated with an increase in environmental demands (e.g., social) and vulnerability for the onset of psychiatric conditions (e.g., depression). There is limited research as to whether such patterns are consonant in youth with autism spectrum disorder (ASD), a condition marked by social challenges, dysregulation of the HPA axis, and higher rates of depression setting the stage for enhanced vulnerability during this developmental period.The current study interrogated diurnal cortisol by examining (1) cortisol expression longitudinally over the pubertal transition between autistic and neurotypical youth, (2) the trajectory of diurnal cortisol and the unique contributions of age vs. puberty, and (3) potential sex differences. As hypothesized, results indicate autistic compared to typically developing youth demonstrate a shallower diurnal slope and elevated evening cortisol. These differences were in the context of higher cortisol and flatter rhythms based on age and pubertal development. Also, sex-based differences emerged such that females in both groups had higher cortisol, flatter slopes, and higher evening cortisol than males. The results show that despite the trait-like stability of diurnal cortisol, HPA maturation is impacted by age, puberty, sex, as well as an ASD diagnosis.

Role of altered cortisol production in the development of sarcopenia

Skeletal muscle mass and function is decreased as we age, a condition known as sarcopenia. Ageing is associated with increases in minimum and mean cortisol plasma levels and shortening of the evening cortisol quiescent period, suggesting impaired circadian function and higher basal levels with increasing age (Stamou et al, 2023). It has also been shown that the deleterious effects of bed rest on human skeletal muscle are exacerbated by hypercortisolemia (Fitts et al, 2007).The aim of this study was to examine the direct effects of increasing levels of cortisol on muscle cells. C2C12 myoblasts were fused to myotubes by serum deprivation for up to 7 days. Cellular viability was assessed using light-microscopy to identify any gross changes in cell morphology at 3, 24 and 48 hours following treatment with a range of cortisol concentrations in the physiological range (10 – 0.1uM). Indices of muscle atrophy and evidence of altered levels of inflammatory cytokines was determined by mRNA analyses and release of cytokines/chemokines by myotubes was assessed using bead based multiplex technology (Luminex immunoassay).Cortisol treatment had no significant effect on C2C12 myotube viability at any concentration or time point, or on gene expression of IL-6, RANTES (CCL5) or MCP-1 (CCL2) compared with control untreated myotubes. No increase in the release of cytokines and chemokines from C2C12 myotubes was seen following treatment with cortisol and in some instances a significant decrease in cytokine/chemokine production was seen, particularly following treatment with higher concentrations of cortisol when compared with control values (eg, 10uM cortisol, 24 hours post-treatment: IL-6: 1.6 +/- 1.6% CXCL5: 17.4 +/- 1.8%; KC (CXCL1): 11.6 +/-10.3%. These data are in contrast to previous work from our group which revealed an increase in the release of IL-6, CXCL-1 (KC), CCL2 (MCP-1) and CCL5 (RANTES) from C2C12 myotubes following treatment of myotubes 25ng/ml TNF-α (Lightfoot et al, 2015).In summary, increased levels of cortisol do not appear to have any direct deleterious effects on myotube viability or production of pro-inflammatory cytokines. However, this does not exclude any indirect effects of cortisol on muscle including the effects on other organs indirectly affecting muscle function. It may also be that cortisol has a deleterious effect when muscle is under stressful conditions and this possibility will also be examined. Fitts et al (2007). doi: 10.1152/ajpcell.00573.2006 ; Lightfoot et al. (2015) doi: 10.1016/j.redox.2015.08.007 ; Stamou et al (2023) doi.org/10.1016/j.maturitas.2022.10.006 . The authors would like to thank the EU/BBSRC and CIMA for generous funding. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Lower diurnal HPA-axis activity in male hypertensive and coronary heart disease patients predicts future CHD risk.

