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Golding H, Ritonja JA, Day AG, Aronson KJ, Tranmer J. Modeling the relationship between shift work and cardiometabolic risk through circadian disruption, sleep and stress pathways. Chronobiol Int 2022; 39:704-713. [PMID: 35100920 DOI: 10.1080/07420528.2022.2032124] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The purpose of this study is to elucidate the multiple pathways linking shift work exposure to cardiometabolic risk (CMR) through the intermediates of circadian disruption, sleep disturbances, and stress. A cross-sectional study was conducted at Kingston Health Sciences Center that included female hospital workers, 160 who worked a day-only schedule and 168 who worked rotating days and nights. Participants completed questionnaires, a clinical exam, and wore accelerometers to collect sleep data for 8 days. Participants also collected urine samples at each void during a 24-h collection period, on the day shift for day-only workers and the night shift for rotating shift workers, for cortisol and melatonin measures. We adapted and tested a conceptual model proposed by Knutsson and Boggild for circadian disruption, sleep, and stress mechanistic pathways linking shift work to CMR using structural equation modeling techniques. Status as a rotating shift worker was associated with increased circadian disruption of cortisol and melatonin production compared to day-only workers (P < .001). Increased circadian disruption was associated with an increased CMR (P = .01). Rotating shift work was associated with sleep disturbances (P = .002) and increased job stress (P < .001), but neither was associated with CMR. We conclude that rotating shift work is associated indirectly with increased CMR. This association is mediated by circadian disruption as indicated by attenuated melatonin and cortisol, and flatter cortisol curves.
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Affiliation(s)
- Haley Golding
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Jennifer A Ritonja
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Andrew G Day
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Kristan J Aronson
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.,Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Joan Tranmer
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.,School of Nursing, Queen's University, Kingston, Ontario, Canada
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Hidalgo V, Pulopulos MM, Puig-Perez S, Montoliu T, Salvador A. Diurnal cortisol secretion and health-related quality of life in healthy older people. Int J Psychophysiol 2021; 166:127-133. [PMID: 34097934 DOI: 10.1016/j.ijpsycho.2021.05.012] [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: 01/10/2021] [Revised: 05/13/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
Several studies have demonstrated that a dysregulated hypothalamic-pituitary-adrenal (HPA) axis is related to worse health status (e.g., depression, posttraumatic stress, or diabetes, among others). However, less is known about the association between the individual's perception of their own health status and HPA-axis functioning in healthy older people. The aim of the present study was to examine the relationship between HPA-axis functioning and health-related quality of life (HRQoL) in healthy older people. To do this, 140 healthy older people (69 men and 71 women) from 56 to 76 years old collected eight saliva samples on two consecutive weekdays to measure the diurnal cortisol cycle (i.e. awakening cortisol levels, cortisol awakening response (CAR), overall morning cortisol levels, change in the cortisol levels during the day, and bedtime cortisol levels). In addition, they completed the SF-36 questionnaire to obtain a measure of HRQoL (i.e. reflecting physical and mental functional health status). Results showed that higher awakening and bedtime cortisol levels and the CAR were associated with a better perception of both physical and mental health. In addition, the wake-to-bed cortisol slope was only positively related to physical health. No sex differences were found. These findings suggest that the awakening and bedtime cortisol levels and the CAR are the most relevant indices of diurnal cortisol secretion for understanding the relationship between HPA-axis functioning and HRQoL status in older people.
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Affiliation(s)
- Vanesa Hidalgo
- Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, 44003 Teruel, Spain; Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, 46010 Valencia, Spain.
| | - Matias M Pulopulos
- Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, 44003 Teruel, Spain; Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, 46010 Valencia, Spain
| | - Sara Puig-Perez
- Research Group of Psychology and Quality of Life, Valencian International University, 46002 Valencia, Spain
| | - Teresa Montoliu
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, 46010 Valencia, Spain
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, 46010 Valencia, Spain
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Abstract
PURPOSE OF REVIEW This review focuses on the concentration of cortisol in human hair as a biomarker of chronic stress in cardiovascular disease (CVD). We outline the cardiovascular consequences of cortisol excess and provide a comprehensive overview of recent studies investigating the relationship of hair cortisol with CVD. In addition, clinical implications and limitations of the evidence are discussed, together with directions for future research. RECENT FINDINGS Hair cortisol may be a reliable biomarker of chronic stress since it provides quantification of total cortisol secreted into hair over several weeks. A growing body of evidence suggests that elevated hair cortisol levels are associated with both the incidence of CVD and poorer recovery and treatment outcomes. Moreover, increased hair cortisol concentration has been linked with established cardiometabolic risk factors for CVD including high blood pressure, diabetes, and adiposity. Hair cortisol is a promising biomarker of chronic cortisol excess which may contribute to both the pathogenesis and prognosis of CVD. However, the current evidence relies on small-scale cross-sectional studies. Further research adopting longitudinal designs across larger samples of CVD patients and healthy participants is required to inform the development of novel evidence-based interventions.
