Log Cortisol Research Articles

STRESS HORMONE LEVELS AMONG CHILDREN BEREAVED BY TERROR ATTACK

Background: Terrorism is characterized by the use of violence against civilians, with the expressed desire of causing terror or panic in the population. Since the Soviet invasion of Afghanistan in 1979, the Khyber Pakhtunkhwa (formerly NWFP) province of Pakistan has suffered the most from unrest and terrorist activities. Terror related bereavement is more stressful and difficult to recover compared from that of bereavement from natural death. Methods: This retrospective study was carried out in the Department of Physiology, IBMS, Khyber Medical University, Peshawar, Pakistan. Salivary Cortisol Levels were estimated in Non-Bereaved and Bereaved Groups of children. Results: Children in the Bereaved Group showed a statistically significant (p=0.005) higher levels of salivary cortisol in the morning sample (Log Cortisol M=14.43) as compared with the children in the Non-Bereaved Group (Log Cortisol M=6.44). Children in the Bereaved Group showed a statistically non-significant (p=0.164) decrease in the levels of salivary cortisol in the post-dexamethasone sample (Log Cortisol M=8.85) as compared with the children in the Non-Bereaved Group (Log Cortisol M=4.25). Conclusion: Terror bereavement causes long-term activation of the Hypothalmo-Pituitary-Adrenal (HPA) axis, elevating the cortisol levels even 3–4 years after the traumatic bereavement. Chronic elevation of cortisol results in the manifestations of depression related signs and symptoms in bereaved children. Pak J Physiol 2023;19(3):11–4

Psychological resilience and diurnal salivary cortisol in young adulthood

BackgroundAdversity exposure and the negative psychological responses that often result have been linked with poor physical health outcomes and deteriorative physiological processes, like dysregulated circulating cortisol. Individuals exposed to early adversity who also demonstrate positive psychological functioning may be characterized as psychologically resilient, but few studies have evaluated whether psychological resilience may disrupt the health-damaging effects of adversity. We tested the hypothesis that among young adults exposed to early adversity, those who are psychologically resilient may manifest more normative diurnal cortisol patterns relative to those who experience more psychological distress. MethodsData are from Growing Up Today Study I participants who provided information on psychological resilience and diurnal salivary cortisol (n = 916). Psychological resilience was derived from self-report questionnaires administered between 2007 and 2010, and salivary cortisol was obtained from saliva samples collected between 2011 and 2014. The predictor of interest, psychological resilience, was defined using two domains: (1) adversity exposure measured via a count of 7 potential psychosocial adversities experienced before age 18, and (2) psychological health in young adulthood measured via a composite score reflecting low psychological distress and high positive affect. The outcome was mean log-transformed diurnal salivary cortisol across 4 samples from one day. Linear regressions evaluated associations of adversity, psychological health, and their potential multiplicative interaction with mean diurnal log-transformed cortisol, adjusting for baseline socio-demographic variables and biological and behavioral factors from the day of saliva sampling. ResultsRelatively few individuals with high adversity demonstrated positive psychological health. Both adversity exposure and psychological health were independently associated with mean log cortisol levels. Models stratified by lower versus higher adversity suggested complex relationships with cortisol, however the interaction between adversity and psychological health was not statistically significant. High adversity was associated with blunted cortisol levels, regardless of psychological health. Conversely, among those with lower adversity, overall levels of cortisol were higher and psychological health associated with more normative, lower cortisol levels. ConclusionsPsychological resilience domains were independently associated with diurnal salivary cortisol in young adulthood. High burden of early adversity may disrupt the physiological stress system, while psychological health may be associated with more normative cortisol levels when adversity is low.

Home ovulation test use and stress during subfertility evaluation: Subarm of a randomized controlled trial.

