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Cruz E, Mendez A, Ting A, Spiegel D, Tsai TC, Carver CS, Kim Y. The associations of spirituality and Hispanic ethnicity with neuroendocrine biomarkers among patients with colorectal cancer. J Psychosom Res 2024; 185:111865. [PMID: 39116686 DOI: 10.1016/j.jpsychores.2024.111865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 07/19/2024] [Accepted: 07/21/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Dealing with cancer evokes not only physical and emotional distress, but may also promote resilience through spirituality. Patients with cancer are vulnerable to neuroendocrine dysregulation. This longitudinal observational study examined the degree to which spirituality was associated with neuroendocrine biomarkers and the moderating role of Hispanic ethnicity. METHODS Participants were adults who were recently diagnosed with colorectal cancer (n = 81, 55 years old, 66% male, 63% Hispanic, 72% advanced cancer, 7 months post-diagnosis). The domains of spirituality (faith, meaning, and peace) and ethnicity (Hispanic vs. non-Hispanic) were self-reported. Cortisol and alpha amylase (sAA) were assayed from saliva samples collected at waking and bedtime on seven consecutive days. Mean levels at waking and bedtime, and diurnal slopes over seven days were calculated. Age and cancer stage were covariates. RESULTS Overall, patients reported moderate to high levels of spirituality. General linear modeling revealed that greater faith was associated with higher levels of sAA at waking and bedtime as well as more blunted diurnal pattern of sAA only among Hispanic patients (p ≤ .045). Greater peace was associated with steeper diurnal pattern of sAA, regardless of ethnicity (B = 0.021, p = .005). Meaning and cortisol were not significantly associated with study variables. CONCLUSIONS Findings indicate that presence of peace facing a cancer diagnosis associated with neuroendocrine regulation, whereas drawing on one's faith, particularly among Hispanic patients, associated with neuroendocrine dysregulation during the first months after the diagnosis. Further investigations of psychobiobehavioral moderators and mediators for healthy neuroendocrine functioning among patients with cancer are warranted.
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Affiliation(s)
| | | | - Amanda Ting
- Department of Psychology, University of Miami, USA
| | - David Spiegel
- Department of Psychiatry & Behavioral Sciences, Stanford University, USA
| | | | | | - Youngmee Kim
- Department of Psychology, University of Miami, USA.
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Weiss SJ, Xu L. Postpartum symptoms of anxiety, depression and stress: differential relationships to women's cortisol profiles. Arch Womens Ment Health 2024; 27:435-445. [PMID: 38214755 PMCID: PMC11116185 DOI: 10.1007/s00737-024-01421-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
PURPOSE Women are at high risk of stress, anxiety, and depression during the postpartum but the ways in which these different types of psychological distress are related to cortisol regulation is not clear. We examined the distinct association of each type of distress with women's average cortisol level, cortisol awakening response (CAR), cortisol decline across the day (diurnal slope), and overall amount of cortisol secretion across the day (AUCG). METHODS At 6 months postpartum, a diverse group of 58 women completed measures of depression, anxiety, perceived stress, and life stressors. Each woman provided 4 salivary samples for cortisol assay from waking to bedtime on each of 2 consecutive days. Linear regressions were used to examine associations of stress, anxiety and depression to each of the 4 cortisol measures, controlling for number of stressful life events. RESULTS Depressive symptoms were associated with less of a rise in the CAR (β = -.46, p = 0.01), steeper diurnal slope (β = .51, p = 0.006), and higher average cortisol level (β = .42, p = .01). Women who met the clinical cutoff for an anxiety disorder had lower overall cortisol output (β = -.29, p = 0.03). Stress was not related to any cortisol metric. CONCLUSIONS Findings suggest that stress is less associated with cortisol alterations in the postpartum than are more severe types of psychological distress. Anxiety and depression may have distinct and opposite profiles of cortisol dysregulation. Results indicate that mental health assessment is critical even in the later postpartum so that interventions can be initiated to reduce emotional suffering and the risk of impaired cortisol regulation.
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Affiliation(s)
- Sandra J Weiss
- Department of Community Health Systems, University of California, San Francisco, CA, USA.
| | - Ling Xu
- Department of Community Health Systems, University of California, San Francisco, CA, USA
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Liebert MA, Urlacher SS, Madimenos FC, Gildner TE, Cepon-Robins TJ, Harrington CJ, Bribiescas RG, Sugiyama LS, Snodgrass JJ. Variation in diurnal cortisol patterns among the Indigenous Shuar of Amazonian Ecuador. Am J Hum Biol 2024:e24056. [PMID: 38517108 DOI: 10.1002/ajhb.24056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 12/24/2023] [Accepted: 02/09/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES The hypothalamic-pituitary-adrenal (HPA) axis and its primary end product, the glucocorticoid cortisol, are major components of the evolved human stress response. However, most studies have examined these systems among populations in high-income settings, which differ from the high pathogen and limited resource contexts in which the HPA axis functioned for most of human evolution. METHODS We investigated variability in diurnal salivary cortisol patterns among 298 Indigenous Shuar from Amazonian Ecuador (147 males, 151 females; age 2-86 years), focusing on the effects of age, biological sex, and body mass index (BMI) in shaping differences in diurnal cortisol production. Saliva samples were collected three times daily (waking, 30 minutes post-waking, evening) for three consecutive days to measure key cortisol parameters: levels at waking, the cortisol awakening response, the diurnal slope, and total daily output. RESULTS Age was positively associated with waking levels and total daily output, with Shuar juveniles and adolescents displaying significantly lower levels than adults (p < .05). Sex was not a significant predictor of cortisol levels (p > .05), as Shuar males and females displayed similar patterns of diurnal cortisol production across the life course. Moreover, age, sex, and BMI significantly interacted to moderate the rate of diurnal cortisol decline (p = .027). Overall, Shuar demonstrated relatively lower cortisol concentrations than high-income populations. CONCLUSIONS This study expands the documented range of global variation in HPA axis activity and diurnal cortisol production and provides important insights into the plasticity of human stress physiology across diverse developmental and socioecological settings.
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Affiliation(s)
- Melissa A Liebert
- Department of Anthropology, Northern Arizona University, Flagstaff, Arizona, USA
| | - Samuel S Urlacher
- Department of Anthropology, Baylor University, Waco, Texas, USA
- Child and Brain Development Program, CIFAR, Toronto, Ontario, Canada
| | - Felicia C Madimenos
- Department of Anthropology, Queens College (CUNY), Flushing, New York, USA
- New York Consortium of Evolutionary Primatology (NYCEP), CUNY Graduate Center, New York, New York, USA
| | - Theresa E Gildner
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Tara J Cepon-Robins
- Department of Anthropology, University of Colorado, Colorado Springs, Colorado, Springs, Colorado, USA
| | | | | | | | - J Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA
- Center for Global Health, University of Oregon, Eugene, Oregon, USA
- Global Station for Indigenous Studies and Cultural Diversity, Hokkaido University, Sapporo, Japan
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Azizi Z, Hirst RJ, O' Dowd A, McCrory C, Kenny RA, Newell FN, Setti A. Evidence for an association between allostatic load and multisensory integration in middle-aged and older adults. Arch Gerontol Geriatr 2024; 116:105155. [PMID: 37597376 DOI: 10.1016/j.archger.2023.105155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/30/2023] [Accepted: 08/03/2023] [Indexed: 08/21/2023]
Abstract
Multisensory integration, the ability of the brain to integrate information from different sensory modalities, is critical for responding to environmental stimuli. While older adults show changes in multisensory integration with age, the impact of allostatic load (AL) (i.e., the effect of exposure to chronic stress, which can accelerate ageing) on multisensory perception remains understudied. We explored the relationship between multisensory integration and AL in 1,358 adults aged 50+ from The Irish Longitudinal Study on Ageing by performing a Sound Induced Flash Illusion (SIFI) task at multiple audio-visual temporal asynchronies. The AL score was created using a battery of biomarkers representing the activity of four major physiological systems: immunological, cardiovascular, metabolic, and renal. The number of biomarkers for which a participant was categorised in the highest risk quartile using sex-specific cutoffs was used to produce an overall AL score. We accounted for medication use when calculating our AL score. We analysed the accuracy of illusion trials on a SIFI task using generalised logistic mixed effects regression models adjusted for a number of covariates. Observation of cross-sectional and longitudinal results revealed that lower accuracy in integration (i.e., higher SIFI susceptibility with larger temporal asynchronies) was associated with higher AL. This confirmed the distinct patterns of multisensory integration in ageing.
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Affiliation(s)
- Zahra Azizi
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland; The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland; School of Applied Psychology, University College Cork, Ireland.
| | - Rebecca J Hirst
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland; The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Alan O' Dowd
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland; The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland
| | - Cathal McCrory
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland; Mercer Institute for Successful Ageing, St. James Hospital, Dublin, Ireland
| | - Fiona N Newell
- School of Psychology and Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Annalisa Setti
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland; School of Applied Psychology, University College Cork, Ireland
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Hantsoo L, Jagodnik KM, Novick AM, Baweja R, di Scalea TL, Ozerdem A, McGlade EC, Simeonova DI, Dekel S, Kornfield SL, Nazareth M, Weiss SJ. The role of the hypothalamic-pituitary-adrenal axis in depression across the female reproductive lifecycle: current knowledge and future directions. Front Endocrinol (Lausanne) 2023; 14:1295261. [PMID: 38149098 PMCID: PMC10750128 DOI: 10.3389/fendo.2023.1295261] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/13/2023] [Indexed: 12/28/2023] Open
Abstract
The aim of this narrative review is to consolidate knowledge on the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression pathophysiology at different reproductive stages across the female lifespan. Despite growing evidence about the impact of gonadal hormones on mood disorders, no previous review has examined the interaction between such hormonal changes and the HPA axis within the context of depressive disorders in women. We will focus on HPA axis function in depressive disorders at different reproductive stages including the menstrual cycle (e.g., premenstrual dysphoric disorder [PMDD]), perinatally (e.g., postpartum depression), and in perimenopausal depression. Each of these reproductive stages is characterized by vast physiological changes and presents major neuroendocrine reorganization. The HPA axis is one of the main targets of such functional alterations, and with its key role in stress response, it is an etiological factor in vulnerable windows for depression across the female lifespan. We begin with an overview of the HPA axis and a brief summary of techniques for measuring HPA axis parameters. We then describe the hormonal milieu of each of these key reproductive stages, and integrate information about HPA axis function in depression across these reproductive stages, describing similarities and differences. The role of a history of stress and trauma exposure as a contributor to female depression in the context of HPA axis involvement across the reproductive stages is also presented. This review advances the pursuit of understanding common biological mechanisms across depressive disorders among women. Our overarching goal is to identify unmet needs in characterizing stress-related markers of depression in women in the context of hormonal changes across the lifespan, and to support future research in women's mental health as it pertains to pathophysiology, early diagnosis, and treatment targets.
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Affiliation(s)
- Liisa Hantsoo
- Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kathleen M. Jagodnik
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, MA, United States
| | - Andrew M. Novick
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ritika Baweja
- Department of Psychiatry and Behavioral Health, Penn State Health, Hershey, PA, United States
- Department of Obstetrics and Gynecology, Penn State Health, Hershey, PA, United States
| | - Teresa Lanza di Scalea
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Women’s Health, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Erin C. McGlade
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake, UT, United States
- Department of Veterans Affairs, Mental Illness Research, Education, and Clinical Center (MIRECC), Salt Lake, UT, United States
| | - Diana I. Simeonova
- Department of Psychiatry and Behavioral Sciences, Brain Health Center, Emory University School of Medicine, Atlanta, GA, United States
- Goizueta Business School, Emory University, Atlanta, GA, United States
| | - Sharon Dekel
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, MA, United States
| | - Sara L. Kornfield
- Center for Women’s Behavioral Wellness, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michelle Nazareth
- Department of Neuroscience, The Johns Hopkins University, Baltimore, MD, United States
| | - Sandra J. Weiss
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, United States
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Sosso FAE, Matos E, Papadopoulos D. Social disparities in sleep health of African populations: A systematic review and meta-analysis of observational studies. Sleep Health 2023; 9:828-845. [PMID: 37880077 DOI: 10.1016/j.sleh.2023.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/29/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES To document the relationship between socioeconomic status (SES) and sleep health in African populations. METHODS Observational cross-sectional or cohort studies examining the association between SES indicators and sleep outcomes in participants from African countries were included. The search was performed in the MEDLINE, Embase, and Web of Science Core Collection electronic databases in June 2021. Selection, confounding, attrition/exclusion, detection, and selective reporting bias were assessed using the OHAT Risk of Bias Tool. Random effects meta-analysis was used for summarizing the effect estimates. RESULTS Forty-three reports were selected, having sampled 153,372 Africans from 26 countries. Education was the most frequent SES indicator and composite measures of sleep quality or disturbances was the most common sleep outcome. Low educational attainment was significantly associated with lower odds of short sleep (odds ratio [OR]=0.65, 95% confidence intervals [0.50, 0.84], p = .001) and higher odds of insomnia (OR=1.53, [1.18, 1.99], p = .001) or poor sleep quality (OR=1.60, [1.17, 2.18], p = .003). Low levels of income/assets were related to higher odds of insomnia (OR=1.38, [1.02, 1.86], p = .04) and low occupational/employment status was linked to lower odds of short sleep duration (OR=0.49, [0.30, 0.79], p = .004). CONCLUSIONS Socioeconomic disadvantage was a significant predictor of insomnia and poor sleep quality, while it was associated with longer sleep duration. Significant heterogeneity in terms of exposure and outcomes, scarcity of longitudinal designs, lack of objective outcome measurement, and low representation of rural samples and participants from low-income countries limit the quality of evidence.