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Affiliation(s)
- Eleonora Iob
- Department of Behavioural Science and Health, University College London, UCL, Gower Street, London, WC1E 6BT UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, UCL, Gower Street, London, WC1E 6BT UK
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Garcez A, Leite HM, Weiderpass E, Paniz VMV, Watte G, Canuto R, Olinto MTA. Basal cortisol levels and metabolic syndrome: A systematic review and meta-analysis of observational studies. Psychoneuroendocrinology 2018; 95:50-62. [PMID: 29800780 DOI: 10.1016/j.psyneuen.2018.05.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/06/2018] [Accepted: 05/15/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To perform a qualitative synthesis (systematic review) and quantitative analysis (meta-analysis) to summarize the evidence regarding the relationship between basal cortisol levels and metabolic syndrome (MetS) in adults. METHODS A systematic search was performed in the PubMed, Embase, and PsycINFO databases for observational studies on the association between basal cortisol levels and MetS. The quality of individual studies was assessed by the Newcastle-Ottawa score. A random effects model was used to report pooled quantitative results and the I2 statistic was used to assess heterogeneity. Egger's and Begg's tests were used to evaluate publication bias. RESULTS Twenty-six studies (19 cross-sectional and seven case-control) met the inclusion criteria for the systematic review. The majority was classified as having a low risk of bias and used established criteria for the diagnosis of MetS. Twenty-one studies provided data on basal cortisol levels as continuous values and were included in the meta-analysis; they comprised 35 analyses and 11,808 subjects. Pooled results showed no significant difference in basal cortisol levels between subjects with and without MetS (standardized mean difference [SMD] = 0.02, 95% confidence interval [CI]=-0.11 to 0.14). There was high heterogeneity between the studies when all comparisons were considered (I2 = 83.1%;p < 0.001). Paradoxically, meta-analysis of studies evaluating saliva samples showed no significantly lower basal cortisol levels among subjects with MetS (SMD=-0.18, 95% CI=-0.37 to 0.01), whereas those studies that evaluated serum samples (SMD = 0.11, 95% CI=-0.02 to 0.24) and urine samples (SMD = 0.73, 95% CI=-0.40 to 1.86) showed no significantly higher basal cortisol levels among subjects with MetS. In the subgroup and meta-regression analyses, a significant difference in basal cortisol levels was observed according to study design, population base, age, gender, cortisol level assessment method, and study quality. CONCLUSION This systematic review and meta-analysis does not reveal any association between basal cortisol levels and MetS based on results of observational studies. The results of a random-effect meta-analysis showed no significant difference in basal cortisol levels between subjects with and without MetS. The present findings should be considered in order to help future studies.
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Affiliation(s)
- Anderson Garcez
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil
| | - Heloísa Marquardt Leite
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Cancer Registry of Norway, Institute of Population-based Cancer Research, Department of Research, Oslo, Norway; Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, Tromsø, Norway; University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Vera Maria Vieira Paniz
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil
| | - Guilherme Watte
- Department of Respiratory Medicine and Thoracic Surgery, Pavilhão Pereira Filho, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Raquel Canuto
- Department of Nutrition, Federal University of Rio Grande do Sul State (UFRGS), Porto Alegre, RS, Brazil
| | - Maria Teresa Anselmo Olinto
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil; Department of Nutrition, Federal University of Health Science of Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
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van Aken M, Oosterman J, van Rijn T, Ferdek M, Ruigt G, Kozicz T, Braat D, Peeters A, Nap A. Hair cortisol and the relationship with chronic pain and quality of life in endometriosis patients. Psychoneuroendocrinology 2018; 89:216-222. [PMID: 29414035 DOI: 10.1016/j.psyneuen.2018.01.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 12/15/2017] [Accepted: 01/02/2018] [Indexed: 12/30/2022]
Abstract
Endometriosis is a chronic estrogen-dependent disease in which pelvic pain is the dominant symptom. The negative effects of endometriosis on the life of women with this disease can be a cause of stress. Stress levels can be measured in different ways, mostly reflecting acute stress responses. Hair cortisol measurements are a reflection of long-term systematic cortisol levels. In this study a first attempt is made to measure cortisol levels in hair of endometriosis patients in comparison with healthy controls. Moreover, it is explored whether chronic pain symptoms as well as different aspects of Health Related Quality of Life (HRQoL) are associated with hair cortisol levels in women with endometriosis. Results show that the mean hair cortisol level is significantly higher in women with endometriosis compared to healthy controls (p = 0.018). There is a positive correlation between hair cortisol level and HRQoL in patients but not in controls (Rho 0.426). The level of hair cortisol does not correlate with the reported pain intensity in patients (Rho -0.082). These results are indicative of an altered HPA-axis function in endometriosis patients, possibly caused by higher chronic stress level in these patients. Moreover, a potential explanation for the positive correlation of cortisol with the HRQoL in these patients is that patients with a high HRQoL have an adequate stress response by increasing their cortisol levels as a response to physical and emotional stress induced by the endometriosis.