Objectives:A prospective, randomized controlled trial in women seeking to conceive examined the impact of using ovulation tests on self-reported levels of stress, psychological well-being, and quality of life in women with unexplained infertility.Method:The test group used a home ovulation test to detect the day of ovulation, whereas the control group were provided with a predicted day of ovulation based on the average length of menstrual cycle reported during study recruitment. Volunteers collected their first morning urine samples to evaluate biochemical levels of stress (urinary cortisol and estrone-3-glucouronide) and completed questionnaires over two complete menstrual cycles.Results:Overall, the use of digital ovulation tests by sub-fertile women under medical care had negligible negative effects and no detectable positive benefit on psychological well-being, according to multiple measurements of stress by questionnaire and biochemical markers. No significant differences were found between groups for all stress measures at the various study time points, except in relation to “couple concordance” where the test group scored much higher than the control group (mean difference at end of study was 21.25 (95% confidence interval: 9.25, 33.25; P = 0.0015)). The maximum difference in log cortisol: creatinine ratio between the test and control groups was −0.28 (95% confidence interval: −0.69, 0.13).Conclusions:These results do not support propositions that using digital ovulation tests can cause stress in women trying to conceive.

Chronic exposure to inhaled, traffic-related nitrogen dioxide and a blunted cortisol response in adolescents

BackgroundChronic health effects of traffic-related air pollution, like nitrogen dioxide (NO2), are well-documented. Animal models suggested that NO2 exposures dysregulate cortisol function. ObjectivesWe evaluated the association between traffic-related NO2 exposure and adolescent human cortisol concentrations, utilizing measures of the cortisol diurnal slope. Methods140 adolescents provided repeated salivary cortisol samples throughout one day. We built a land use regression model to estimate chronic NO2 exposures based on home and school addresses. We then generated model-based estimates of the association between cortisol and NO2 exposure one year prior to cortisol sampling, examining changes in cortisol diurnal slope. The final model was adjusted other criteria pollutants, measures of psychosocial stress, anthropometry, and other demographic and covariates. ResultsWe observed a decrease in diurnal slope in cortisol for adolescents exposed to the estimated 75th percentile of ambient NO2 (high exposure) relative to those exposed at the 25th percentile (low exposure). For a highly exposed adolescent, the log cortisol was lower by 0.06 µg/dl at waking (95% CI: −0.15, 0.02), 0.07 µg/dl at 30 min post waking (95% CI: −0.15, 0.02), and higher by 0.05 µg/dl at bedtime (95% CI: 0.05, 0.15), compared to a low exposed adolescent. For an additional interquartile range of exposure, the model-based predicted diurnal slope significantly decreased by 0.12 (95% CI: −0.23, −0.01). ConclusionsIn adolescents, we found that increased, chronic exposure to NO2 and the mixture of pollutants from traffic sources was associated with a flattened diurnal slope of cortisol, a marker of an abnormal cortisol response which we hypothesize may be a mechanism through which air pollution may affect respiratory function and asthma in adolescents.

Diurnal salivary cortisol, glycemia and insulin resistance: The multi-ethnic study of atherosclerosis

Hypercortisolism is associated with insulin resistance (IR) and diabetes mellitus (DM); however, to our knowledge prior studies have not examined the association of diurnal cortisol curve features with measures of glycemia or IR in a population-based setting. Using log-transformed salivary cortisol data on 850 ethnically diverse men and women from the Multi-Ethnic Study of Atherosclerosis, we investigated the cross-sectional association of cortisol curve features with (1) glycemia in those with and without DM and (2) IR, in non-diabetic subjects. The log-transformed salivary cortisol curve features included wake-up cortisol, cortisol awakening response (CAR), early decline slope (30min to 2h post-awakening), late decline slope (2h post-awakening to bedtime), overall decline slope (0min to bedtime, excluding 30min cortisol), bedtime cortisol and total area under the curve (AUC). Overall, following multivariable adjustment, among those with diabetes mellitus (DM), early decline slope, overall decline slope, bedtime cortisol, and AUC were significantly and positively associated with a 5.4% (95% CI: 1.3, 9.7), 54.7% (95% CI: 12.4, 112.9), 4.0% (95% CI: 1.6,6.4), and 6.8% (95% CI: 3.3,10.4) higher HbA1c per 1 unit increase in log cortisol feature, respectively. Cortisol curve features were not associated with HbA1c among non-diabetic participants; however, wake-up cortisol and AUC were associated with a 8.2% lower (95% CI: −13.3,−2.7) and 7.9% lower (95% CI: −14.6, −0.6) log HOMA-IR, respectively. This was attenuated by adjustment for waist circumference. Among participants with DM, cortisol curve parameters suggestive of higher hypothalamic-pituitary-adrenal (HPA) axis activity and dysfunction were associated with higher HbA1c. In non-diabetic participants, greater HPA activity was paradoxically associated with lower insulin resistance.