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Affiliation(s)
| | - Elsa Matos
- Sleep Laboratory of Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Schwartz JA, Calvi JL, Allen SL, Granger DA. Adrenocortical Responses to Daily Stressors Are Calibrated by Early Life Adversity: An Investigation of the Adaptive Calibration Model. EVOLUTIONARY PSYCHOLOGY 2023; 21:14747049231212357. [PMID: 37964553 PMCID: PMC10647968 DOI: 10.1177/14747049231212357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 10/20/2023] [Indexed: 11/16/2023] Open
Abstract
Studies examining the impact of early adversity on physiological responsivity to environmental challenges in later life yield a complex pattern of findings and ambiguity regarding the direction of effect, with some studies reporting heightened responses and others reporting dampened responses. One potential reason for these mixed findings is an oversimplified theoretical model surrounding the connection between early life stressor exposure and subsequent stress responsivity. The adaptive calibration model offersa contemporary set of assumptions aimed at providing a better understanding of the ways that early life experiences shape the stress response system to better align with current and future environments. The current study utilized a large subsample from the National Study of Daily Experiences (N = 1,605) to examine the extent to which the association between daily stressor exposure and cortisol levels varies across levels of early life adversity. Results revealed that those individuals who experienced extremely low levels of early life adversity displayed the greatest increase in cortisol levels across the day as daily stressor exposure increased. Alternatively, those individuals who experienced extremely high levels of early life adversity displayed almost no change in diurnal production of cortisol as daily stressor exposure increased. The results are discussed within the evolutionary-developmental context of the adaptive calibration model along with suggestions for future research.
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Affiliation(s)
- Joseph A. Schwartz
- College of Criminology and Criminal Justice, Florida State University, Tallahassee, FL, USA
| | - Jessica L. Calvi
- Nebraska Athletic Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Samantha L. Allen
- College of Criminology and Criminal Justice, Florida State University, Tallahassee, FL, USA
| | - Douglas A. Granger
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA
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Díaz-Mardomingo MDC, Utrera L, Baliyan S, García-Herranz S, Suárez-Falcón JC, Rodríguez-Fernández R, Sampedro-Piquero P, Valencia A, Venero C. Sex-related differences in the associations between diurnal cortisol pattern and social and emotional loneliness in older adults. Front Psychol 2023; 14:1199405. [PMID: 37744609 PMCID: PMC10517049 DOI: 10.3389/fpsyg.2023.1199405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/08/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Loneliness is a distressful feeling that can affect mental and physical health, particularly among older adults. Cortisol, the primary hormone of the Hypothalamic-Pituitary-Adrenal axis (HPA-axis), may act as a biological transducer through which loneliness affects health. While most previous studies have evaluated the association between loneliness, as a unidimensional construct, and diurnal cortisol pattern, no research has examined this relationship discriminating between social and emotional loneliness in older adults. As sex differences in the negative mental health outcomes of loneliness have been reported, we also investigated whether diurnal cortisol indices and loneliness associations occur in a sex-specific manner. Methods We analyzed the diurnal cortisol- pattern in 142 community-dwelling, non-depressed, Caucasian older adults (55,6% female) aged 60-90. Social and emotional (family and romantic) loneliness scores were assessed using the Spanish version of the Social and Emotional Loneliness Scale for Adults (SELSA). Five salivary cortisol samples were used to capture key features of the diurnal cortisol pattern, including: awakening and bedtime cortisol levels, awakening response (CAR), post-awakening cortisol output (post-awakening cortisol [i.e., the area under the curve with reference to the ground: AUCG]), total diurnal cortisol release (AUCG), and diurnal cortisol slope (DCS). Results After controlling for sociodemographic variables, the hierarchical linear multiple regression analyses revealed that in male older adults, higher scores on social and family loneliness were associated with elevated awakening cortisol levels, total diurnal cortisol output, and a steeper diurnal cortisol slope (DCS). However, these associations were not observed in female older adults. In addition, feelings of romantic loneliness were positively associated with bedtime cortisol levels and AUCG in older males. Multilevel growth curve modeling showed that experiencing more social and emotional loneliness predicted higher diurnal cortisol output throughout the day in older male adults. Discussion The presence of sex differences in the relationship between cortisol indices and loneliness among older adults holds particular significance for diagnostic and screening procedures. Combining loneliness scales as screening tools with diurnal cortisol measures has the potential to be an effective and cost-efficient approach in identifying higher-risk individuals at early stages.
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Affiliation(s)
- María del Carmen Díaz-Mardomingo
- Department of Basic Psychology I, UNED, Madrid, Spain
- Instituto Mixto de Investigación – Escuela Nacional de Sanidad (IMIENS), Madrid, Spain
| | - Lucía Utrera
- Department of Psychobiology, UNED, Madrid, Spain
- Escuela Internacional de Doctorado – Universidad Nacional de Educación a Distancia (EIDUNED), Madrid, Spain
| | - Shishir Baliyan
- Department of Psychobiology, UNED, Madrid, Spain
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Madrid, Spain
| | - Sara García-Herranz
- Instituto Mixto de Investigación – Escuela Nacional de Sanidad (IMIENS), Madrid, Spain
- Department of Basic Psychology II, UNED, Madrid, Spain
| | | | | | | | - Azucena Valencia
- Instituto Mixto de Investigación – Escuela Nacional de Sanidad (IMIENS), Madrid, Spain
- Department of Psychobiology, UNED, Madrid, Spain
| | - César Venero
- Instituto Mixto de Investigación – Escuela Nacional de Sanidad (IMIENS), Madrid, Spain
- Department of Psychobiology, UNED, Madrid, Spain
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Mahzari M, AlSohaim A, Al Mulla A, AlAssaf A, Al Amri K, Hussain SD, Sabico S, Al Daghri NM, Saleh Y. Variations in cortisol response in patients with known and suspected adrenal insufficiency. Medicine (Baltimore) 2022; 101:e32557. [PMID: 36595973 PMCID: PMC9803485 DOI: 10.1097/md.0000000000032557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Adrenal insufficiency (AI) is a relatively rare disease. While the adrenocorticotropic hormone (ACTH) stimulation test remains as one of the commonly used diagnostic test for AI, to date there is no consensus on the cortisol cutoff value post-ACTH stimulation test. This study aimed to investigate and characterize the cortisol response after the standard ACTH stimulation test in a group of Saudi Arabian patients. A single center retrospective study was conducted on Saudi Arabian adult patients who underwent ACTH stimulation test at the endocrinology clinics of King Abdulaziz Medical City in Riyadh, Saudi Arabia between 2015 and 2018. Demographic, clinical and biochemical variables were collected and analyzed. A total of 154 medical records of patients (44 males, 110 females, mean age 44.4 ± 17.0 years) were included in the study. All patients underwent ACTH stimulation test. Fatigue was the most common symptom of participants. Type 1 diabetes was the most frequent comorbidity. Cortisol levels were significantly lower in patients who received corticosteroid replacement therapy, and, within the context of ACTH stimulation tests, were useful in diagnosing AI in patients with vague symptoms and signs. For basal cortisol, the cutoff of ≤258.5 has a sensitivity and specificity of 69.2% and 58.6%, respectively. For 30-minute, the cutoff of ≤386 sensitivity and specificity are 61.5% and 69.0%. For 60-minute, the cutoff of ≤491.5 has a sensitivity and specificity of 61.5% and 65.5%, respectively. Higher cortisol cutoff values have better sensitivity. Patients with AI present with mostly nonspecific symptoms, with type 1 diabetes as the most common comorbidity. The cortisol level cutoffs obtained from Arab patients who underwent ACTH stimulation tests showed wide variability for its utility in AI diagnosis. Further studies to evaluate the optimal cortisol cutoff values for AI diagnosis in this population are needed.
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Affiliation(s)
- Moeber Mahzari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- * Correspondence: Moeber Mahzari, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 22490, Saudi Arabia (e-mail: )
| | - Abdullah AlSohaim
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulrhman Al Mulla
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdullah AlAssaf
- Department of Medicine, Security Force Hospital, Riyadh, Saudi Arabia
| | - Khalid Al Amri
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Syed D. Hussain
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Naser M. Al Daghri
- Chair for Biomarkers of Chronic Diseases, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Yousef Saleh
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Ortiz R, Kluwe B, Lazarus S, Teruel MN, Joseph JJ. Cortisol and cardiometabolic disease: a target for advancing health equity. Trends Endocrinol Metab 2022; 33:786-797. [PMID: 36266164 PMCID: PMC9676046 DOI: 10.1016/j.tem.2022.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/29/2022] [Indexed: 11/05/2022]
Abstract
Stress, in both intrinsic psychosocial and extrinsic physical environmental forms, can impact the development of, and outcomes in, cardiovascular disease (CVD) through allostatic load. Cortisol is a core hormonal mediator of allostatic load produced in response to various stresses. Alterations in morning serum cortisol and daily diurnal cortisol have been associated with adiposity, dyslipidemia, incident diabetes, and CVDs such as hypertension. The review examines the role of cortisol as a key mechanistic link between stress physiology and cardiometabolic disease. Importantly, we discuss the role of targeting cortisol through pharmacological, behavioral, and environmental interventions to advance health equity in cardiometabolic disease.
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Affiliation(s)
- Robin Ortiz
- Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA; Institute for Excellence of Health Equity, NYU Langone Health, New York, NY, USA
| | - Bjorn Kluwe
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sophie Lazarus
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Mary N Teruel
- Department of Biochemistry and the Drukier Institute for Children's Health, Weill Cornell Medicine, New York, NY, USA
| | - Joshua J Joseph
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, OH, USA.
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Harris BN, Cooke JT, Littlefield AK, Tucker CA, Campbell CM, King KS. Relations among CRFR1 and FKBP5 genotype, cortisol, and cognitive function in aging humans: A Project FRONTIER study. Physiol Behav 2022; 254:113884. [PMID: 35718217 DOI: 10.1016/j.physbeh.2022.113884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 06/04/2022] [Accepted: 06/13/2022] [Indexed: 01/23/2023]
Abstract
Here we use the glucocorticoid cascade hypothesis framework to address the role of baseline cortisol on changes in cognitive function over a 3-year span in non-demented rural Americans. We also determine if genotype at 4 different single nucleotide polymorphisms (SNPs) relates to change in cognitive function. We predicted 1) over time, increases in baseline cortisol will be associated with decline in cognitive function, 2) individuals homozygous for 3 CRFR1 SNP rare alleles (AA rs110402, TT rs7209436, and TT rs242924 vs. others) will show less cognitive decline and this will be particularly pronounced in those with lower baseline cortisol, and 3) FKBP5 T carriers (TT or CT vs. CC homozygotes) will have decreased cognitive performance and this will be particularly pronounced in individuals with higher baseline cortisol. Collectively, our data do not robustly support the glucocorticoid cascade hypothesis. In several cases, higher baseline cortisol related to better cognitive performance over time, but within individuals, increased cortisol over time related to decreased performance on some cognitive domains over time. Contrary to our predictions, individuals with the rare CRFR1 haplotype (AA, TT, TT) performed worse than individuals with the common haplotype across multiple domains of cognitive function. FKBP5 genotype status had minimal impacts on cognitive outcomes. Genotype effects were largely not dependent on cortisol. The Project FRONTIER dataset is supported by Texas Tech University Health Sciences Center Garrison Institute on Aging.
