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Karapicak E, Dulger K, Sahin E, Alver A. Investigation of the effect of music listened to by patients with moderate dental anxiety during restoration of posterior occlusal dental caries. Clin Oral Investig 2023:10.1007/s00784-023-04966-8. [PMID: 36959385 PMCID: PMC10036243 DOI: 10.1007/s00784-023-04966-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/19/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE The aim of this randomized controlled study was to investigate the effect of music therapy during restorative dental treatments on patients with moderate dental anxiety. MATERIALS AND METHODS Seventy patients were determined to have moderate dental anxiety by the Modified Dental Anxiety Scale (MDAS) and were divided randomly into two groups (n = 35). The first group did not listen to music during their restorative treatment (control group), and the second group listened to music of their choice (experimental group). Systolic blood pressure, diastolic blood pressure, heart rate, oxygen saturation, and body temperature were measured three times for each patient: once before the treatment, once after their dental caries were removed, and once at the end of the treatment. Salivary cortisol samples were taken from each patient before and after the treatment. The MDAS was re-administered to the patients at the end of the treatment, and the data were analyzed statistically. RESULTS Only the diastolic blood pressure (P = 0.042) and the MDAS scores of the experimental group (P = 0.001) were significantly lower than the control group at the end of the treatment. CONCLUSION While music listening did not have an effect on the physiologic parameters of the patients during restorative treatment, it decreased the MDAS scores of the patients. CLINICAL RELEVANCE Although music therapy did not affect the physiological parameters during the restorative dental treatment, it may help to reduce patients' self reported anxiety level.
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Affiliation(s)
- Elif Karapicak
- Department of Restorative Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Kivanc Dulger
- Department of Restorative Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey.
| | - Elif Sahin
- Department of Medical Biochemistry, Graduate School of Medical Science, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet Alver
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Moyers SA, Hagger MS. Physical Activity and Cortisol Regulation: A Meta-Analysis. Biol Psychol 2023; 179:108548. [PMID: 37001634 DOI: 10.1016/j.biopsycho.2023.108548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
Physical activity participation is associated with effective stress coping, indicated by decreases in both physiological stress reactivity and perceived stress. Quantifying the effect of physical activity on the diurnal regulation of one key physiological stress indicator, the stress hormone, cortisol, across studies may demonstrate the extent to which physical activity participation is associated with diurnal HPA axis regulation. We meta-analyzed studies examining relations between physical activity participation and indices of HPA axis regulation: the diurnal cortisol slope and the cortisol awakening response. We also examined moderators of the relation. The analysis revealed a small, non-zero negative averaged correlation between physical activity and the diurnal cortisol slope (r = -0.043, 95% CI [-0.080, -0.004]). Examination of sample sociodemographic differences, study design characteristics, cortisol measurement methods, and physical activity variables as moderators revealed few effects on the relation between physical activity and diurnal cortisol slope. We did not observe lower levels of variability in the mean cortisol awakening response at higher levels of physical activity participation, and moderator analyses showed little evidence of reductions in heterogeneity for this effect. We found some evidence of systematic publication bias. Findings suggest higher physical activity is associated with a steeper diurnal cortisol slope. However, the cortisol awakening response did not differ by physical activity level. Future studies testing the physical activity and cortisol regulation association should use standardized physical activity measures, follow guidelines for better quality cortisol sampling collection and analysis, and test relations in large-scale empirical studies to confirm the direction and causality of the effect.