Coronary heart disease (CHD) and its major risk factor hypertension have both been associated with altered activity of the hypothalamus-pituitary-adrenal (HPA)-axis but the biological mechanisms underlying prospective associations with adverse disease outcomes are unclear. We investigated diurnal HPA-axis activity in CHD-patients, hypertensive (HT) and healthy normotensive men (NT) and tested for prospective associations with biological CHD risk factors. Eighty-three male CHD-patients, 54 HT and 54 NT men repeatedly measured salivary cortisol over two consecutive days. Prospective CHD risk was assessed by changes between baseline and follow-up in the prothrombotic factors D-dimer and fibrinogen, the pro-inflammatory measures interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), and acute phase protein C-reactive protein (CRP), as well as blood lipids in terms of total cholesterol (tChol)/high-density-lipoprotein cholesterol (HDL)-ratio. We aggregated coagulation and inflammatory measures to respective indices. The groups differed in repeated daytime cortisol (dayCort) secretion (p=.005,η2 p=.03,f=0.18) and cortisol awakening response (CAR) (p=.006,η2 p=.03,f=0.18), with similarly lower overall dayCort and CAR in CHD-patients and HT, as compared to NT. The groups differed further in cortisol at awakening (p=.015,η2 p=.04,f=0.20) with highest levels in HT (p´s≤.050), and in diurnal slope between waking and evening cortisol (p=.033,η2 p=.04,f=0.20) with steepest slopes in HT (p´s≤.039), although in part not independent of confounders. Lower aggregated dayCort and CAR in terms of area-under-the-curve (AUC) independently predicted increases in future overall CHD risk (AUCdayCort: p=.021,η2 p=.10,f=0.33;AUCCAR: p=.028,η2 p=.09,f=0.31) 3.00 ± 0.06(SEM) years later, with risk prediction most pronounced in fibrinogen (AUCdayCort: p=.017,ΔR 2= 0.12;AUCCAR: p=.082). We found evidence for an HPA-axis hypoactivity in CHD and HT with lower diurnal HPA-axis activity predicting increases in cardiovascular risk as evidenced by increases in circulating levels of biomarkers of atherothrombotic risk. Down-regulation of basal HPA-axis activity may contribute to the pathogenesis of atherosclerosis and thrombosis in CHD via effects on coagulation.

A Study to Assess Changes in Cortisol Level and Heart Rate Variability between Fixed Duty and Shift Duty Health Care Providers in a Tertiary Care HospitalA Cross-Sectional Study

Introduction: Increased demand of service 24 hours around the clock has divided the workers into 2 domains as “Fixed duty” and “Shift duty”. Personals associated with shift duty are increasing in numbers day by day. Shift duty or more specifically night duty is associated with increased stress which results in high morbidity and decrease in work efficiency. Cortisol hormone and Heart Rate Variability (HRV) are useful parameters to determine the effects of stress. Aim: To find any change in cortisol levels, HRV, Athens score among the fixed duty and shift duty healthcare providers. Materials and Methods: A descriptive cross-sectional comparative study was conducted in a tertiary care hospital at Kolkata between July, 15th to Sept, 15th 2021. Predesigned and pretested questionnaire was made and ethical clearance was taken from institutional IEC. Then after taking consent total 120 (60 fixed duty and 60 shift duty) healthcare providers were recruited for the study. Subjects of the study filled up a questionnaire {including Athens Insomnia Scale (AIS)}. After applying exclusion criteria (any cardiovascular, neurological, psychological, sleep disorder) 120 health individuals were taken five minutes short-term HRV (time and frequency domain) recording in supine posture and 4 PM blood sample (for cortisol) were obtained from the participants which was further analysed in Chemiluminescence Immunoassay (CLI). Data was analysed in SPSS version 20.0. Statistical tests like student t-test, Cron bach’s alpha and chi-square tests were applied significant p&lt;0.05 (95% CI). Results: After analysis, shift duty workers showed a significant (p&lt;0.001, Odd’s 10.706) higher chance of having insomnia (Athens score &gt;6) than fixed duty workers. Blood test showed that shift duty workers had significantly high evening cortisol level than fixed duty workers (p= 0.036). The time domain of HRV showed that the parameters like Standard Deviation all NN interval (SDNN) (p=0.001), Mean HR (p=0.037), RMSSD (p &lt;0.001), NN50 (p=0.006), pNN50 (p=0.002) were significantly different in the two groups. Whereas the frequency domain of HRV showed that HF power was lower and LF power (p=0.002), LF/HF ratio (p &lt;0.001) were significantly higher in shift duty workers. Conclusion: The study showed that shift duty workers had comparatively higher stress levels resulting in significantly high sympathetic drive and increased risk of insomnia. This can be associated with morbidity and ill health in the shifting duty workers.