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Affiliation(s)
- Breanna N Harris
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States of America.
| | - Jeffrey T Cooke
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States of America
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States of America
| | - Cody A Tucker
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States of America
| | - Callie M Campbell
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States of America
| | - Kaleb S King
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States of America
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12
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Nam S, Jeon S, Lee SJ, Ash G, Nelson LE, Granger DA. Real-time racial discrimination, affective states, salivary cortisol and alpha-amylase in Black adults. PLoS One 2022; 17:e0273081. [PMID: 36103465 PMCID: PMC9473392 DOI: 10.1371/journal.pone.0273081] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 08/02/2022] [Indexed: 02/04/2023] Open
Abstract
Perceived racial discrimination has been associated with the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis activities-two major stress response systems. To date, most studies have used cross-sectional data that captured retrospective measures of the racial discrimination associated with current physiological stress responses. The purpose of this study was to examine the relationship between racial discrimination measured in real-time and physiological stress responses. Twelve healthy Black adults completed baseline surveys and self-collected saliva samples 4x/day for 4 days to measure cortisol and alpha amylase (AA) as a proxy of HPA and ANS systems, respectively. Real-time racial discrimination was measured using ecological momentary assessments (EMA) sent to participants 5x/day for 7 days. Multilevel models were conducted to examine the relationship between racial discrimination and stress responses. In multilevel models, the previous day's racial discrimination was significantly associated with the next day's cortisol level at wakening (β = 0.81, partial r = 0.74, p<0.01) and diurnal slope (β = -0.85, partial r = -0.73, p<0.01). Also, microaggressions were significantly associated with the diurnal cortisol slope in the same day, indicating that on the day when people reported more microaggressions than usual, a flatter diurnal slope of cortisol was observed (β = -0.50, partial r = -0.64, p<0.01). The concurrent use of salivary biomarkers and EMA was feasible methods to examine the temporal relationship between racial discrimination and physiological stress responses. The within-person approach may help us understand the concurrent or lagged effects of racial discrimination on the stress responses. Further studies are needed to confirm the observed findings with a large sample size and to improve stress related health outcomes in racial/ethnic minorities.
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Affiliation(s)
- Soohyun Nam
- Yale University, School of Nursing, Orange, CT, United States of America
| | - Sangchoon Jeon
- Yale University, School of Nursing, Orange, CT, United States of America
| | - Soo-Jeong Lee
- School of Nursing, University of California, San Francisco, San Francisco, CA, United States of America
| | - Garrett Ash
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, United States of America
- Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States of America
| | - LaRon E. Nelson
- Yale University, School of Nursing, Orange, CT, United States of America
| | - Douglas A. Granger
- School of Social Ecology, Institute for Interdisciplinary Salivary Bioscience Research, University of California, Irvine, Irvine, CA, United States of America
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Physical Activity Influences Cortisol and Dehydroepiandrosterone (Sulfate) Levels in Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2022; 31:330-351. [PMID: 35981715 DOI: 10.1123/japa.2021-0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/18/2022] [Accepted: 06/24/2022] [Indexed: 11/18/2022]
Abstract
Age-related changes affect the ratio between two steroid hormones of the hypothalamic-pituitary-adrenal axis, cortisol and dehydroepiandrosterone (sulfate) (DHEA[S]). Physical activity (PA) may buffer the effects of chronic stress and counteract the aging decline of DHEA(S). Therefore, a systematic review was conducted to understand how PA influences physiological markers of cortisol and/or DHEA(S) and whether there is a difference in observational associations or experimental effects in older adults aged 65 years and older. A narrative synthesis was performed on nine observational studies, and meta-analyses were performed on 22 randomized controlled trials. There was low- to moderate-quality evidence that regular PA beneficially reduces cortisol and increases DHEA(S) levels. Subgroup analyses showed no clinically important differences between men and women, different exercise modalities, or health states. The findings cautiously suggest that regular PA of older adults' own choice that they find enjoyable could be recommended to improve cortisol and/or DHEA(S) levels.
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Towards A Socioeconomic Model of Sleep Health among the Canadian Population: A Systematic Review of the Relationship between Age, Income, Employment, Education, Social Class, Socioeconomic Status and Sleep Disparities. Eur J Investig Health Psychol Educ 2022; 12:1143-1167. [PMID: 36005229 PMCID: PMC9407487 DOI: 10.3390/ejihpe12080080] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 12/05/2022] Open
Abstract
A better understanding of the contribution of the socioeconomic status (SES) in sleep health could guide the development of population-based interventions aiming to reduce “the silent public health issue” that are sleep disturbances. PRISMA was employed to identify relevant studies having examined the association between social class, social capital, education, income/assets, occupation/employment status, neighborhood deprivation and sleep health. Sixteen cross-sectional and three longitudinal studies were selected, having sampled 226,029 participants aged from 2 months to 85 years old. Findings showed that: (1) sleep health disparities among children and adolescent are strongly correlated to parental socioeconomic indicators; (2) poor parental income, poor family SES and poor parental education are associated with higher sleep disturbances among children and adolescents; (3) lower education is a predictor of increased sleep disturbances for adults; (4) low SES is associated with high sleep disturbances in adults and old people and; (5) low income and full-time employment was significantly associated with short sleep among adults and old people. In conclusion, sleep health should be an important public health target. Such intervention would be beneficial for populational health, for all taxpayers and public administrations, which would see a reduction in absenteeism and productivity losses attributable to sleep-related health problems in the global economy.
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Diurnal dynamic range as index of dysregulation of system dynamics. A cortisol examplar using data from the Study of Midlife in the United States. Psychoneuroendocrinology 2022; 142:105804. [PMID: 35623318 PMCID: PMC9262344 DOI: 10.1016/j.psyneuen.2022.105804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/22/2022]
Abstract
We discuss the importance of including measures of dysregulated system dynamics in the operationalization of allostatic load. The concept of allostatic load, as originally proposed by McEwen and Stellar, included dysregulation not only in the resting state of physiological systems, but also in system dynamics. We describe previous work on cortisol diurnal dynamic range (peak to nadir spread) as an index of the health of the hypothalamic-pituitary-adrenal axis, with compression of dynamic range being a marker of dysregulation. In particular, we review the evidence for a) diurnal dynamic range compression in people from disadvantaged backgrounds, b) cross-sectional association of cortisol diurnal dynamic range compression with dysregulation in other systems' resting states, and c) cross-sectional association of cortisol diurnal dynamic range compression with lower scores on cognitive testing. Then, we present new data from the Study of Midlife in the United States (MIDUS) on longitudinal associations of cortisol dynamic range compression with subsequent cognitive decline and all-cause mortality. Briefly, each standard deviation decrement in cortisol diurnal dynamic range is associated with adjusted mortality hazard ratio of 1.35 (95% confidence interval: 1.19, 1.54). Among those who scored at median or lower in executive functioning at baseline and survive, each standard deviation decrement in cortisol dynamic range is associated with 1% greater decline in executive functioning over a decade (95% confidence interval: 0.4%, 2.0%). We conclude that including measures of system dynamics like diurnal dynamic range in the next generation of allostatic load measurement will likely advance understanding of the cumulative physiological burden of chronic stress and life experiences, and improve the prediction of future health consequences.
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16
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Ortiz R, Joseph JJ, Branas CC, MacDonald JM, Nguemeni Tiako MJ, Oyekanmi K, South EC. Advancing health equity through integrated biology and population health research: A community-based sample cortisol feasibility and exploratory study. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 11:100145. [PMID: 35757172 PMCID: PMC9228000 DOI: 10.1016/j.cpnec.2022.100145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 12/21/2022] Open
Abstract
Background Community-based research inclusive of self-assessment and objective environmental metrics can be enhanced by the collection of biomarker data in unity toward assessing the health impacts of the totality of environmental stress driven by structural racism. Cortisol dynamic range (CDR), a measure of chronic stress burden, may underpin place-based connections to health, but a gap remains in elucidating community-based CDR methodology. Purpose To 1) assess the feasibility of cortisol collection and CDR measurement in a community-based study with home-based, participant-directed specimen collection, and 2) explore the association between CDR and other individual and environmental measures in a sample of predominantly Black participants. Methods: In this cross-sectional, observational study in predominantly Black urban neighborhoods, participants (n = 73) completed health assessments and in-home, self-collected salivary cortisol. For feasibility, CDR (peak-nadir) was compared to cortisol awakening response (CAR) slope over time. Comparisons of CDR quartile by person and place variables were explored (ANOVA). Results The cohort (77% Black, 39.7% <$15 k/year income, high perceived stress) completed 98.6% of cortisol collection timepoints. CDR was calculated in all participants without interruptions to sleep-wake cycle as seen with CAR collection. Participants in the lowest quartile of CDR were the oldest (p = 0.03) with lowest reported mental health (p = 0.048) with no associations seen for CAR. Conclusion Participant-collected 10.13039/501100011622CDR is more feasible than cortisol measures dependent on slopes over time in a community-based, predominately Black cohort with exploratory findings supporting relevance to outcomes of interest to future work. Future community-based studies should integrate CDR with environment and psychosocial measures. Biological and social metrics can enhance community studies of structural racism. Cortisol dynamic range (CDR) may reflect the burden of chronic stress in a community. In-home, participant-collected salivary cortisol is feasible with in-field guidance. CDR may be more feasible in community-based study than measures dependent on time. Greatest CDR is seen with youngest age and best self-reported mental health.
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Affiliation(s)
- Robin Ortiz
- Departments of Pediatrics and Population Health, New York University, Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA
- Institute for Excellence in Health Equity, New York University Langone Health, New York, Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA
- National Clinician Scholars Program, University of Pennsylvania Perelman School of Medicine, 1300 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA
- Corresponding author. Departments of Pediatrics and Population Health, New York University, Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA
| | - Joshua J. Joseph
- The Ohio State University, Wexner Medical Center, Division of Endocrinology, Diabetes and Metabolism, 579 McCampbell Hall, Columbus, OH, 43210, USA
| | - Charlie C. Branas
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Rm 1508, New York, NY, 10032, USA
| | - John M. MacDonald
- Department of Criminology, School of Arts and Sciences, University of Pennsylvania, 558 McNeil Building, Locus Walk, Philadelphia, PA, 19104, USA
| | | | - Kehinde Oyekanmi
- Department of Emergency Medicine, University of Pennsylvania, Perelman School of Medicine, 423 Guardian Drive, Philadelphia, PA, 19104, USA
- Urban Health Lab, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Eugenia C. South
- Department of Emergency Medicine, University of Pennsylvania, Perelman School of Medicine, 423 Guardian Drive, Philadelphia, PA, 19104, USA
- Urban Health Lab, University of Pennsylvania, Philadelphia, PA, 19104, USA
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17
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Montoliu T, Pulopulos MM, Puig-Pérez S, Hidalgo V, Salvador A. Mediation of perceived stress and cortisol in the association between neuroticism and global cognition in older adults: A longitudinal study. Stress Health 2022; 38:290-303. [PMID: 34363312 DOI: 10.1002/smi.3088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 07/23/2021] [Accepted: 07/29/2021] [Indexed: 11/06/2022]
Abstract
Neuroticism has been associated with a greater dementia risk, but its association with cognitive decline in healthy older adults remains unclear. Stress has been proposed as one of the mechanisms that could explain this relationship. Our aim was to analyse, in healthy older people, the mediating role of perceived stress and the Hypothalamic-Pituitary-Adrenal (HPA) axis in the association between neuroticism and global cognition. At Waves 1 and 2 (4-year follow-up), 87 older people (49.4% women; M age = 65.08, SD = 4.54 at Wave 1) completed a neuropsychological battery and the Perceived Stress Scale (PSS), and provided saliva samples on two (Wave 1) and three (Wave 2) consecutive days to measure the wake-to-bed slope. In Wave 2, neuroticism was assessed with the NEO-Five-Factor Inventory. PSS, but not the wake-to-bed slope, mediated the negative associations between neuroticism and global cognition (Waves 1, 2 and change). Regarding gender differences, PSS (Waves 1, 2 and change) and the wake-to-bed slope (Wave 2 and change) mediated these associations in men. Our results suggest that perceived stress and HPA-axis dysregulation could act as mechanisms underlying the association between neuroticism and cognitive functioning and decline, at least in older men.