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Affiliation(s)
- Susette A Moyers
- Department of Psychological Sciences, University of California, Merced, USA; Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Martin S Hagger
- Department of Psychological Sciences, University of California, Merced, USA; Health Sciences Research Institute, University of California, Merced, USA; Faculty of Sport and Health Sciences, University of Jyväskylä, Finland; School of Applied Psychology, Griffith University, Australia
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3
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Glucocorticoid-induced microRNA-378 signaling mediates the progression of pancreatic cancer by enhancing autophagy. Cell Death Dis 2022; 13:1052. [PMID: 36535942 PMCID: PMC9763328 DOI: 10.1038/s41419-022-05503-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
Glucocorticoids (GCs) are widely used in tumor therapy to reduce tumor growth, inflammation, edema, and other side effects. Controversially, GCs may also cause the progression of highly aggressive pancreatic ductal adenocarcinoma (PDAC). Because microRNA (miR) and autophagy signaling support the invasive growth of PDAC, we asked whether these mechanisms may be targeted by GCs. Six established human PDAC cell lines, tissue from patients who received GC medication (n = 35) prior to surgery, or not (n = 35), and tumor xenografts were examined by RT‒qPCR, transmission electron microscopy (TEM), monodansylcadaverine (MDC) staining, immunohistochemistry, in situ hybridization, gene array and Kaplan‒Meier analysis with bioinformatics, and MTT, western blot, colony, spheroid, migration, and invasion assays. We found that various GCs, including dexamethasone (DEX), induced typical features of macroautophagy with the appearance of autolysosomes, enhanced LC3-II, decreased SQSTM1/p62 expression and induced epithelial-mesenchymal transition (EMT) and gemcitabine resistance. The GC receptor (GR) antagonist mifepristone (RU486) counteracted DEX-induced autophagy features, suggesting that the GC-GR complex is involved in the induction of autophagy. The autophagy-related miR-378i and miR-378a-3p were selected as the top upregulated candidates, and their high expression in PDAC patient tissue correlated with low survival. siRNA-mediated downregulation of miR-378 inhibited DEX-induced autophagy, and tumor progression. Bioinformatics confirmed the contribution of miR-378 to the regulation of signaling networks involved in GC-induced autophagy and tumor progression. The construction of a molecular docking model revealed stable binding of miR-378 to the DEX-GR complex, suggesting direct regulation. These substantial, novel, in-depth data reveal that GCs favor autophagy-mediated cancer progression by inducing miR-378 and GR binding and implicate GR and miR-378 as new therapeutic targets.
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Michaud DS, Thomson EM, van Oosterhout P, McNamee JP. Hair cortisol as a viable tool for the assessment of an association between environmental noise exposure and chronic stress. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:866. [PMID: 36050175 DOI: 10.1121/10.0012887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/07/2022] [Indexed: 06/15/2023]
Abstract
Entrenched in the well-established link between stress and health, noise exposure as a potential contributor to stress-related health effects receives tremendous attention. Indeed, exposure to noise can act as a stressor as evidenced through increased heart rate, blood pressure, adrenaline, epinephrine, and cortisol. Cortisol is secreted from the adrenal glands in response to stressor-induced activation of the hypothalamic-pituitary-adrenal axis. For assessment of environmental noise and stress, repeated sampling in blood, saliva, or urine is necessary to evaluate the association between environmental noise exposure and protracted changes in cortisol. Controlling for the many variables that influence the secretion of cortisol at discrete sampling intervals is challenging. Studies suggest that systemically produced cortisol integrates and remains in hair as it grows, providing a measure that integrates a cortisol response over a longer period, circumventing several limitations associated with multiple sampling. Robust evidence supports the integration of cortisol into hair, yet recent studies call into question the notion that cortisol is retained with growth. The current paper discusses the strengths and limitations of hair cortisol analysis with an emphasis on its utility as a measure of chronic stress in environmental noise studies.
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Affiliation(s)
- David S Michaud
- Health Canada, Environmental and Radiation Health Sciences Directorate, Consumer and Clinical Radiation Protection Bureau, 775 Brookfield Road, Ottawa, Ontario K1A 1C1, Canada
| | - Errol M Thomson
- Health Canada, Environmental and Radiation Health Sciences Directorate, Environmental Health Science and Research Bureau, 251 Sir Frederick Banting Driveway, Tunney's Pasture, Ottawa, Ontario K1A 0K9, Canada
| | - Priya van Oosterhout
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada
| | - James P McNamee
- Health Canada, Environmental and Radiation Health Sciences Directorate, Consumer and Clinical Radiation Protection Bureau, 775 Brookfield Road, Ottawa, Ontario K1A 1C1, Canada
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Rajaee M, Karson SN, McCullough AM. Teachers on the margins: How low-income public schools burden our teachers. Work 2022; 72:949-965. [DOI: 10.3233/wor-210010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Teachers experience high work-related stress, which can lead to missed workdays and lower quality of life. OBJECTIVE: The objective of this exploratory pilot study was to assess occupational and environmental stressors in public school districts by income level to examine the influence these stressors have on teachers perceived stress and biological stress response. METHODS: Fifty-nine teachers were recruited from four school districts in Michigan (three low-income and one high-income). Participants completed a self-administered survey on teaching stressors, health, and demographics. Stress response was measured through blood pressure, heart rate, and salivary cortisol. Six salivary cortisol measurements were collected for each participant; three in the afternoon and three in the evening. Each teacher’s classroom and school underwent an environmental assessment on quality and proximity to environmental hazards. RESULTS: Teachers at low-income school districts had significantly higher afternoon cortisol levels, lower self-reported health, higher body mass index, higher perceived teaching stressors, and worked at schools within one km of a greater number of environmentally-contaminated sites, in comparison to their high-income school district counterparts. CONCLUSIONS: This research aims to inform future interventions that could lessen occupational and environmental stressors for teachers, improve teacher health outcomes and retention, and impact student success rates.