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Affiliation(s)
- Mieke van Aken
- Department of Anatomy, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Gynaecology and Obstetrics, Rijnstate, Arnhem, The Netherlands.
| | - Joukje Oosterman
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Tineke van Rijn
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Magdalena Ferdek
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Psychology Laboratory, Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Gé Ruigt
- Clinical Consultancy for Neuroscience Drug Development BV, Oss, The Netherlands
| | - Tamas Kozicz
- Department of Anatomy, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Didi Braat
- Department of Obstetrics and Gynaecology, Radboud University Medical Centre Nijmegen, The Netherlands
| | - Ard Peeters
- Department of Anatomy, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Annemiek Nap
- Department of Gynaecology and Obstetrics, Rijnstate, Arnhem, The Netherlands
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Ragnarsson O, Trimpou P, Oleröd G, Landin-Wilhelmsen K. Urinary free cortisol and androgens in the population-Hormone interactions and the relationship with body composition and bone status. Steroids 2016; 115:154-159. [PMID: 27639100 DOI: 10.1016/j.steroids.2016.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/23/2016] [Accepted: 09/11/2016] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Abnormal secretion of thyroid hormones, growth hormone, cortisol and androgens influences body composition. We hypothesised that higher cortisol excretion, in combination with higher androgen and IGF-I concentrations, had a synergistic, favourable effect on body mass and bone. DESIGN, PATIENTS AND METHODS This was a cross-sectional study on a population sample of 290 women and 93men. The mean age was 65.4±7.2yearsinwomen and 59.7±10.0yearsinmen. Body composition was assessed with bioimpedance, and skeletal health with calcaneal quantitative ultrasound and fracture rate. The influence of urinary free cortisol (UFC), serum DHEAs (women), testosterone (men), free T4andIGF-I on the outcome was studied with regression analyses adjusted for age and body mass index. RESULTS In women, higher concentrations of UFC, DHEAs, IGF-I and lower free T4, were associated with higher fat-free mass. Only a higher UFC concentration was associated with favourable calcaneal measurements. In men, higher testosterone was associated with higher fat-free mass and lower fat mass. Higher IGF-I concentration, but not UFC, was independently associated with higher fat-free mass in men. Interaction analyses did not reveal any additive effects of hormones on body composition or bone in either sex. In both men and women, only age was associated with osteoporotic fractures. CONCLUSION Serum concentrations of androgens together with IGF-I were positively associated with body composition in both sexes. Urinary cortisol was positively associated with fat-free mass and bone status in women only. Increasing age, but not hormones, was the major determinant of osteoporotic fractures in this population sample.
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Affiliation(s)
- Oskar Ragnarsson
- Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Penelope Trimpou
- Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Göran Oleröd
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kerstin Landin-Wilhelmsen
- Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Compare A, Marchettini P, Zarbo C. Risk Factors Linked to Psychological Distress, Productivity Losses, and Sick Leave in Low-Back-Pain Employees: A Three-Year Longitudinal Cohort Study. PAIN RESEARCH AND TREATMENT 2016; 2016:3797493. [PMID: 27635259 PMCID: PMC5008025 DOI: 10.1155/2016/3797493] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/02/2016] [Accepted: 07/28/2016] [Indexed: 11/17/2022]
Abstract
Background. Low back pain (LBP) is one of the most common health problems worldwide. Purpose. To investigate the link between baseline demographic and occupational, medical, and lifestyle data with following psychological and occupational outcomes in a large sample of employees with LBP over a 3-year period. Study Design. Three-year prospective cohort study. Methods. Italian-speaking employees (N = 4492) with a diagnosis of LBP were included. Screening at Time 1 was done in order to collect information about severity and classification of LBP, demographic, lifestyle, and occupational status data. Psychological distress (PGWBI) and occupational burden were assessed after 3 years. Results. After 3 years, employees with LBP not due to organic causes had an increased risk of psychological distress. Gender appears to be an important variable for following occupational burden. Indeed, being a white-collar man with a LBP without organic causes seems to be a protective factor for following work outcomes, while being a white-collar woman with a LBP not due to organic causes appears to be a risk factor for subsequent sick leave. Moreover, LBP severity affects psychological and occupational outcomes. Conclusion. Our findings have several implications that could be considered in preventive and supportive programs for LBP employees.
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Affiliation(s)
- Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
- Human Factors and Technologies in Healthcare Research Centre, University of Bergamo, Bergamo, Italy
| | - Paolo Marchettini
- Pain Medicine Centre, Centro Diagnostico Italiano, Milan, Italy
- Pain Medicine Centre, Ospedale San Raffaele, Milan, Italy
- University of Applied Science of Southern Switzerland, Pain Pathophysiology and Therapy Programme, Manno, Switzerland
| | - Cristina Zarbo
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
- Human Factors and Technologies in Healthcare Research Centre, University of Bergamo, Bergamo, Italy
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