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Affiliation(s)
- Teresa Montoliu
- Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Matías M Pulopulos
- IIS Aragón, Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, Teruel, Spain
| | - Sara Puig-Pérez
- Research Group of Psychology and Quality of Life, Valencian International University, Valencia, Spain
| | - Vanesa Hidalgo
- Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, Faculty of Psychology, University of Valencia, Valencia, Spain.,IIS Aragón, Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, Teruel, Spain
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, Faculty of Psychology, University of Valencia, Valencia, Spain
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18
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Lipponen M, Hallikainen V, Kilpeläinen P. Effects of Nature-Based Intervention in Occupational Health Care on Stress – A Finnish Pilot Study Comparing Stress Evaluation Methods. J Multidiscip Healthc 2022; 15:577-593. [PMID: 35378740 PMCID: PMC8976576 DOI: 10.2147/jmdh.s353168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/28/2022] [Indexed: 12/20/2022] Open
Abstract
Purpose To assess methodology and its limitations for measuring effects of nature-based intervention (NBI). Patients and Methods Participants were 11 middle-aged female health care workers with lowered capacity to work. NBI included six group appointments in six months study period. Heart rate variability (HRV) and self-reported pain and work exhaustion were measured pre-post study period. Salivary α-amylase samples were collected immediately before and after three individual interventions. Salivary cortisol samples were collected on the same three interventions, on three consecutive days starting from the day of intervention, to assess (a) month effect (pre-post study period) and (b) day effect (intervention day vs non-intervention day). Results Individual interventions resulted in increase in α-amylase activity. However, the average fold increase decreased from the 3.05 ± 1.20 of the first intervention to 1.91 ± 1.00 and 1.46 ± 0.77 in the second and third intervention, respectively (p < 0.001). Cortisol concentrations were lower on intervention days vs non-intervention days, the difference being indicative (p = 0.050). Pain and work exhaustion decreased during the study period, as well as HRV, although any of these changes was not statistically significant. Conclusion For a large-scale study, it would be ideal to select assays for both major pathways: hypothalamic-pituitary-adrenal axis can be measured by cortisol, whereas response via autonomic nervous system can be measured by HRV, when roles of sympathetic and parasympathetic nervous systems can be pinpointed separately. Salivary α-amylase can be used when continuous monitoring is not possible. Psychological well-being of participants should be surveyed, as well as their activities and moods on sampling days recorded.
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Affiliation(s)
- Maija Lipponen
- Unit of Bioeconomy and Environment, Natural Resources Institute Finland, Paltamo, Finland
- Correspondence: Maija Lipponen, Unit of Bioeconomy and Environment, Natural Resources Institute Finland, Manamansalontie 90, Paltamo, FI-88300, Finland, Tel +35 8295322024, Email
| | - Ville Hallikainen
- Unit of Natural Resources, Natural Resources Institute Finland, Rovaniemi, Finland
| | - Pekka Kilpeläinen
- Unit of Measurement Technology, Kajaani University Consortium, University of Oulu, Kajaani, Finland
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19
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Imami L, Jiang Y, Murdock KW, Zilioli S. Links Between Socioeconomic Status, Daily Depressive Affect, Diurnal Cortisol Patterns, and All-Cause Mortality. Psychosom Med 2022; 84:29-39. [PMID: 34419996 DOI: 10.1097/psy.0000000000001004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Socioeconomic status (SES) remains a robust risk factor for mortality. Various theoretical models postulate that lower SES is associated with higher negative affect, which then initiates a cascade of physiological disturbances that contribute to illness and early mortality. However, few studies have explicitly investigated the interplay between psychological and biological factors in determining SES disparities in mortality. This study examined the role of daily negative affect and cortisol secretion in explaining the SES-mortality link in a large sample of US adults. METHODS Using data from the Midlife in the United States study (n = 1735, mean [standard deviation] age = 56.40 [12.10] years, 56.4% female), we tested longitudinal associations between SES, daily negative affect, daily cortisol levels, and all-cause mortality 13 years later. Daily negative affect was classified into three clusters reflecting depressive affect, anxiety, and anger. RESULTS Higher SES was linked to a lower risk of all-cause mortality (hazard ratio = 0.94, 95% confidence interval = 0.90 to 0.97). Furthermore, there was a sequential link between higher SES and lower mortality through lower daily depressive affect and a steeper ("healthier") diurnal cortisol slope (indirect effect = -0.0007, 95% confidence interval = -0.0014 to -0.0002). Daily anxiety and anger were not associated with cortisol levels or mortality (p values > .05). CONCLUSIONS These findings suggest that daily negative emotional experiences and the hypothalamic-pituitary-adrenal axis functioning may constitute important psychological and physiological pathways underlying the link between SES and all-cause mortality.
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Affiliation(s)
- Ledina Imami
- From the Department of Psychology (Imami), Purdue University, West Lafayette, Indiana; Department of Psychology (Jiang, Zilioli), Wayne State University, Detroit, Michigan; Department of Biobehavioral Health (Murdock), The Pennsylvania State University, University Park, Pennsylvania; and Department of Family Medicine and Public Health Sciences (Zilioli), Wayne State University, Detroit, Michigan
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20
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Borghi F, Rocha-Teles CM, McFadden SK, da Silva PC, Souza AL, Grassi-Kassisse DM. The influence of the academic exams routine on the perceived stress, resilience and salivary cortisol in Brazilian pharmacy undergraduate students. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2021.110928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Weak and uneven associations of home, neighborhood, and school environments with stress hormone output across multiple timescales. Mol Psychiatry 2021; 26:4823-4838. [PMID: 32366955 PMCID: PMC9030635 DOI: 10.1038/s41380-020-0747-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 04/14/2020] [Accepted: 04/20/2020] [Indexed: 01/15/2023]
Abstract
The progression of lifelong trajectories of socioeconomic inequalities in health and mortality begins in childhood. Dysregulation in cortisol, a stress hormone that is the primary output of the hypothalamus-pituitary-adrenal (HPA) axis, has been hypothesized to be a mechanism for how early environmental adversity compromises health. However, despite the popularity of cortisol as a biomarker for stress and adversity, little is known about whether cortisol output differs in children being raised in socioeconomically disadvantaged environments. Here, we show that there are few differences between advantaged and disadvantaged children in their cortisol output. In 8-14-year-old children from the population-based Texas Twin Project, we measured cortisol output at three different timescales: (a) diurnal fluctuation in salivary cortisol (n = 400), (b) salivary cortisol reactivity and recovery after exposure to the Trier Social Stress Test (n = 444), and (c) cortisol concentration in hair (n = 1210). These measures converged on two moderately correlated, yet distinguishable, dimensions of HPA function. We tested differences in cortisol output across nine aspects of social disadvantage at the home (e.g., family socioeconomic status), school (e.g., average levels of academic achievement), and neighborhood (e.g., concentrated poverty). Children living in neighborhoods with higher concentrated poverty had higher diurnal cortisol output, as measured in saliva; otherwise, child cortisol output was unrelated to any other aspect of social disadvantage. Overall, we find limited support for alteration in HPA axis functioning as a general mechanism for the health consequences of socioeconomic inequality in childhood.
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22
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Deer LK, Shields GS, Alen NV, Hostinar CE. Curvilinear associations between family income in early childhood and the cortisol awakening response in adolescence. Psychoneuroendocrinology 2021; 129:105237. [PMID: 34004490 PMCID: PMC9286487 DOI: 10.1016/j.psyneuen.2021.105237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/23/2021] [Accepted: 04/13/2021] [Indexed: 11/20/2022]
Abstract
Previous evidence on cortisol output and socioeconomic status (SES) has been mixed, with studies finding that lower SES can be associated with higher or lower cortisol output, and null associations have also been reported. We hypothesized that these inconsistencies may be due to an underlying curvilinear, inverted-U pattern of association, such that low income is related to increased likelihood of both low and high cortisol output. We tested these curvilinear links among family income and cortisol indices in the Avon Longitudinal Study of Parents and Children (N = 803). Maternal reports of family income when the study children were 33 and 47 months of age were averaged to estimate early-childhood family income. Three cortisol indices were derived from samples collected in adolescence (15.5 years of age): the cortisol awakening response (CAR), area under the curve (AUC) cortisol, and the diurnal cortisol slope. As hypothesized, the CAR exhibited a curvilinear, inverted-U relation with childhood income, with low childhood income being associated with both the lowest and the highest CARs. These findings suggest that discrepancies in prior findings on low SES and the CAR may be due to curvilinear patterns of association. However, childhood income was not significantly associated with adolescent cortisol diurnal slope or AUC. Future work should clarify the factors that might predispose to high versus low CAR given equivalent low SES in childhood.
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Affiliation(s)
- LillyBelle K Deer
- Center for Mind and Brain, University of California, Davis, CA, United States; Department of Psychology, University of California, Davis, CA, United States.
| | - Grant S Shields
- Center for Mind and Brain, University of California, Davis, CA, United States
| | - Nicholas V Alen
- Center for Mind and Brain, University of California, Davis, CA, United States; Department of Psychology, University of California, Davis, CA, United States
| | - Camelia E Hostinar
- Center for Mind and Brain, University of California, Davis, CA, United States; Department of Psychology, University of California, Davis, CA, United States.
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23
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Kongtip P, Nankongnab N, Kallayanatham N, Pengpumkiat S, Gore R, Pundee R, Konthonbut P, Woskie SR. Disruption of the Diurnal Cortisol Hormone Pattern by Pesticide Use in a Longitudinal Study of Farmers in Thailand. Ann Work Expo Health 2021; 65:406-417. [PMID: 33604604 DOI: 10.1093/annweh/wxaa124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/04/2020] [Accepted: 11/16/2020] [Indexed: 11/13/2022] Open
Abstract
Alteration of the hypothalamic-pituitary-adrenal (HPA) axis hormones has been associated with a range of chronic metabolic and cardiovascular health conditions. This study evaluated whether type of farming (organic versus conventional) or the number of self-reported days of spraying pesticides in the past 8 months was associated with diurnal cortisol levels. Salivary cortisol levels were measured four times a day (waking, 30 min after waking, 6 h after waking and bedtime) longitudinally, 8 months apart during three rounds of data collection. Pesticide using (conventional) and organic farmers were recruited to participate. Pesticide use in the previous 8 months was determined as the number of spray days for each type of pesticide used (herbicide, insecticide, fungicide) from self-reported questionnaires. Estimates of cortisol levels at four time points, the cortisol awakening response (CAR), and the diurnal cortisol slope (DCS) were estimated with a longitudinal mixed model that accounted for the non-linearity of cortisol levels across the day. Conventional farmers had significantly lower cortisol levels at waking than organic farmers (3.39 versus 3.86 ng ml-1), 30 min after waking (5.87 versus 6.96 ng ml-1), 6 h after waking (1.62 versus 1.88 ng ml-1), and lower diurnal cortisol slope (-2.26 versus -2.51 ng ml-1). Farmers who frequently applied herbicides (90th percentile of the number of spray days in the past 8 months) had significantly lower waking, 30 min after waking, 6 h after waking, bedtime and diurnal cortisol slopes compared with those with no spray days of herbicide in the past 8 months (organic and some of the conventional farmers). Those who frequently applied insecticides in the past 8 months had significantly lower bedtime levels and diurnal cortisol slopes, compared with those with no spray days of insecticide in the past 8 months. There were no significant differences in cortisol hormones between those who frequently applied fungicides and those who did not spray fungicides. Repeated pesticide use appears to be disrupting the HPA axis and depressing the normal diurnal cortisol rhythm among conventional Thai farmers.
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Affiliation(s)
- Pornpimol Kongtip
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand
| | - Noppanun Nankongnab
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand
| | - Nichcha Kallayanatham
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand
| | - Sumate Pengpumkiat
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand
| | - Rebecca Gore
- Department of Public Health, University of Massachusetts Lowell, Lowell, MA 01854-2867, USA
| | | | - Pajaree Konthonbut
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand
| | - Susan R Woskie
- Department of Public Health, University of Massachusetts Lowell, Lowell, MA 01854-2867, USA
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Dominguez A, Mendoza M, Badanes L, Dmitrieva J, Watamura SE. Cortisol reactivity in preschoolers at home and child care: Effects of setting in eliciting a normative stress response by child race/ethnicity. INFANT AND CHILD DEVELOPMENT 2021. [DOI: 10.1002/icd.2225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Amy Dominguez
- Department of Psychology University of Denver Denver Colorado USA
| | | | - Lisa Badanes
- Department of Psychological Sciences Metropolitan State University of Denver Denver Colorado USA
| | - Julia Dmitrieva
- Department of Psychology University of Denver Denver Colorado USA
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Kluwe B, Zhao S, Kline D, Ortiz R, Brock G, Echouffo-Tcheugui JB, Sims M, Kalyani RR, Golden SH, Joseph JJ. Adiposity Measures and Morning Serum Cortisol in African Americans: Jackson Heart Study. Obesity (Silver Spring) 2021; 29:418-427. [PMID: 33491313 PMCID: PMC9017492 DOI: 10.1002/oby.23056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/28/2020] [Accepted: 09/06/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Altered hormonal regulation, including cortisol, is a proposed mechanism linking adiposity to obesity-related disorders. We examined the association of anthropometric, adipokine, and body fat distribution measures of adiposity with morning serum cortisol in an African American (AA) cohort. METHODS We investigated the cross-sectional associations of adiposity measures (BMI, waist circumference, leptin, adiponectin, leptin:adiponectin ratio, subcutaneous and visceral adipose tissue) and liver attenuation with cortisol in the Jackson Heart Study. Linear regression models were used to analyze the association between exposures and cortisol. Models were adjusted for multiple covariates. RESULTS Among 4,211 participants, a 1-SD higher BMI and waist circumference were associated with a 3.92% and 3.05% lower cortisol, respectively. A 1-SD higher leptin and leptin:adiponectin ratio were associated with a 6.48% and 4.97% lower morning serum cortisol, respectively. A 1-SD higher subcutaneous adipose tissue was associated with a 4.97% lower cortisol (all P < 0.001). There were no associations of liver attenuation or visceral adipose tissue with cortisol. CONCLUSIONS Several measures of adiposity are associated with lower morning serum cortisol among AAs, with leptin having the greatest magnitude. Future studies examining the role of morning serum cortisol in the pathway from adiposity to cardiometabolic disease in AAs are warranted.