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Affiliation(s)
- Mozhgon Rajaee
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Samantha N. Karson
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Ashley M. McCullough
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
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Kovac K, Vincent GE, Paterson JL, Reynolds A, Aisbett B, Hilditch CJ, Ferguson SA. The impact of a short burst of exercise on sleep inertia. Physiol Behav 2021; 242:113617. [PMID: 34606883 DOI: 10.1016/j.physbeh.2021.113617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/16/2021] [Accepted: 09/29/2021] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVES Determine whether 30 s (s) of exercise performed upon waking can reduce sleep inertia and accelerate an increase in the cortisol awakening response (CAR) and core body temperature (CBT), compared to when sedentary. METHODS Fifteen participants (mean age ± SD, 25.9 ± 5.9 years; six females) completed a counterbalanced, repeated measures, in-laboratory study involving three single experimental nights, each separated by a four-night recovery period. Participants were woken following a 2-h nap (2400-0200) and completed a cycling bout of high-intensity (30-s sprint), low-intensity (30 s at 60% maximum heart rate), or no exercise (sedentary). Sleep inertia testing (eight batteries, 15-min intervals) began immediately following and included measures of subjective sleepiness (Karolinska Sleepiness Scale) and cognitive performance tasks (psychomotor vigilance, serial addition and subtraction, and spatial configuration). CBT was measured continuously via an ingestible telemetric capsule. The CAR was determined using salivary cortisol samples collected at 0, 30 and 45 min post-waking. Data were analysed using mixed effects analysis of variance. RESULTS There was no difference in cognitive performance or CBT between conditions. Participants felt less sleepy in the high-intensity condition, followed by the low-intensity and sedentary conditions (p = .003). The CAR was greatest in the high-intensity condition, followed by the sedentary condition, and low-intensity condition (p < 0.001), with no differences between the low-intensity and sedentary conditions. CONCLUSIONS Those who exercise upon waking should be aware that while they may feel more alert, they may not be performing better than if they had not exercised. Future research should investigate whether exercise of different duration or timing may impact sleep inertia.
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Affiliation(s)
- Katya Kovac
- Central Queensland University, Appleton Institute, School of Health, Medical and Applied Sciences, Wayville, Adelaide, Australia.
| | - Grace E Vincent
- Central Queensland University, Appleton Institute, School of Health, Medical and Applied Sciences, Wayville, Adelaide, Australia
| | - Jessica L Paterson
- Central Queensland University, Appleton Institute, School of Health, Medical and Applied Sciences, Wayville, Adelaide, Australia
| | - Amy Reynolds
- Central Queensland University, Appleton Institute, School of Health, Medical and Applied Sciences, Wayville, Adelaide, Australia
| | - Brad Aisbett
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Cassie J Hilditch
- Fatigue Countermeasures Laboratory, San José State University, San José, CA, USA
| | - Sally A Ferguson
- Central Queensland University, Appleton Institute, School of Health, Medical and Applied Sciences, Wayville, Adelaide, Australia
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Stoffel M, Neubauer AB, Ditzen B. How to assess and interpret everyday life salivary cortisol measures: A tutorial on practical and statistical considerations. Psychoneuroendocrinology 2021; 133:105391. [PMID: 34607270 DOI: 10.1016/j.psyneuen.2021.105391] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 12/23/2022]
Abstract
Salivary cortisol has been the central marker in psychoneuroendocrinological stress research for three decades. Given the technological possibilities to assess data in ecologically valid circumstances, many studies have implemented longitudinal assessments of salivary cortisol in study participants' everyday life. Such studies bear the potential to understand real-life associations of cortisol with psychological traits, states, and health variables. Furthermore, changes in the neuroendocrine regulation and in cortisol reactivity can be used to evaluate the effects of behavioral interventions in real-life circumstances. While standardized paradigms have been developed to measure cortisol in laboratory settings, there is high heterogeneity in the assessment, statistical processing, and interpretation of everyday life cortisol measures. This methodological tutorial aims at summarizing important knowledge which had been accumulated during the past two decades and which could be used to set up an ambulatory assessment study focusing on salivary cortisol in everyday life. Practical advice for possible strategies at all stages of the research process is outlined in detail. Additionally, an example on how to statistically process cortisol data in a multilevel framework (including syntax) is provided. In these analyses, we investigate within- and between-person research questions regarding the association between stress and cortisol in daily life. Thus, the present work (a) can be used as tutorial for setting up everyday life studies focusing on the assessment of salivary cortisol, and (b) can be useful to avoid inconsistencies in study planning, data assessment and data processing in future studies.