Maternal distress, DNA methylation, and fetal programing of stress physiology in Brazilian mother-infant pairs.

Maternal prenatal psychosocial stress is associated with adverse hypothalamic-pituitary-adrenal axis (HPAA) function among infants. Although the biological mechanisms influencing this process remain unknown, altered DNA methylation is considered to be one potential mechanism. We investigated associations between maternal prenatal psychological distress, infant salivary DNA methylation, and stress physiology at 12 months. Mother's distress was measured via depression and anxiety in early and late pregnancy in a cohort of 80 pregnant adolescents. Maternal hair cortisol was collected during pregnancy. Saliva samples were collected from infants at 12 months to quantify DNA methylation of three stress-related genes (FKBP5, NR3C1, OXTR) (n=62) and diurnal cortisol (n=29). Multivariable linear regression was used to test for associations between prenatal psychological distress, and infant DNA methylation and cortisol. Hair cortisol concentrations in late pregnancy were negatively associated with two sites of FKBP5 (site 1: B=-22.33, p=.003; site 2: B=-15.60, p=.012). Infants of mothers with elevated anxiety symptoms in late pregnancy had lower levels of OXTR2 CpG2 methylation (B=-2.17, p=.03) and higher evening salivary cortisol (B=0.41, p=.03). Furthermore, OXTR2 methylation was inversely associated with evening cortisol (B=-0.14, p-value≤.001). Our results are, to our knowledge, the first evidence that the methylation of the oxytocin receptor may contribute to the regulation of HPAA during infancy.

Is in‐home saliva collection of cortisol and DHEA‐S effective to measure stress in dementia care dyads?: A comparison between music‐based intervention group and comparison group

AbstractBackgroundDespite the fact that music provides a wide array of benefits for dementia care dyads (persons with dementia and family caregivers), the increased attention to music for stress reduction in dementia care dyads has sparked questions about whether and how to effectively measure changes in stress throughout the interventions. The purpose of this study was to explore the feasibility of collecting salivary cortisol and dehydroepiandrosterone sulfate (DHEA‐S) as stress biomarkers to assess the short‐term effects of music among dementia care dyads living at home.MethodParticipants who were recruited from the memory evaluation center collected their saliva three times a day, five days a week, over the eight weeks of in‐home online music intervention. In this non‐randomized open study, we examined concentrations of endpoints morning cortisol and DHEA‐S, evening cortisol, and the ratio of cortisol to DHEA‐S. Mean values of logarithmically transformed endpoints during the last available week were compared between the intervention and comparison groups with adjustment for baseline mean values in linear regression models or non‐parametric Willett’s residual method.ResultA total of 34 dyads (34 persons with dementia and 34 family caregivers; n = 24 dyads [intervention group], n = 10 dyads [comparison group]) were included. We did not find statistically significant differences between the intervention group and the comparison group in persons with dementia. Caregivers in the intervention group had lower concentrations of morning saliva cortisol (geometric mean: 3262 pg/ml) compared to the comparison group (geometric mean: 5271 pg/ml) (p = 0.013).ConclusionThe in‐home daily saliva collection of cortisol and DHEA‐S may be feasible to examine the short‐term effects of music on stress among dementia care dyads. The findings suggest that our in‐home music intervention may help reduce stress among family caregivers who provide care to persons with dementia. Considering the small sample with high intra‐individual variation of salivary biomarkers, a randomized controlled trial with a larger sample is needed in future research.