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Affiliation(s)
- Bjorn Kluwe
- Division of Endocrinology, Diabetes and Metabolism, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Songzhu Zhao
- Department of Biomedical Informatics and Center for Biostatistics, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - David Kline
- Department of Biomedical Informatics and Center for Biostatistics, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Robin Ortiz
- Department of Internal Medicine and Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Guy Brock
- Department of Biomedical Informatics and Center for Biostatistics, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Justin B. Echouffo-Tcheugui
- Division of Endocrinology, Diabetes and Metabolism, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, University of Mississippi, Jackson, Mississippi, USA
| | - Rita R. Kalyani
- Division of Endocrinology, Diabetes and Metabolism, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sherita H. Golden
- Division of Endocrinology, Diabetes and Metabolism, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Joshua J. Joseph
- Division of Endocrinology, Diabetes and Metabolism, College of Medicine, The Ohio State University, Columbus, Ohio, USA
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Effects of Health Behavior Interventions on Psychosocial Outcomes and Cortisol Regulation Among Chronically Stressed Midlife and Older Adults. Int J Behav Med 2021; 28:627-640. [PMID: 33495978 DOI: 10.1007/s12529-021-09957-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Altered cortisol dynamics have been associated with increased risk for chronic health problems among midlife and older adults (≥ 45 years of age). Yet, studies investigating the impact of health behavior interventions on cortisol activity in this age group are limited. OBJECTIVE AND METHODS The current study examined whether 48 midlife and older adults (50% family caregivers, 69% women) randomized to one of four telephone-based health behavior interventions (stress management (SM), exercise (EX), nutrition (NUT), or exercise plus nutrition (EX+NUT)) showed improvements in their perceived stress, mood, and cortisol dynamics at 4 months post-intervention. Participants collected four salivary cortisol samples (waking, 30 min after waking, 4 p.m., and bedtime) across two collection days at baseline and at 4 months post-intervention to assess for total cortisol, cortisol awakening response (CAR), and diurnal cortisol slope. RESULTS Participants in SM showed lower levels of total cortisol and a smaller CAR compared with those in EX, NUT, or EX+NUT from baseline to 4 months post-intervention. Participants in EX showed lower levels of perceived stress, depression, and anxiety compared with those in NUT or SM. Finally, participants in NUT showed a greater diurnal decline in cortisol and lower levels of anxiety compared with those in SM. CONCLUSIONS These findings provide support for the efficacy of telephone-based, health behavior interventions in improving different stress outcomes among chronically stressed midlife and older adults and suggest the need to test the longer-term effects of these interventions for improving health outcomes in this population.
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Kluwe B, Ortiz R, Odei JB, Zhao S, Kline D, Brock G, Echouffo-Tcheugui JB, Lee JM, Lazarus S, Seeman T, Greenland P, Needham B, Carnethon MR, Golden SH, Joseph JJ. The association of cortisol curve features with incident diabetes among whites and African Americans: The CARDIA study. Psychoneuroendocrinology 2021; 123:105041. [PMID: 33227536 PMCID: PMC8046489 DOI: 10.1016/j.psyneuen.2020.105041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 10/16/2020] [Accepted: 10/26/2020] [Indexed: 01/04/2023]
Abstract
INTRODUCTION A flatter diurnal cortisol curve has been associated with incident diabetes among older white adults. However, this relationship has not been examined among middle-aged individuals or African Americans [AA]. We analyzed the longitudinal association of baseline diurnal cortisol curve features with incident diabetes over a 10 year period in a cohort of AA and white participants who were, on average, 40 years old. METHODS Salivary cortisol was collected immediately post-awakening, then subsequently 45 min, 2.5 h, 8 h, and 12 h later, as well as at bedtime. Cortisol curve features included wake-up cortisol; cortisol awakening response (CAR); early, late, and overall decline slopes; bedtime cortisol; and 16 -h area under the curve (AUC). Salivary cortisol (nmol/L) was log-transformed due to positively skewed distributions. Diabetes was defined as fasting plasma glucose ≥ 126 mg/dL or taking diabetes medication. Logistic regression models were used to investigate the association of log-transformed cortisol curve features with incident diabetes. The analysis was stratified by race and adjusted for age, sex, education, depressive symptoms, smoking status, beta-blocker and steroid medication use and BMI. RESULTS Among 376 AA and 333 white participants (mean age 40 years), 67 incident diabetes cases occurred over 10 years. After full adjustment for additional covariates, a 1-unit log increase in CAR was associated with a 53 % lower odds of incident diabetes among whites (Odds Ratio [OR] 0.47, 95 % CI: 0.24, 0.90). A 1-SD increase in late decline slope was associated with a 416 % higher odds of incident diabetes among whites (OR 5.16, 95 % CI: 1.32, 20.20). There were no significant associations in AAs. CONCLUSION A robust CAR and flatter late decline slope are associated with lower and higher odds of incident diabetes, respectively, among younger to middle-aged whites and may provide a future target for diabetes prevention in this population.
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Affiliation(s)
- Bjorn Kluwe
- The Ohio State University College of Medicine, Columbus, OH, United States
| | - Robin Ortiz
- Department of Internal Medicine and Pediatrics, University of Pennsylvania, Philadelphia, PA, United States
| | - James B Odei
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, United States
| | - Songzhu Zhao
- The Ohio State University College of Medicine, Columbus, OH, United States
| | - David Kline
- The Ohio State University College of Medicine, Columbus, OH, United States
| | - Guy Brock
- The Ohio State University College of Medicine, Columbus, OH, United States
| | - Justin B Echouffo-Tcheugui
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Ju-Mi Lee
- Department of Preventative Medicine, Eulji University College of Medicine, Daejeon, South Korea
| | - Sophie Lazarus
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Teresa Seeman
- Division of Geriatrics, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, United States
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Belinda Needham
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Sherita H Golden
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Joshua J Joseph
- The Ohio State University College of Medicine, Columbus, OH, United States.
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Does the cortisol: CRP ratio inform the measurement of individual burden of illness for depression in community samples? JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2020.100058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
OBJECTIVE The Menopause Strategies: Finding Lasting Answers for Symptoms and Health clinical trials network was funded by the National Institutes of Health to find new ways to alleviate the most common, bothersome menopausal symptoms by designing and conducting multiple concurrent clinical intervention studies, accommodating a wide scope of populations and intervention strategies. METHODS Trials were conducted in Boston, Indianapolis, Minneapolis, Oakland, Philadelphia, and Seattle, with the Data Coordinating Center in Seattle, and were designed with standardized eligibility criteria and endpoints. Primary outcomes focused on vasomotor symptoms, sleep quality and insomnia symptoms, and vaginal symptoms. Secondary outcomes included quality of life, sexual function, and mood. RESULTS We completed five randomized clinical trials and three ancillary studies, testing nine interventions in over 1,300 women and collecting nearly 16,000 bio-specimens. Escitalopram, venlafaxine hydrochloride extended release, and low-dose estradiol diminished hot flashes by approximately 50% as compared with a 30% decrease by placebo. No benefits on vasomotor symptoms were observed with yoga or exercise compared with usual activity, nor with omega-3 supplementation compared with placebo. Cognitive behavioral therapy for insomnia reduced self-reported insomnia symptoms and improved overall sleep quality compared with menopause education control. We did not find significant benefit from a vaginal estradiol tablet or a vaginal moisturizer compared with placebo tablet and gel in diminishing the severity of vaginal symptoms. CONCLUSIONS The MsFLASH trials contributed substantially to our understanding of bothersome menopausal symptom treatment. It is important that clinicians counseling women about available treatment options consider all therapies-both nonhormonal and hormonal.
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Mickle AM, Garvan C, Service C, Pop R, Marks J, Wu S, Edberg JC, Staud R, Fillingim RB, Bartley EJ, Sibille KT. Relationships Between Pain, Life Stress, Sociodemographics, and Cortisol: Contributions of Pain Intensity and Financial Satisfaction. CHRONIC STRESS 2020; 4:2470547020975758. [PMID: 33403312 PMCID: PMC7745543 DOI: 10.1177/2470547020975758] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/03/2020] [Indexed: 11/16/2022]
Abstract
Objective The relationship between psychosocial stress and chronic pain is bidirectional. An improved understanding regarding the relationships among chronic pain, life stress, and ethnicity/race will inform identification of factors contributing to health disparities in chronic pain and improve health outcomes. This study aims to assess relationships between measures of clinical pain, life stress, sociodemographics, and salivary cortisol levels. Methods A cross-sectional analysis involving data from 105 non-Hispanic White (NHW) and non-Hispanic Black (NHB) participants aged 45–85 years old with or at risk for knee osteoarthritis. Data included sociodemographics, clinical pain, psychosocial stress, and salivary cortisol across five time points over an approximate 12-hour period. Non-parametric correlation analysis, sociodemographic group comparisons, and regression analyses were performed. Results Clinical pain and psychosocial stress were associated with salivary cortisol levels, particularly morning waking and the evening to morning awakening slope. With the inclusion of recognized explanatory variables, the Graded Chronic Pain Scale characteristic pain intensity and financial satisfaction were identified as the primary pain and psychosocial measures associated with cortisol levels. Sociodemographic group differences were indicated such that NHB participants reported higher pain-related disability, higher levels of discrimination, lower financial and material satisfaction, and showed higher evening salivary cortisol levels compared to NHW participants. In combined pain and psychosocial stress analyses, greater financial satisfaction, lower pain intensity, and lower depression were associated with higher morning waking saliva cortisol levels while greater financial satisfaction was the only variable associated with greater evening to morning awakening slope. Conclusion Our findings show relationships among clinical pain, psychosocial stress, sociodemographic factors, and salivary cortisol levels. Importantly, with inclusion of recognized explanatory variables, financial satisfaction remained the primary factor accounting for differences in morning waking cortisol and evening to morning awakening cortisol slope in an ethnic/racially diverse group of middle aged and older adults with or at risk for knee osteoarthritis.
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Affiliation(s)
- Angela M Mickle
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.,Department of Community of Dentistry and Behavioral Sciences, University of Florida, Gainesville, FL, USA
| | - Cynthia Garvan
- Department of Anesthesiology, University of Florida, Gainesville, FL, USA
| | - Chelsea Service
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Ralisa Pop
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - John Marks
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Stanley Wu
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Jeffrey C Edberg
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Roland Staud
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.,Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Roger B Fillingim
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Emily J Bartley
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.,Department of Community of Dentistry and Behavioral Sciences, University of Florida, Gainesville, FL, USA
| | - Kimberly T Sibille
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA.,Department of Aging & Geriatric Research, University of Florida, Gainesville, FL, USA
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Hernández LM, Padilla GA, Koehn BW, Taylor MK. Post-awakening Cortisol in Explosive Ordnance Disposal Technicians: A Replication Study in a Novel Population. Mil Med 2020; 186:6-12. [PMID: 33005944 DOI: 10.1093/milmed/usaa245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/13/2020] [Accepted: 07/29/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Amassing evidence suggests that post-awakening salivary cortisol rhythms (changes in cortisol throughout the day) may indicate health status. We previously established summary parameters for salivary cortisol in U.S. Navy Sea, Air, and Land and reported excellent parameter stability across 2 days of repeated sampling. To confirm the generalizability of our original findings to other military populations, we replicated the procedures of our prior report in another specialized military group. The purpose of this study was to (1) establish summary parameters of daily salivary cortisol rhythms, (2) evaluate summary parameter stability, and (3) assess the impact of sampling compliance in U.S. Navy Explosive Ordnance Disposal (EOD) technicians. MATERIALS AND METHODS Seventy active duty, male Explosive Ordnance Disposal technicians (mean ± SD age; 34.9 ± 6.5 years) self-collected saliva samples in a nondeployed setting on two consecutive weekdays at WAKE, WAKE + 30 min, WAKE + 60 min, 4 p.m., and 9 p.m. For salivary cortisol, we computed summary parameters, i.e., measures of magnitude and measures of pattern, and then evaluated their stabilities via correlational analyses and Cronbach's alpha (α). Compliance was objectively and subjectively evaluated using actigraphy and self-reported data, respectively. This research was conducted under a Naval Health Research Center Institutional Review Board approved study (NHRC.2015.0013). RESULTS Average salivary cortisol concentrations increased at WAKE + 30 (mean ± SE reactivity; 48.9 + 6.8%) from WAKE, followed by a swift recovery at WAKE + 60. Approximately 10.9% of the group were classified as negative-responders (i.e., < 0% change from WAKE to WAKE + 30). The measures of magnitude demonstrated fair stability across two days (r value range: 0.37-0.45, ps < 0.01; α range: 0.54-0.62). Fifty-five percent of the sample was classified as compliant (defined as <15 min deviation from target sampling times) across both days. Compliance decreased to 31% when compliance criteria were refined to <5 min deviation; however, controlling for compliance did not overwhelmingly influence the more stable summary parameters of magnitude. CONCLUSIONS These findings demonstrate a thorough replication, with some additional refinement, of our prior study, implying generalizability across diverse military populations. Study limitations include unsupervised saliva collection in a free-living setting, which is counterbalanced by ecological validity. The noninvasive salivary sampling protocol used in this study yields stable estimations of daily cortisol rhythms in specialized military men and is recommended as an operational health surveillance tool by which to monitor chronically stressed military members.