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Affiliation(s)
- Martin Stoffel
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Bergheimer Straße 20, 69115 Heidelberg, Germany; Ruprecht-Karls University Heidelberg, Germany.
| | - Andreas B Neubauer
- Department for Education and Human Development, DIPF
- Leibniz Institute for Research and Information in Education, Rostocker Straße 6, 60323 Frankfurt/Main, Germany; Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Rostocker Straße 6, 60323 Frankfurt/Main, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, University Hospital, Heidelberg University, Bergheimer Straße 20, 69115 Heidelberg, Germany; Ruprecht-Karls University Heidelberg, Germany.
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Zane L, Ensminger DC, Vázquez-Medina JP. Short-term elevations in glucocorticoids do not alter telomere lengths: A systematic review and meta-analysis of non-primate vertebrate studies. PLoS One 2021; 16:e0257370. [PMID: 34597314 PMCID: PMC8486123 DOI: 10.1371/journal.pone.0257370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/29/2021] [Indexed: 12/11/2022] Open
Abstract
Background The neuroendocrine stress response allows vertebrates to cope with stressors via the activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis, which ultimately results in the secretion of glucocorticoids (GCs). Glucocorticoids have pleiotropic effects on behavior and physiology, and might influence telomere length dynamics. During a stress event, GCs mobilize energy towards survival mechanisms rather than to telomere maintenance. Additionally, reactive oxygen species produced in response to increased GC levels can damage telomeres, also leading to telomere shortening. In our systematic review and meta-analysis, we tested whether GC levels impact telomere length and if this relationship differs among time frame, life history stage, or stressor type. We hypothesized that elevated GC levels are linked to a decrease in telomere length. Methods We conducted a literature search for studies investigating the relationship between telomere length and GCs in non-human vertebrates using four search engines: Web of Science, Google Scholar, Pubmed and Scopus, last searched on September 27th, 2020. This review identified 31 studies examining the relationship between GCs and telomere length. We pooled the data using Fisher’s Z for 15 of these studies. All quantitative studies underwent a risk of bias assessment. This systematic review study was registered in the Open Science Framework Registry (https://osf.io/rqve6). Results The pooled effect size from fifteen studies and 1066 study organisms shows no relationship between GCs and telomere length (Fisher’s Z = 0.1042, 95% CI = 0.0235; 0.1836). Our meta-analysis synthesizes results from 15 different taxa from the mammalian, avian, amphibian groups. While these results support some previous findings, other studies have found a direct relationship between GCs and telomere dynamics, suggesting underlying mechanisms or concepts that were not taken into account in our analysis. The risk of bias assessment revealed an overall low risk of bias with occasional instances of bias from missing outcome data or bias in the reported result. Conclusion We highlight the need for more targeted experiments to understand how conditions, such as experimental timeframes, stressor(s), and stressor magnitudes can drive a relationship between the neuroendocrine stress response and telomere length.
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Affiliation(s)
- Lauren Zane
- Department of Integrative Biology, University of California, Berkeley, CA, United States of America
- * E-mail:
| | - David C. Ensminger
- Department of Integrative Biology, University of California, Berkeley, CA, United States of America
- Department of Biological Sciences, San Jose State University, San Jose, CA, United States of America
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Uçar C, Özgöçer T, Yıldız S. Effects of late-night eating of easily-or slowly-digestible meals on sleep, hypothalamo-pituitary-adrenal axis, and autonomic nervous system in healthy young males. Stress Health 2021; 37:640-649. [PMID: 33426778 DOI: 10.1002/smi.3025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/18/2020] [Accepted: 12/31/2020] [Indexed: 01/26/2023]
Abstract
Aim of the current study was to assess the effects of the digestibility of late-night high calorie meal on sleep and the activities of the hypothalamo-pituitary-adrenal (HPA) and autonomous nervous system (ANS) in healthy young males. For that purpose, effects of an easily digestible meal (starch + sugar-rich meal, SSR, i.e., dessert) or a slowly digestible meal (protein + fat-rich, PFR, i.e. kebab) were investigated in a crossover design in 16 participants (20-26 year old). They did not eat anything after 07:00 PM on Day 0; had an SSR meal on Day 1 and a PFR meal on Day 2 at 10:00 PM. HPA and ANS activities were measured by cortisol awakening response (CAR) and heart rate variability (HRV), respectively. The participants provided salivary samples for CAR; had a 5-min continuous electrocardiogram recording for HRV; and filled in sleep questionnaires. Late-night eating of SSR and PFR diets increased the area under the curve of CAR (p < 0.05) but did not affect HRV parameters (p > 0.05). PFR meal significantly disturbed sleep (p < 0.05). The data suggests that increased activity of HPA, but not ANS, might be involved in pathophysiology of late-night eating and that this might be due to disturbed sleep if slowly-digestible meal is consumed.