Plasma cortisol and prognosis of patients with acute myocardial infarction

Cortisol is associated with increased cardiovascular morbidity and mortality in patients with chronic heart failure and in the general population. The negative predictive effect of cortisol on survival in non-diabetic patients who have suffered an acute myocardial infarction (AMI) has been shown. We aimed to determine the prognostic significance of cortisol in a general group of AMI patients, as this is not well known. Plasma cortisol levels were measured in 955 consecutive patients admitted with AMI. We prospectively evaluated the relationship between cortisol and major adverse cardiovascular event (MACE), which was a composite of all-cause mortality, and combination all-cause mortality and re-hospitalization for heart failure, in post-AMI patients. During the 2-year follow-up, MACE occurred in 261 patients (27.3%). Patients with MACE had significantly higher median levels of cortisol than those without (609.4 versus 549.4 pmol/ml, P = 0.0073). Log cortisol was independently predictive of MACE after adjusting for covariates with hazard ratio (95% confidence interval) of 1.55 (1.05-2.27), P = 0.027. Patients in the highest quartile of cortisol had significantly more risk of MACE compared with those in the lowest quartile, with an adjusted hazard ratio (95% confidence interval) of 1.91(1.16-3.15), P = 0.0120. Kaplan-Meier survival estimates for MACE were lower in patients with plasma cortisol levels in the highest quartile compared with those in the first three quartiles (Log rank test χ² for survival = 10.41, P = 0.0013). This study has shown the prognostic significance of cortisol in 955 post-AMI patients from a single centre.

Disrupted Prenatal Maternal Cortisol, Maternal Obesity, and Childhood Wheeze. Insights into Prenatal Programming

Exploring prenatal factors influencing childhood wheeze may inform programming mechanisms. We examined associations among prenatal maternal cortisol profiles, maternal obesity, and repeated wheeze up to age 2 years (n = 261). Salivary cortisol was collected five times per day over 3 days at 29.0 ± 4.9 weeks gestation. Mothers were categorized as obese (body mass index ≥ 30 kg/m(2)) versus nonobese (body mass index < 30 kg/m(2)). Using logistic regression, we examined the influence of log-transformed cortisol metrics (level at each time point, morning rise, diurnal and afternoon slopes) and obesity on wheeze adjusting for covariates. Linear mixed models were implemented to examine associations between cortisol trajectories and wheezing. Interactions between maternal cortisol and obesity were considered. Mothers were primarily minority (56.5% Hispanic, 24.1% African American), 61% had less than or equal to 12 years of education, 34% were obese, and 8.4% of children had repeated wheeze. An interquartile range increase in mean log cortisol at bedtime (odds ratio, 2.2; 95% confidence interval, 1.09-4.09) and maternal obesity (odds ratio, 3.43; 95% confidence interval, 1.26-9.35) were independently associated with wheeze. Linear mixed models revealed an association between a flatter afternoon slope (slower decline in log cortisol per hour) and repeated wheeze in children of obese mothers (children with [-0.017 change] and without [-0.061 change] wheeze [P = 0.009 for time × wheeze interaction]), but not in children of nonobese mothers (with [-0.050 change] and without [-0.061 change] wheeze [P = 0.51]). Maternal prenatal cortisol disruption and obesity were independently associated with children's wheeze. Obese women with adverse cortisol profiles were most likely to have children with repeated wheeze.