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Affiliation(s)
- Lisa M Hernández
- Biobehavioral Sciences Lab, Warfighter Performance Department, Naval Health Research Center, San Diego, CA 92106, USA.,Leidos, San Diego, CA 92121, USA
| | - Genieleah A Padilla
- Biobehavioral Sciences Lab, Warfighter Performance Department, Naval Health Research Center, San Diego, CA 92106, USA.,Leidos, San Diego, CA 92121, USA
| | - Blake W Koehn
- Biobehavioral Sciences Lab, Warfighter Performance Department, Naval Health Research Center, San Diego, CA 92106, USA.,Leidos, San Diego, CA 92121, USA
| | - Marcus K Taylor
- Biobehavioral Sciences Lab, Warfighter Performance Department, Naval Health Research Center, San Diego, CA 92106, USA
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Passmore CJ, Mandryk RL. A Taxonomy of Coping Strategies and Discriminatory Stressors in Digital Gaming. FRONTIERS IN COMPUTER SCIENCE 2020. [DOI: 10.3389/fcomp.2020.00040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Prasad N, Jabbar PK, Jayakumari C, John M, Haridasan RK, Surendran Nair Anish T, Gomez R, Das DV, Sreenath R, George GS, Nair A. Late-Night Salivary Cortisol in Healthy, Community-Dwelling Asian Indians Assessed by Second-Generation ECLIA. J Clin Endocrinol Metab 2020; 105:5840379. [PMID: 32424408 DOI: 10.1210/clinem/dgaa269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/08/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Late-night salivary cortisol (LNSC) is used as a screening test for Cushing syndrome (CS), but there is no community-derived normative data for the normal upper limit in the South Asian population. This study aimed to determine the upper limit of normal (97.5th percentile) for LNSC in an Asian Indian population using a commercially available second-generation electrochemiluminiscence immunoassay (ECLIA). METHODS LNSC in apparently healthy community-dwelling individuals was assessed by multistage cluster sampling. Healthy individuals age 18 to 60 years from 8 urban and 8 rural clusters of Thiruvananthapuram district were studied. Thirty people from an approximate population of 1000 individuals from each cluster participated in the study. A saliva sample was collected between 11 PM and 12 midnight and analyzed using Roche COBAS-e-411 and ultrasensitive Cortisol II kits the next day. RESULTS Cortisol values from 474 salivary samples were available for final analysis after exclusion of improperly collected samples. The 97.5th percentile of the LNSC concentrations was 0.25 μg/dL (6.89 nmol/L) (90% CI, 0.23-0.27 μg/dL; ie, 6.34-7.45 nmol/L). In postmenopausal women, median LNSC was significantly higher but the 90% CI for the upper limit of their LNSC (0.28μg/dL or 7.72 nmol/L) overlapped with that of premenopausal women. CONCLUSIONS This study establishes the normal value of LNSC estimated by second-generation ECLIA in healthy community-dwelling Asian Indian individuals for the first time. Salivary cortisol at 11 pm to 12 am is less than 0.25μg/dL (6.89 nmol/L) in the general Asian Indian population. Menopause causes a significant increase in LNSC and may lead to overdiagnosis of CS if not interpreted carefully.
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Affiliation(s)
- Nandini Prasad
- Department of Endocrinology & Metabolism, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
| | - Puthiyaveettil Khadar Jabbar
- Department of Endocrinology & Metabolism, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
| | - Chellamma Jayakumari
- Department of Endocrinology & Metabolism, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
| | - Mathew John
- Department of Endocrinology & Metabolism, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
- Providence Endocrine and Diabetes Specialty Centre, Thiruvananthapuram, Kerala, India
| | | | - Thekkumkara Surendran Nair Anish
- Providence Endocrine and Diabetes Specialty Centre, Thiruvananthapuram, Kerala, India
- Department of Community Medicine, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
| | - Ramesh Gomez
- Department of Endocrinology & Metabolism, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
| | - Darvin Vamadevan Das
- Department of Endocrinology & Metabolism, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
| | - Ravindranath Sreenath
- Department of Endocrinology & Metabolism, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
| | - Geena Susan George
- Department of Endocrinology & Metabolism, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
| | - Abilash Nair
- Department of Endocrinology & Metabolism, Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
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Rothe N, Steffen J, Penz M, Kirschbaum C, Walther A. Examination of peripheral basal and reactive cortisol levels in major depressive disorder and the burnout syndrome: A systematic review. Neurosci Biobehav Rev 2020; 114:232-270. [DOI: 10.1016/j.neubiorev.2020.02.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/27/2020] [Accepted: 02/19/2020] [Indexed: 12/15/2022]
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Hypothalamic-Pituitary-Adrenal Axis Responses in Women with Endometriosis-Related Chronic Pelvic Pain. Reprod Sci 2020; 27:1839-1847. [PMID: 32572832 DOI: 10.1007/s43032-020-00201-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/01/2020] [Indexed: 12/13/2022]
Abstract
Some chronic pain conditions and comorbidities suppress the hypothalamic-pituitary-adrenal (HPA) axis and response to dynamic testing. We measured HPA axis responses to corticotropin-releasing hormone (CRH) administration in relation to chronic pelvic pain and endometriosis. In a cross-sectional study of women (n = 54) with endometriosis-associated chronic pelvic pain (n = 22), chronic pelvic pain alone (n = 12), or healthy volunteers (n = 20), adrenocorticotropic-releasing hormone (ACTH) and cortisol levels were measured at 0, 15, 30, and 45 min after intravenous ovine CRH administration. ACTH and cortisol delta (peak-baseline) and area under the curve (AUC) were compared by study group and assessed for association with race and menstrual and non-menstrual pain severity. HPA axis responses did not differ among the racially diverse groups or in those with pain compared with healthy volunteers. However, when stratified by race, ACTH delta (129.9 ± 130.7 vs. 52.5 ± 66.0 pg/mL; p = 0.003), ACTH AUC (4813 ± 4707 vs. 2290 ± 2900 min*pg/mL; p = 0.013), and cortisol delta (26.3 ± 21.5 vs. 13.2 ± 9.7 μg/mL; p = 0.005) were significantly higher in black (n = 10) than predominately white (non-black) subjects (n = 44; 39/44 white). In analyses among primarily white (non-black) women, greater menstrual pain severity was associated with blunted ACTH delta (p = 0.015) and cortisol delta (p = 0.023), and greater non-menstrual pain severity with blunted cortisol delta (p = 0.017). Neuroendocrine abnormalities in women with chronic pelvic pain may differ by pain manifestations and may vary by race. The higher HPA axis response in black women merits investigation in pelvic pain studies stratified by race. In white (non-black) women experiencing pain, a blunted response was related to pain severity suggesting pain affects women independently of endometriosis lesions.
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Tachachartvanich P, Sanchez SS, Gomez SL, John EM, Smith MT, Fejerman L. Plasma glucocorticogenic activity, race/ethnicity and alcohol intake among San Francisco Bay Area women. PLoS One 2020; 15:e0233904. [PMID: 32479509 PMCID: PMC7263601 DOI: 10.1371/journal.pone.0233904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/14/2020] [Indexed: 11/18/2022] Open
Abstract
Racial and ethnic minorities are at higher risk for a variety of diseases. While sociodemographic and lifestyle factors contribute to racial/ethnic health disparities, the biological processes underlying these associations remain poorly understood. Stress and its biological consequences through the glucocorticoid receptor (GR) have been hypothesized to mediate adverse disease outcomes. In fasting morning samples of 503 control women from the San Francisco Bay Area Breast Cancer Study, we used a sensitive Chemical-Activated LUciferase gene eXpression (CALUX) assay to examine the association of sociodemographic and lifestyle factors with plasma glucocorticogenic (G) activity in three racial/ethnic groups. The G activity is a sensitive measure that reflects biological activity of total plasma glucocorticoids including cortisol and glucocorticoid-like compounds. Associations between G activity and sociodemographic and lifestyle factors were examined using multivariable linear regression models. Latina and non-Latina Black (NLB) women had 9% (P = 0.053) and 14% (P = 0.008) lower morning G activity than non-Latina White (NLW) women, respectively. Additionally, we replicated a previously reported association between G activity and alcohol intake (women who drank >10gms had 19% higher G activity than non-drinkers, P = 0.004) in Latina and NLB women. Further research should assess the association between G activity and health outcomes in a prospective cohort so as to characterize the relationship between total plasma G activity in pre-disease state and disease outcomes across different racial/ethnic populations.
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Affiliation(s)
- Phum Tachachartvanich
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, United States of America
| | - Sylvia S. Sanchez
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, United States of America
| | - Scarlett L. Gomez
- Cancer Prevention Institute of California, Fremont, CA, United States of America
- Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, United States of America
| | - Esther M. John
- Cancer Prevention Institute of California, Fremont, CA, United States of America
- Division of Oncology and Stanford Cancer Institute, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Martyn T. Smith
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, United States of America
| | - Laura Fejerman
- Division of General Internal Medicine and Institute of Human Genetics, Department of Medicine, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, United States of America
- * E-mail:
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Lacker TJ, Walther A, Ehlert U. Age-Related Alterations in Endocrine Markers Do Not Match Changes in Psychosocial Measures: Findings From the Men's Health 40+ Longitudinal Study. Am J Mens Health 2020; 14:1557988320926332. [PMID: 32456528 PMCID: PMC7278106 DOI: 10.1177/1557988320926332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
While life expectancy continues to increase, aging can bring several distinct
endocrine and psychosocial changes. The study aimed to investigate the interplay
between biopsychosocial factors of healthy aging in specifically healthy aging
men. Ninety-seven healthy aging men were investigated at two time points
spanning 4 years. Participants completed questionnaires measuring several
psychosocial dimensions and gave saliva samples for hormone quantification
during a laboratory appointment. The study applied a random intercept
mixed-model approach. Age-related changes were found in most endocrine markers
(cortisol, testosterone, dehydroepiandrosterone-sulfate, and progesterone),
except for estradiol. Psychosocial measures remained stable, except for
increased social support. Further, changes in endocrine and psychosocial
measures were independent of each other. The results suggest that in healthy
aging men, age-related endocrine changes occur, but do not necessarily determine
a change in psychosocial measures. Potentially, preventive interventions can be
derived from these results.