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Affiliation(s)
- Cihat Uçar
- Department of Physiology, Faculty of Medicine, University of Adıyaman, Adıyaman, Turkey
| | - Tuba Özgöçer
- Department of Physiology, Faculty of Medicine, University of Harran, Şanlıurfa, Turkey
| | - Sedat Yıldız
- Department of Physiology, Faculty of Medicine, University of Inonu, Malatya, Turkey
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Bonato M, La Torre A, Saresella M, Marventano I, Merati G, Banfi G, Vitale JA. Effect of High-Intensity Interval Training Versus Small-Sided Games Training on Sleep and Salivary Cortisol Level. Int J Sports Physiol Perform 2020; 15:1237-1244. [PMID: 32871556 DOI: 10.1123/ijspp.2019-0498] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/10/2019] [Accepted: 12/12/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE The authors compared sleep quality and salivary cortisol concentration after high-intensity interval training (HIIT) and small-sided games (SSGs) performed at the habitual training time in nonprofessional male soccer players. METHODS A total of 32 players (age = 24 [6] y, height = 1.77 [0.06] m, and body mass = 75 [12] kg) were randomized into an HIIT group or an SSG group. Actual sleep time, sleep efficiency (SE), sleep latency, immobility time (IT), moving time (MT), and fragmentation index were monitored using actigraphy before (PRE) and 2 nights after (POST 1 and POST 2) the training session. Salivary cortisol levels were measured before (PRE) and after (POST) training. Cortisol awakening response was evaluated. RESULTS Significant intragroup differences in the HIIT group were noted for actual sleep time (P < .0001), SE (P < .0001), sleep latency (P = .047), IT (P < .0001), MT (P < .0001), and fragmentation index (P < .0001) between PRE and POST 1 and for SE (P = .035), IT (P = .004), MT (P = .006), and fragmentation index (P = .048) between PRE and POST 2. Intergroup differences for actual sleep time (P = .014), SE (P = .048), IT (P < .0001), and MT (P = .046) were observed between the HIIT and the SSGs group at POST 1 were detected. Significant intragroup variations were observed in PRE and POST salivary cortisol levels (P < .0001 for HIIT; P = .0003 for SSGs) and cortisol awakening response (P < .0001 for HIIT; P < .0001 for SSGs). Significant intergroup differences between the HIIT and the SSGs group were found at POST (P < .0001) and in cortisol awakening response (P = .017). CONCLUSIONS Changes in actigraphy-based sleep parameters and salivary cortisol levels were greater after an acute session of HIIT than SSGs in this sample of nonprofessional male soccer players.
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Current methods for stress marker detection in saliva. J Pharm Biomed Anal 2020; 191:113604. [PMID: 32957066 PMCID: PMC7474833 DOI: 10.1016/j.jpba.2020.113604] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023]
Abstract
Introduction of relevant biomarkers in stress conditions. Reference ranges of biomarkers in normal conditions. Saliva as easy-accessible specimen. Review of analytical methods for biomarker determination in saliva. Possibilities for design of point-of-care devices.
Stress and stress-related diseases are leading to drastic consequences in private and professional life. Therefore, the need for stress prevention strategies is of personal and economic interest. Especially during the recent period related to covid-19 outbreak and lock-down, an ongoing discussion of increasing stress etiology is reported. Biomarker analysis may help to assist diagnosis and classification of stress-related diseases and therefore support therapeutical decisions. Due to its non-invasive sampling, the analysis of saliva has become highly attractive compared to the detection methods in other specimen. This review article summarizes the status of research, innovative approaches, and trends. Scientific literature published since 2011 was excerpted with concentration on the detection of up to seven promising marker substances. Most often reported cortisol represents the currently best evaluated stress marker, while norepinephrine (noradrenaline) or its metabolite 3-methoxy-4-hydroxyphenylglycol is also a quite commonly considered stress marker. Other complementary stress marker candidates are testosterone, dehydroepiandrosterone (DHEA) and its sulfonated analogue DHEA-S, alpha-amylase, secretory immunoglobulin A, and chromogranin A. Several working groups are researching in the field of stress marker detection to develop reliable, fast, and affordable methods. Analytical methods reported mainly focused on immunological and electrochemical as well as chromatographic methods hyphenated to mass spectrometric detection to yield the required detection limits.