Salivary Biomarkers of Stress Among Teachers in an Urban Setting

The aim of this study was to determine the prevalence of job stress among secondary school teachers using Karasek Job Content Questionnaire (JCQ), the association between salivary cortisol, salivary IgA, and sociodemographic characteristics, and the association between log cortisol, IgA levels, and job strain categories. A cross-sectional study was undertaken using JCQ and salivary cortisol and IgA samples. Cluster sampling was done yielding 302 respondents. The prevalence of stress among all teachers was 20.2%. Being a Malay, teaching experience of 5 to 10 years, and those without a supervisor's support had higher prevalence of high job strain. Teachers in the 31 to 40 years age bracket, educating handicapped children with the absence of supervisor support exhibited higher stress levels with lower log salivary IgA levels. Further studies must be conducted using salivary biomarkers to study the in-depth relationship of stress, extending into other occupational groups.

Childhood Maltreatment and Diurnal Cortisol Patterns in Women With Chronic Pain

To assess whether alleged childhood maltreatment is associated with daily cortisol secretion in women with chronic pain. Women with fibromyalgia (FM group, n = 35) or with osteoarthritis only (OA group, n = 35) completed diaries and collected three saliva samples daily for 30 days, with compliance monitored electronically. Childhood abuse and neglect were assessed by self-report (Childhood Trauma Questionnaire-short form [CTQ-sf]). Multilevel regression analyses estimated associations between maltreatment and diurnal cortisol levels and slopes, controlling for depressive symptoms, posttraumatic stress disorder (PTSD), and daily experience variables. Women reporting more severe childhood maltreatment had higher cortisol throughout the day. The estimated effect of CTQ on log cortisol (beta = 0.007, p = .001) represents a 0.7% increase in raw cortisol level for every unit increase in maltreatment score, which ranged from 25 (no maltreatment) to 106 in this sample. Although different forms of maltreatment were interrelated, emotional and sexual abuse were most closely linked to cortisol levels. Fibromyalgia and osteoarthritis groups showed similar secretory patterns, and maltreatment was associated with elevated cortisol in both. Although maltreatment was related to symptoms of depression, PTSD, and averaged daily reports of positive and negative affect, none of these variables mediated the link between maltreatment and cortisol. In women with chronic pain, self-reported childhood maltreatment was associated with higher diurnal cortisol levels. These results add to the evidence that abuse in childhood can induce long-term changes in hypothalamic-pituitary-adrenocortical activity. They further underscore the importance of evaluating childhood maltreatment in fibromyalgia and other chronic pain conditions.

Depression and Stress Reactivity in Metastatic Breast Cancer

Cancer-related distress due to the psychological and physical challenges of metastatic breast cancer (MBC) may result in symptoms of depression, which negatively affects quality and may influence quantity of life. This study investigated how depression affects MBC stress reactivity, including autonomic (ANS) and hypothalamic-pituitary-adrenal (HPA) axis function. Forty-five nondepressed and 45 depressed patients with MBC underwent a modified Trier Social Stress Test (TSST) while affect, cardiovascular, respiratory, and cortisol responses were measured. At study entry, depressed compared with nondepressed patients had significantly lower log cortisol waking rise levels (p = .005) but no other HPA differences. Positive affect (p = .025) and high-frequency heart-rate variability (lnHF) (p = .002) were significantly lower at TSST baseline in depressed patients. In response to the TSST, depressed patients reported significantly lower positive (p = .050) and greater negative affect (p = .037) and had significantly reduced lnHF (p = .031). In secondary analyses, at TSST baseline both low-frequency (lnLF) (p = .002) and very-low-frequency (lnVLF) (p = .0001) heart rate variability were significantly lower in the depressed group. In secondary analyses during the TSST, those who were depressed had significantly lower lnVLF (p = .008) and did not increase aortic impedance reactivity as much as did the nondepressed during the stressor (p = .005). Depression in patients with MBC was associated with alterations in autonomic regulation, particularly reductions in respiratory sinus arrhythmia, a measure of cardiac vagal control, at baseline and during the TSST. In addition, depression was associated with blunted HPA response to awakening. Both MBC groups had relative cortisol hyporesponsiveness to acute stress.