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Affiliation(s)
- T J Lacker
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.,University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Switzerland
| | - A Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.,University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Switzerland.,Biopsychology, Technical University Dresden, Dresden, Germany
| | - U Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.,University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Switzerland
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Walls M, Dertinger M, Unzen M, Forsberg A, Aronson B, Wille S, al’Absi M. Assessment of feasibility and outcomes of a salivary cortisol collection protocol in five American Indian communities. Stress 2020; 23:265-274. [PMID: 31578895 PMCID: PMC7174135 DOI: 10.1080/10253890.2019.1675628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
We evaluated the feasibility and outcomes of administering a naturalistic saliva collection procedure and assessment in American Indian (Indigenous) communities. We focus on Indigenous adults living with type 2 diabetes given the "epidemic" of the disease disproportionately impacting many tribal groups. Data are from community-based participatory research (CBPR) involving 5 tribal communities. Participants were randomly selected from tribal clinic records. The sample includes 188 adults living with type 2 diabetes (56% female; age range = 18-77 years; M age = 46.3 years). Participants provided a total of 748 saliva samples, representing 4 samples/participant on a single day with instructions for collection at 4 time points: upon waking, 1 h after waking, 2 h after waking, and at 8 PM. Saliva sample times were recorded by participants on paper and electronically via placement in a Medication Event Monitoring System (MEMS®) bottle. Overall, 67% of samples were completed within 10 min of protocol instructions and 91% of participants provided at least one useable sample (79% provided four useable samples). Noncompliance, behavioral and environmental factors were not robustly associated with deviations in observed cortisol indices. Results suggest that home-based, community interviewer-involved protocols yields valid data with high compliance. The success of this study was facilitated by exemplary efforts of tribal community-based interviewers and our overall CBPR approach.Lay summaryAuthentic efforts for tribal community partnerships in research are critical to successfully implementing biological assessments with American Indians given legacies of research misconduct and mistrustOur Community-Based Participatory Research with 5 tribes yielded high participant compliance to a home-based salivary cortisol collection protocolLack of compliance to salivary cortisol protocol and medication usage were not consistently associated with observed cortisol indices.
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Affiliation(s)
- Melissa Walls
- Johns Hopkins University, Bloomberg School of Public Health, Center for American Indian Health
- 1915 South Street, Duluth, MN 55812,
| | - Melinda Dertinger
- Department of Family Medicine & Biobehavioral Health, University of Minnesota Medical School, Duluth campus
| | - Michael Unzen
- Department of Family Medicine & Biobehavioral Health, University of Minnesota Medical School, Duluth campus
| | - Angie Forsberg
- Johns Hopkins University, Bloomberg School of Public Health, Center for American Indian Health
| | - Benjamin Aronson
- Department of Social and Administrative Pharmacy, Ohio Northern University
| | - Stephanie Wille
- Johns Hopkins University, Bloomberg School of Public Health, Center for American Indian Health
| | - Mustafa al’Absi
- Department of Family Medicine & Biobehavioral Health, University of Minnesota Medical School, Duluth campus
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Lacker TJ, Walther A, Fiacco S, Ehlert U. The Relation Between Steroid Secretion Patterns and the Androgen Receptor Gene Polymorphism on Physical Health and Psychological Well-Being-Longitudinal Findings From the Men's Health 40+ Study. Front Hum Neurosci 2020; 14:43. [PMID: 32116617 PMCID: PMC7033643 DOI: 10.3389/fnhum.2020.00043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/29/2020] [Indexed: 11/25/2022] Open
Abstract
Research is increasingly focusing on promoting healthy aging and the related extension of the health span by targeting crucial biological processes responsible for age-related conditions. While age-related gradual changes in steroid hormones such as testosterone, estradiol, or cortisol are well described in men, their interactions among each other or with genetic markers have not been sufficiently investigated with regard to physical health or psychological well-being. More specifically, the examination of age-related alterations in hormone interactions and the androgen receptor polymorphism, which modulates androgen action on target cells, in relation to physical health and psychological well-being represents a promising avenue for research on healthy aging in men. A total of 97 healthy aging men provided complete data on psychometric health measures as well as hormonal and genetic parameters at baseline and a 4-year follow-up assessment. Fasting saliva samples were taken at 8:00 am under standardized laboratory conditions, while the androgen receptor gene polymorphism was analyzed from dried blood spots. Longitudinal analyses revealed that psychological well-being and physical health remained stable over time. Analyses indicated that E2 moderated the course of psychological well-being, while the androgen receptor gene polymorphism moderated the course of physical health. Further, T was a strong predictor of physical health. These results suggest that the hypothalamic-pituitary-gonadal (HPG) axis might be important for the maintenance of psychological well-being in men, while physical health depends more on interindividual differences in the androgen receptor gene and T.
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Affiliation(s)
- Tim Jonas Lacker
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
- Biopsychology, TU Dresden, Dresden, Germany
| | - Serena Fiacco
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
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Charles ST, Mogle J, Piazza J, Karlamangla A, Almeida DM. Going the distance: The diurnal range of cortisol and its association with cognitive and physiological functioning. Psychoneuroendocrinology 2020; 112:104516. [PMID: 31805455 PMCID: PMC6948931 DOI: 10.1016/j.psyneuen.2019.104516] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/18/2019] [Accepted: 11/12/2019] [Indexed: 12/21/2022]
Abstract
Cortisol features prominently in theories describing how chronic stress wears away at physical and cognitive health. The current study examines composite measures of physiological and cognitive functioning in relation to two aspects of daily cortisol: total daily output and change in levels throughout the day. Participants (N = 1001; aged 28-84 years-old) from the Midlife Development in the United States (MIDUS) study provided 4 daily saliva samples across four consecutive days and underwent a physical exam that provided information about six inter-related physiological systems that were combined into a measure of allostatic load. They also completed a phone-based battery of cognitive tasks, which provided a composite score combining memory, reasoning, and speed of processing performance. Total daily cortisol output was captured using area under the curve with respect to ground (AUCg). Change in cortisol levels was assessed using two methods: slope, calculated through piecewise spline models, and dynamic range, calculated by the difference between the day's highest and lowest log-cortisol levels. Findings indicate that, when examined together, overall cortisol output was not associated with either outcome, but a greater range in cortisol throughout the day was associated with both lower allostatic load and higher cognitive functioning. Results emphasize the importance of dynamic daily processes, assessed either using slopes or dynamic range, to both physiological and cognitive functioning.
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Affiliation(s)
- Susan T. Charles
- Department of Psychological Science, 4568 Social & Behavioral Sciences Gateway, University of California, Irvine, CA 92697-7085 USA
| | - Jacqueline Mogle
- Prevention Research Center, The Pennsylvania State University, v320D Biobehavioral Health Building, University Park, PA 16802, USA.
| | - Jennifer Piazza
- Department of Public Health, KHS 243, California State University, Fullerton Fullerton, CA 92831 USA
| | - Arun Karlamangla
- Department of Medicine, David Geffen School of Medicine, 200 UCLA Medical Plaza Suite 365, Los Angeles, CA 90095, USA.
| | - David M. Almeida
- Department of Human Development and Family Studies, 403 Biobehavioral Health Building, University Park, PA 16802 USA
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41
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Etindele-Sosso FA. Insomnia, excessive daytime sleepiness, anxiety, depression and socioeconomic status among customer service employees in Canada. Sleep Sci 2020; 13:54-64. [PMID: 32670493 PMCID: PMC7347365 DOI: 10.5935/1984-0063.20190133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/28/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE It is the first study investigating deeply symptoms of neuropsychiatric diseases among a large population of customer service employees (n=1238, 640 females and 598 males). The study's goals were document presence of sleep disorders, anxiety and depression among customer service advisors and determine the influence of the socioeconomic status (pSES), duration in position and full-time or part-time shift on the diseases above. METHODS Linear regressions and ANOVA with a Tukey multiple comparisons of means was performed to analyze correlation and differences between citizens, international students and immigrants in their pSES and neuropsychiatric diseases. RESULTS Customer service employees (578 Canadians, 264 immigrants and 358 international students) are in majority undergraduate students (286 men and 289 females) with a high school degree (280 men and 308 women). They work full-time (560 men and 548 women) and are single (420 men and 560 women). Among customer service advisors, the time spent as an advisor was an excellent predictor of insomnia, sleepiness and anxiety (respectively with R2=91,83%, R2=81,23% and R2=87,46%) but a moderate predictor of depression (R2=69,14%). The pSES was a moderate predictor of sleep disorders (respectively R2=62,04% for insomnia and R2=53,62% for sleepiness) and strongly associated with anxiety and depression (R2=82,95% for anxiety and R2=89,77% for depression). DISCUSSION Insomnia, sleepiness and anxiety are more prevalent for full-time employees (higher for immigrants and international students compared to Canadians) compared with part-time employees, while depression was similarly higher for Canadian and immigrants compared to international students. Regarding full-time employees, symptoms of insomnia, anxiety and depression were higher for men compared to women. Regarding part-time employees, symptoms of insomnia and sleepiness were higher for women compared to men. Employees working full-time with rotating shifts are more exposed to insomnia, sleepiness and anxiety than employees working part-time. More research is needed to understand mental health of customer service employees regardless of their area and it is worthy of interest to study the link between sleep disorders and mood disorders with work conditions. Here some practical suggestions are made to reduce neuropsychiatric disorders for customer service employees or to at least mitigate the work burden on their brains.
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Affiliation(s)
- Faustin Armel Etindele-Sosso
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine (CEAMS) - Montréal - Qc - Canada
- Université du Québec à Montréal, Institut Santé et Société - Montréal - Qc - Canada
- Douglas Institute of Mental Health, Quebec Network on Suicide, Mood Disorders and Related Disorders (RQSHA) - Montréal - Qc - Canada
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42
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Individual differences in glucocorticoid regulation: Does it relate to disease risk and resilience? Front Neuroendocrinol 2020; 56:100803. [PMID: 31697962 PMCID: PMC7189329 DOI: 10.1016/j.yfrne.2019.100803] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/03/2019] [Accepted: 10/29/2019] [Indexed: 12/17/2022]
Abstract
Glucocorticoid (GC) signaling varies among individuals, and this variation may relate to individual differences in health outcomes. To determine if and which aspects of signaling (basal, circadian, integrative, or reactivity) are associated with specific health outcomes, we reviewed recent studies that relate GCs to health outcomes. We identified papers through PubMed and reviewed 100 original research articles related to mental health, cardiovascular health, cancer, diabetes, obesity, pulmonary health, sleep, and fitness. Many studies reported elevated GC secretion associated with worse health, but this was only particularly true for integrative GC measures. On the other hand, accentuated cortisol awakening response and a steeper circadian rhythm were both associated with positive health outcomes. Overall, relationships between GC secretion and health outcomes were relatively weak. This systematic review of relationships between GC metrics and health outcomes highlights the importance of careful consideration when selecting methods to measure GC regulation in health research.
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43
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Karlamangla AS, Merkin SS, Almeida DM, Friedman EM, Mogle JA, Seeman TE. Early-Life Adversity and Dysregulation of Adult Diurnal Cortisol Rhythm. J Gerontol B Psychol Sci Soc Sci 2019; 74:160-169. [PMID: 30165409 DOI: 10.1093/geronb/gby097] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Indexed: 12/20/2022] Open
Abstract
Objectives Exposure to life stresses can lead to diminution in the capacity of stress response systems to mount a robust response to new challenges, with blunting of dynamic range-the spread between maximal attainable and minimal resting levels. We investigate the association between early-life adversity and the dynamic range of adult diurnal cortisol secretion. Method In 35- to 86-year-old adults, cortisol assayed from 16 saliva samples over 4 consecutive days was used to compute diurnal dynamic range and area under the curve (AUC). Economic adversity in childhood was indexed by recalled parental education, family welfare dependence, and perceived financial status; and childhood social adversity by parental separation, death, and abuse. Results Adjusted for age, gender, and race/ethnicity, both childhood adversities were strongly associated with smaller adult cortisol diurnal dynamic range, but not with AUC. The association with cortisol dynamic range was explained by adult social and economic variables. Discussion Early-life adversity appears to leave a long-term imprint on cortisol secretion dynamics, reducing diurnal dynamic range without increasing total secretion. This points to the importance of examining the adaptation capacity of physiological systems when studying the impact of early-life and chronic stresses on adult health.
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Affiliation(s)
- Arun S Karlamangla
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Sharon Stein Merkin
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - David M Almeida
- Department of Human Development and Family Studies, Pennsylvania State University, University Park
| | | | | | - Teresa E Seeman
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
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44
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Brivio P, Paladini MS, Racagni G, Riva MA, Calabrese F, Molteni R. From Healthy Aging to Frailty: In Search of the Underlying Mechanisms. Curr Med Chem 2019; 26:3685-3701. [PMID: 31333079 DOI: 10.2174/0929867326666190717152739] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/14/2018] [Accepted: 03/08/2019] [Indexed: 11/22/2022]
Abstract
Population aging is accelerating rapidly worldwide, from 461 million people older than 65 years in 2004 to an estimated 2 billion people by 2050, leading to critical implications for the planning and delivery of health and social care. The most problematic expression of population aging is the clinical condition of frailty, which is a state of increased vulnerability that develops as a consequence of the accumulation of microscopic damages in many physiological systems that lead to a striking and disproportionate change in health state, even after an apparently small insult. Since little is known about the biology of frailty, an important perspective to understand this phenomenon is to establish how the alterations that physiologically occur during a condition of healthy aging may instead promote cumulative decline with subsequent depletion of homoeostatic reserve and increase the vulnerability also after minor stressor events. In this context, the present review aims to provide a description of the molecular mechanisms that, by having a critical impact on behavior and neuronal function in aging, might be relevant for the development of frailty. Moreover, since these biological systems are also involved in the coping strategies set in motion to respond to environmental challenges, we propose a role for lifestyle stress as an important player to drive frailty in aging.