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12
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A systematic review of the Trier Social Stress Test methodology: Issues in promoting study comparison and replicable research. Neurobiol Stress 2020; 13:100235. [PMID: 33344691 PMCID: PMC7739033 DOI: 10.1016/j.ynstr.2020.100235] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/27/2022] Open
Abstract
Since its development in 1993, the Trier Social Stress Test (TSST) has been used widely as a psychosocial stress paradigm to activate the sympathetic nervous system and hypothalamic-pituitary-adrenal axis (HPAA) stress systems, stimulating physiological functions (e.g. heart rate) and cortisol secretion. Several methodological variations introduced over the years have led the scientific community to question replication between studies. In this systematic review, we used the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) to synthesize procedure-related data available about the TSST protocol to highlight commonalities and differences across studies. We noted significant discrepancies across studies in how researchers applied the TSST protocol. In particular, we highlight variations in testing procedures (e.g., number of judges, initial number in the arithmetic task, time of the collected saliva samples for cortisol) and discuss possible misinterpretation in comparing findings from studies failing to control for variables or using a modified version from the original protocol. Further, we recommend that researchers use a standardized background questionnaire when using the TSST to identify factors that may influence physiological measurements in tandem with a summary of this review as a protocol guide. More systematic implementation and detailed reporting of TSST methodology will promote study replication, optimize comparison of findings, and foster an informed understanding of factors affecting responses to social stressors in healthy people and those with pathological conditions.
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13
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Kovac K, Ferguson SA, Paterson JL, Aisbett B, Hilditch CJ, Reynolds AC, Vincent GE. Exercising Caution Upon Waking-Can Exercise Reduce Sleep Inertia? Front Physiol 2020; 11:254. [PMID: 32317980 PMCID: PMC7155753 DOI: 10.3389/fphys.2020.00254] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/05/2020] [Indexed: 11/13/2022] Open
Abstract
Sleep inertia, the transitional state of reduced alertness and impaired cognitive performance upon waking, is a safety risk for on-call personnel who can be required to perform critical tasks soon after waking. Sleep inertia countermeasures have previously been investigated; however, none have successfully dissipated sleep inertia within the first 15 min following waking. During this time, on-call personnel could already be driving, providing advice, or performing other safety-critical tasks. Exercise has not yet been investigated as a sleep inertia countermeasure but has the potential to stimulate the key physiological mechanisms that occur upon waking, including changes in cerebral blood flow, the cortisol awakening response, and increases in core body temperature. Here, we examine these physiological processes and hypothesize how exercise can stimulate them, positioning exercise as an effective sleep inertia countermeasure. We then propose key considerations for research investigating the efficacy of exercise as a sleep inertia countermeasure, including the need to determine the intensity and duration of exercise required to reduce sleep inertia, as well as testing the effectiveness of exercise across a range of conditions in which the severity of sleep inertia may vary. Finally, practical considerations are identified, including the recommendation that qualitative field-based research be conducted with on-call personnel to determine the potential constraints in utilizing exercise as a sleep inertia countermeasure in real-world scenarios.
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Affiliation(s)
- Katya Kovac
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Sally A Ferguson
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Jessica L Paterson
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Brad Aisbett
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Cassie J Hilditch
- Fatigue Countermeasures Laboratory, San José State University Research Foundation, Moffett Field, CA, United States
| | - Amy C Reynolds
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
| | - Grace E Vincent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, SA, Australia
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14
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Smyth N, Rossi E, Wood C. Effectiveness of stress-relieving strategies in regulating patterns of cortisol secretion and promoting brain health. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 150:219-246. [PMID: 32204833 DOI: 10.1016/bs.irn.2020.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Stress leads to ill-health and disease, and with today's fast-pace western society, engaging in strategies to relieve stress is crucial for good health across the life-course. Activities such as focusing on positive characteristics, art/music therapies, mindfulness, yoga and engaging with nature and/or physical activity have been shown to reduce stress and enhance well-being. It is thought that patterns of cortisol secretion, which are regulated by the brain, are a key mediator of stress-disease and well-being-health links. Measurement of cortisol in saliva is a non-invasive and ecologically valid tool for detecting early changes in brain health, as well as evaluating the effectiveness of strategies in relieving stress and improving brain health as well as monitoring stress-related brain changes. This chapter will review the evidence that engaging in stress-relieving strategies promotes regulation and/or restoration of patterns of cortisol secretion. If such strategies are found to be effective in healthy populations, they could potentially inform ways of promoting brain health and the prevention or delay of clinical disorders involving disorders in the brain (e.g., Parkinson's disease) and symptoms experienced with such disorders. To inform this field of research, recommendations are provided for the use of salivary cortisol as a marker of early monitoring of brain health and effectiveness of stress-alleviating interventions.