Ethnicity, Stress, and Cortisol Function in Hispanic and Non-Hispanic White Women: A Preliminary Study of Family Dementia Caregivers and Noncaregivers

This study examined differences in psychologic and physiological responses to caregiving stress in Hispanic and non-Hispanic white women dementia caregivers and noncaregivers. Dependent variables were perceived stress, depression, and salivary cortisol. Eighty-three women caregivers (20 Hispanic and 24 non-Hispanic white) and noncaregivers (19 Hispanic and 20 non-Hispanic white) completed the Perceived Stress Scale (PSS), Center for Epidemiological Studies-Depression Scale (CES-D), and collected three saliva samples daily for 3 consecutive days. A subsample of 17 Hispanic and 28 non-Hispanic white participants matched on age and education was used for the main analyses. Caregivers had higher levels of 8 am, 5 pm, and 9 pm log cortisol as well as higher perceived stress than noncaregivers. Non-Hispanic whites had higher depression scores than noncaregivers, but there was no significant difference for Hispanics. Hispanics, regardless of caregiving status had flatter daytime cortisol slopes than the non-Hispanic whites. Multivariate regression analyses showed that both ethnicity and depressive symptoms independently predicted daytime cortisol slope. Results support the relationship between chronic stress and hypothalamic-pituitary-adrenal axis dysregulation among women dementia caregivers and highlight the need to examine further the role of ethnicity and depressive symptoms in their physiological responses.

Tumor Necrosis Factor and Steroid Metabolism in Chronic Heart Failure: Possible Relation to Muscle Wasting

Objectives. We sought to assess the possible relations between clinical severity of chronic heart failure and catabolic factors, specifically tumor necrosis factor (TNF), soluble TNF receptors 1 and 2 (sTNFR-1 and sTNFR-2), cortisol, testosterone and dehydroepiandrosterone (DHEA).Background. Chronic heart failure is associated with loss of muscle bulk that may be related to alteration of the balance between catabolism and anabolism.Methods. Sixty-three patients (average age ±SD 60.4 ± 11.3 years) with stable chronic heart failure and 20 control subjects aged 52.8 ± 11.4 years were studied. We measured body mass index (BMI) and obtained maximal incremental exercise testing with metabolic gas exchange measurements and measurements of venous levels of TNF, sTNFR-1 and sTNFR-2, cortisol and DHEA.Results. There was no difference in total TNF-alpha levels between patients and control subjects (9.76 ± 8.59 vs. 6.84 ± 2.7 pg/ml). sTNFR-1 (128.9 ± 84.5 vs. 63.6 ± 23.3 pg/ml, p < 0.003) and sTNFR-2 (250.1 ± 109.5 vs. 187.9 ± 92.2 pg/ml, p = 0.03) were higher in patients. DHEA was lower in patients (9.88 ± 6.94 vs. 15.64 ± 8.33 nmol/liter, p = 0.004). The ratio of log cortisol to log DHEA correlated with log TNF level (r = 0.50, p < 0.001 for the patients alone; r = 0.48, p < 0.001 for the group as a whole). Peak oxygen consumption correlated with both sTNFR-1 and sTNFR-2 (r = −0.51, p < 0.001 and r = −0.39, p < 0.001, respectively). There was a negative correlation between BMI and TNF levels (r = −0.43, p < 0.001 for the patients) and the cortisol/DHEA ratio (r = −0.32, p = 0.01 for the patients).Conclusions. There is an increase in TNF and its soluble receptors in chronic heart failure. This increase is associated with a rise in the cortisol/DHEA (catabolic/anabolic) ratio. These changes correlate with BMI and clinical severity of heart failure, suggesting a possible etiologic link.