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Affiliation(s)
- Paola Brivio
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Maria Serena Paladini
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Giorgio Racagni
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.,Associazione di Psicofarmacologia, Milan, Italy
| | - Marco Andrea Riva
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Francesca Calabrese
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Raffaella Molteni
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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45
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Kirsch JA, Love GD, Radler BT, Ryff CD. Scientific imperatives vis-à-vis growing inequality in America. AMERICAN PSYCHOLOGIST 2019; 74:764-777. [PMID: 31219260 PMCID: PMC6776687 DOI: 10.1037/amp0000481] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A landmark article published in the American Psychologist (Adler et al., 1994) encouraged psychologists to engage in research on socioeconomic inequality and health. Numerous contributions followed to fill in psychosocial and behavioral pathways. Specifically, we review advances on health inequalities research from a large public-use study (Midlife in the United States [MIDUS]). The Great Recession of 2007 to 2009 and its lingering effects are then reviewed to underscore widening inequality in access to education, employment, and income. Two MIDUS national samples of same-aged adults recruited 2 decades apart are then compared to assess historical changes in socioeconomic, physical health, and well-being profiles from the 1990s to postrecession. Despite historical gains in educational attainment over time, we show that indicators of socioeconomic status, health, and well-being are more compromised in the postrecession sample relative to the 1990s sample. Building on these preliminary findings, we elaborate opportunities for further inquiry by the scientific community to examine whether widening socioeconomic inequalities exacerbated by the Great Recession translate to widening health inequalities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Hajat A, Hazlehurst MF, Golden SH, Merkin SS, Seeman T, Szpiro AA, Kaufman JD, Roux AD. The cross-sectional and longitudinal association between air pollution and salivary cortisol: Evidence from the Multi-Ethnic Study of Atherosclerosis. ENVIRONMENT INTERNATIONAL 2019; 131:105062. [PMID: 31491811 PMCID: PMC6994173 DOI: 10.1016/j.envint.2019.105062] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Cortisol, a stress hormone released by the activation of the hypothalamic-pituitary-adrenal (HPA) axis, is critical to the body's adaptive response to physiological and psychological stress. Cortisol has also been implicated in the health effects of air pollution through the activation of the sympathetic nervous system. This study evaluates the cross-sectional and longitudinal association between several air pollutants and salivary cortisol. METHODS We used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort of 45-85 years old participants from six US cities. Salivary cortisol was evaluated at two time points between 2004 and 2006 and then again from 2010 to 2012. Cortisol samples were taken several times per day on two or three consecutive days. Particulate matter <2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2) and nitrogen oxides (NOx) in the year prior to cortisol sampling were examined. We used piecewise linear mixed models that were adjusted for demographics, socioeconomic status and cardiovascular risk factors to examine both cross-sectional and longitudinal associations. Longitudinal models evaluated change in cortisol over time. RESULTS The pooled cross-sectional results revealed largely null results with the exception of a 9.7% higher wake-up cortisol associated with a 10 ppb higher NO2 (95% CI, -0.2%, 20.5%). Among all participants, the features of the cortisol curve became flatter over 5 years. The wake-to-bed slope showed a more pronounced flattening over time (0.014, 95% CI, 0.0, 0.03) with a 10 ppb higher NO2 level. Other air pollutants were not associated with change in cortisol over time. CONCLUSIONS Our results suggest only a moderate association between traffic related air pollution and cortisol. Very few epidemiologic studies have examined the long-term impact of air pollution on the stress response systems, thus warranting further exploration of these findings.
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Affiliation(s)
- Anjum Hajat
- University of Washington, Department of Epidemiology, Box 357236, Seattle, WA 98195, USA.
| | - Marnie F Hazlehurst
- University of Washington, Department of Epidemiology, Box 357236, Seattle, WA 98195, USA.
| | - Sherita Hill Golden
- Johns Hopkins University, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, 1830 E. Monument Street, Room 9052, Baltimore, MD 21287, USA.
| | - Sharon Stein Merkin
- University of California Los Angeles, Geffen School of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Teresa Seeman
- University of California Los Angeles, Geffen School of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Adam A Szpiro
- University of Washington, Department of Biostatistics, Box 357232, Seattle, WA 98195, USA.
| | - Joel D Kaufman
- University of Washington, Departments of Environmental and Occupational Health Sciences and Epidemiology, Box 354695, Seattle, WA 98195, USA.
| | - Ana Diez Roux
- Drexel University Dornsife School of Public Health, Urban Health Collaborative Nesbitt Hall 3215 Market Street Philadelphia, PA 19104, USA.
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47
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Friedenreich CM, Wang Q, Shaw E, Heer EV, Zhou R, Brenner DR, Courneya KS, Wynne-Edwards KE. The effect of prescribed exercise volume on biomarkers of chronic stress in postmenopausal women: Results from the Breast Cancer and Exercise Trial in Alberta (BETA). Prev Med Rep 2019; 15:100960. [PMID: 31384527 PMCID: PMC6664156 DOI: 10.1016/j.pmedr.2019.100960] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/16/2019] [Accepted: 07/21/2019] [Indexed: 12/02/2022] Open
Abstract
There is epidemiologic and biologic evidence for a role of stress in breast cancer etiology and physical activity mitigates the negative effects of stress. We examined the potential for a dose-response relationship between two volumes of aerobic exercise and biomarkers of chronic stress in post-menopausal women. The Breast Cancer and Exercise Trial in Alberta is a randomized controlled trial with post-menopausal women randomized to either a MODERATE (150 min per week) or HIGH (300 min per week) volume of exercise over a one year intervention period. Fasting serum concentrations of cortisol, cortisone, corticosterone and 11-deoxycortisol at baseline, 12 months (the end of the intervention), and 24 months. Intention-to-treat analyses were performed using general linear models, adjusted for baseline biomarker concentrations. There were modest but non-statistically significant decreases in cortisol (HIGH: −4%, 95% CI: −7%, 2%; MODERATE: −1%, 95%: CI: −14%, 4%) and corticosterone (HIGH: −4%, 95% CI: −12%, 6%; MODERATE: −5%, 95% CI: −14%, 4%) concentrations for both exercise groups between baseline and 12 months, and no difference in cortisone concentrations. Intention-to-treat analysis of 386 (97%) participants showed no statistically significant group differences for changes in biomarker levels at 12 months. Between baseline and 12 months, there were no differences in cortisol or cortisone and, at 24 months all stress hormone levels increased to near-baseline levels with no significant differences between the two intervention groups. There is evidence for a role of stress in the development of breast cancer. Physical activity has been shown to lower levels of stress hormones. Currently no evidence for a dose-response relationship Volume of physical activity had no impact on levels of stress hormones. All stress hormone returned to baseline levels 12-months following intervention.
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Affiliation(s)
- Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Qinggang Wang
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Eileen Shaw
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Emily V Heer
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Ruokun Zhou
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Katherine E Wynne-Edwards
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
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Allen JO, Watkins DC, Chatters L, Geronimus AT, Johnson-Lawrence V. Cortisol and Racial Health Disparities Affecting Black Men in Later Life: Evidence From MIDUS II. Am J Mens Health 2019; 13:1557988319870969. [PMID: 31423887 PMCID: PMC6710693 DOI: 10.1177/1557988319870969] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/15/2019] [Accepted: 07/27/2019] [Indexed: 01/07/2023] Open
Abstract
In the United States, Black men have poorer overall health and shorter life spans than most other racial/ethnic groups of men, largely attributable to chronic health conditions. Dysregulated patterns of daily cortisol, an indicator of hypothalamic-pituitary-adrenal (HPA) axis stress-response functioning, are linked to poor health outcomes. Questions remain regarding whether and how cortisol contributes to Black-White differences in men's health. This exploratory study compared early day changes in cortisol levels (diurnal cortisol slopes from peak to pre-lunch levels) and their associations with medical morbidity (number of chronic medical conditions) and psychological distress (Negative Affect Scale) among 695 Black and White male participants in the National Survey of Midlife in the United States (MIDUS II, 2004-2009). Black men exhibited blunted cortisol slopes relative to White men (-.15 vs. -.21, t = -2.97, p = .004). Cortisol slopes were associated with medical morbidity among Black men (b = .050, t = 3.85, p < .001), but not White men, and were unrelated to psychological distress in both groups. Findings indicate cortisol may contribute to racial health disparities among men through two pathways, including the novel finding that Black men may be more vulnerable to some negative health outcomes linked to cortisol. Further, results suggest that while cortisol may be a mechanism of physical health outcomes and disparities among older men, it may be less important for their emotional health. This study increases understanding of how race and male sex intersect to affect not only men's lived experiences but also their biological processes to contribute to racial health disparities among men in later life.
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Affiliation(s)
- Julie Ober Allen
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - Linda Chatters
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Arline T. Geronimus
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Vicki Johnson-Lawrence
- Department of Family Medicine/Division of Public Health, College of Human Medicine, Michigan State University, Ann Arbor, MI, USA
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Fiacco S, Walther A, Ehlert U. Steroid secretion in healthy aging. Psychoneuroendocrinology 2019; 105:64-78. [PMID: 30314729 DOI: 10.1016/j.psyneuen.2018.09.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 01/16/2023]
Abstract
Nowadays, people spend a considerable amount of their lives as older adults, but this longer lifespan is often accompanied by an increase in chronic conditions and disease, resulting in reduced quality of life and unprecedented societal and economic burden. Healthy aging is therefore increasingly recognized as a healthcare priority. Physical and mental adaptations to changes over the life course, and the maintenance of well-being, represent pivotal challenges in healthy aging. To capture the complexity of healthy aging, we propose a specific phenotype based on body composition, cognition, mood, and sexual function as indicators of different dimensions of healthy aging. With increasing age, sex hormones as well as glucocorticoids undergo significant alterations, and different patterns emerge for women and men. This review describes age-related patterns of change for women and men, and sheds light on the underlying mechanisms. Furthermore, an overview is provided of the challenges for healthy aging resulting from these age-related steroid alterations. While clinical practice guidelines recommend hormonal treatment only in the case of consistently low hormone levels and symptoms of hormone deficiency, physical exercise and a healthy lifestyle emerge as preventive strategies which can counter age-related hormonal changes and at best prevent chronic conditions.
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Affiliation(s)
- Serena Fiacco
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Biopsychology, TU Dresden, Dresden, Germany
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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50
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Liu Y, Almeida DM, Rovine MJ, Zarit SH. Modeling Cortisol Daily Rhythms of Family Caregivers of Individuals With Dementia: Daily Stressors and Adult Day Services Use. J Gerontol B Psychol Sci Soc Sci 2019; 73:457-467. [PMID: 27738082 DOI: 10.1093/geronb/gbw140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/27/2016] [Indexed: 11/15/2022] Open
Abstract
Objectives The study examined the typical diurnal cortisol trajectory and its differential associations with an intervention, the adult day services (ADS) use, among a sample of family caregivers who experienced high levels of daily stress. Method On hundred and sixty-five caregivers of individuals with dementia completed an 8-day diary on daily stressors, positive events, sleep quality, and ADS use. The caregivers also provided five saliva samples on each diary day. Daily cortisol trajectories were modeled as a function of time elapsed since awakening, and three spline growth curve models were fit to the cortisol data. Based on the best-fitting linear spline model, the effect of daily ADS use was examined at both daily and person levels. Covariates included daily experiences and other caregiving characteristics. Results On ADS days, caregivers had a steeper cortisol awakening response (CAR) slope and a steeper morning decline. ADS use remained significant after controlling for covariates at both daily and person levels. Discussion The findings suggested potential biophysiological benefits of daily ADS use for a sample that was under chronic stress and high levels of daily stress.
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Affiliation(s)
- Yin Liu
- Center for Healthy Aging, The Pennsylvania State University, State College
| | - David M Almeida
- Center for Healthy Aging, The Pennsylvania State University, State College.,Department of Human Development and Family Studies, The Pennsylvania State University, State College
| | - Michael J Rovine
- Human Development and Quantitative Methods Division, Graduate School of Education, University of Pennsylvania, Philadelphia
| | - Steven H Zarit
- Department of Human Development and Family Studies, The Pennsylvania State University, State College
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