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Affiliation(s)
- Nina Smyth
- Psychology, School of Social Sciences, University of Westminster, London, England.
| | - Elena Rossi
- Psychology, School of Social Sciences, University of Westminster, London, England
| | - Carly Wood
- School of Life Sciences, University of Westminster, London, England
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15
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16
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Strahler J, Nater UM, Skoluda N. Associations between Health Behaviors and Factors on Markers of Healthy Psychological and Physiological Functioning: a Daily Diary Study. Ann Behav Med 2019; 54:22-35. [DOI: 10.1093/abm/kaz018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background
Cross-sectional and experimental knowledge highlight the contribution of various health-promoting behaviors, such as physical activity, regular sleep, and healthy nutrition to mental and physical health. Beyond these well-studied lifestyle behaviors, music listening and perceived respect in social interactions are just recently proposed everyday life experiences, which may act as health-promoting factors.
Purpose
This study tested the simultaneous contribution of several health-promoting behaviors and factors and examined listening to music and positive social interaction by means of perceived respect as new potentially preventive and health-promoting behaviors and factors using an ambulatory assessment design.
Methods
Seventy-seven young healthy adults (38 women, 23.9 ± 4.5 years) completed surveys on their psychological state (i.e., mood, stress, and fatigue) five times a day for four consecutive days. A saliva sample was collected with each data entry to explore the physiological stress markers salivary cortisol, alpha-amylase, and flow rate as further outcome variables. As predictors, perceived respect, self-reported physical activity, the sleep’s restfulness, daily coffee, alcohol, vegetable/fruit consumption, and music listening behavior were recorded.
Results
Overall, restful sleep, mean daily perceived respect, and listening to music were most clearly associated with more positive psychological states, that is, better mood and lower fatigue and perceived stress. Associations with daily alcohol, coffee, and vegetable/fruit consumption appeared rather minor. While perceived respect scores were associated with lower daily cortisol output, coffee consumption was positively related to daily cortisol and alpha-amylase. Self-reported physical activity was unrelated to either outcome measure.
Conclusions
These findings provide important insights regarding potential resources of health (i.e., music and respect), their covariation, and which psycho-physiological mechanisms may underlie the links between health factors and well-being. Findings also have implications for the development of interventions aiming to increase resilience and foster health. Here, strategies for improving sleep quality, the use of music, and approaches that emphasize mutual respect and appreciation appear useful additions.
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Affiliation(s)
- Jana Strahler
- Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany
- Psychotherapy and Systems Neuroscience, Department of Psychology and Sport Science, Justus Liebig University Giessen, Giessen, Germany
| | - Urs M Nater
- Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, University of Vienna, Vienna, Austria
| | - Nadine Skoluda
- Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Medical School, University of Tübingen, Tübingen, Germany
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, University of Vienna, Vienna, Austria
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17
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Hammond TT, Au ZA, Hartman AC, Richards-Zawacki CL. Assay validation and interspecific comparison of salivary glucocorticoids in three amphibian species. CONSERVATION PHYSIOLOGY 2018; 6:coy055. [PMID: 30279992 PMCID: PMC6158758 DOI: 10.1093/conphys/coy055] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/30/2018] [Accepted: 09/04/2018] [Indexed: 05/23/2023]
Abstract
Amphibians are one of the most threatened groups of species, facing stressors ranging from habitat degradation and pollution to disease and overexploitation. Stress hormones (glucocorticoids, GCs) provide one quantitative metric of stress, and developing non-invasive methods for measuring GCs in amphibians would clarify how diverse environmental stressors impact individual health in this taxonomic group. Saliva is an advantageous matrix for quantifying GCs, as it is sampled less invasively than plasma while still detecting both baseline and acute elevation of GCs within a short timeframe. Little work has employed this method in amphibian species, and it has never been pharmacologically and biologically validated. Here, we conduct analytical, pharmacological and biological validation experiments for measuring salivary corticosterone in three amphibian species: the American bullfrog (Rana catesbeiana), the green frog (Rana clamitans) and the northern leopard frog (Rana pipiens). These species are faced with a broad range of environmental challenges, and in part of its range R. pipiens populations are currently in decline. In addition to demonstrating that this method can be reliably used in multiple amphibian species, we present an examination of intrinsic biological factors (sex, body condition) that may contribute to GC secretion, and a demonstration that saliva can be collected from free-living animals in the field to quantify corticosterone. Our findings suggest that saliva may be useful for less invasively quantifying GCs in many amphibian species.
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Affiliation(s)
- Talisin T Hammond
- Department of Biological Sciences, University of Pittsburgh, 105 Clapp Hall, 5th Ave. at Ruskin Ave., Pittsburgh, PA, USA
| | - Zoe A Au
- Department of Biological Sciences, University of Pittsburgh, 105 Clapp Hall, 5th Ave. at Ruskin Ave., Pittsburgh, PA, USA
| | - Allison C Hartman
- Department of Biological Sciences, University of Pittsburgh, 105 Clapp Hall, 5th Ave. at Ruskin Ave., Pittsburgh, PA, USA
| | - Corinne L Richards-Zawacki
- Department of Biological Sciences, University of Pittsburgh, 105 Clapp Hall, 5th Ave. at Ruskin Ave., Pittsburgh, PA, USA
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18
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LUNDGREN-KOWNACKI K, DAHL M, GAO C, JAKOBSSON K, LINNINGE C, SONG D, KUKLANE K. Exploring how a traditional diluted yoghurt drink may mitigate heat strain during medium-intensity intermittent work: a multidisciplinary study of occupational heat strain. INDUSTRIAL HEALTH 2018; 56:106-121. [PMID: 29057769 PMCID: PMC5889929 DOI: 10.2486/indhealth.2017-0030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
It is common practice in India to consume the dairy drink buttermilk as a way of mitigating occupational heat strain. This paper explores the thermoregulatory and hydration benefits of drinking buttermilk but also the impacts of work in a hot environment on the gut microbiota, renal and cognitive function. Twelve healthy participants were subjected to a 3-h period of medium load physical intermittent work in a climatic chamber (34°C, 60% RH). The subjects were given water, buttermilk (700 ml) or no rehydration at random. Mean body temperatures when no rehydration was given were significantly higher (p≤0.001). When subjects drank water or buttermilk they had a lower sweat rate than with no rehydration (p≤0.05) and the perception of feeling hot, uncomfortable, thirsty and physically exerted was significantly reduced (p≤0.05). A hormonal stress response at the end of the exposure was seen when not drinking (p≤0.05). No differences in cognitive abilities and gut microbiota were found. The exposure lowered the renal blood flow suggesting an acute impact of short term heat exposure. It was also found that buttermilk has a protective effect on this impact. Our results demonstrated that keeping hydrated by water/buttermilk consumption mitigates heat strain in well-nourished subjects.
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Affiliation(s)
- Karin LUNDGREN-KOWNACKI
- Thermal Environment Laboratory, Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Sweden
- *To whom correspondence should be addressed. E-mail:
| | - Mats DAHL
- Department of Psychology, Lund University, Sweden
| | - Chuansi GAO
- Thermal Environment Laboratory, Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Sweden
| | - Kristina JAKOBSSON
- Department of Laboratory Medicine Lund, Unit of Occupational and Environmental Medicine, Lund University
- Department of Public Health and Community Medicine, Unit of Occupational and Environmental Medicine Sahlgrenska Academy, University of Gothenburg
| | - Caroline LINNINGE
- Department of Food Technology, Engineering and Nutrition, Lund University, Sweden
| | - Danping SONG
- Department of Food Technology, Engineering and Nutrition, Lund University, Sweden
| | - Kalev KUKLANE
- Thermal Environment Laboratory, Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Sweden
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19
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Strahler J, Nater UM. Differential effects of eating and drinking on wellbeing—An ecological ambulatory assessment study. Biol Psychol 2018; 131:72-88. [DOI: 10.1016/j.biopsycho.2017.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/07/2016] [Accepted: 01/18/2017] [Indexed: 10/20/2022]
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20
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Simultaneous measurement of salivary cortisol and alpha-amylase: Application and recommendations. Neurosci Biobehav Rev 2017; 83:657-677. [DOI: 10.1016/j.neubiorev.2017.08.015] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/16/2017] [Accepted: 08/21/2017] [Indexed: 01/20/2023]
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21
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Anderson T, Wideman L. Exercise and the Cortisol Awakening Response: A Systematic Review. SPORTS MEDICINE - OPEN 2017; 3:37. [PMID: 29019089 PMCID: PMC5635140 DOI: 10.1186/s40798-017-0102-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/26/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND The cortisol awakening response (CAR) has been used as a biomarker of stress response in a multitude of psychological investigations. While a myriad of biochemical responses have been proposed to monitor responses to exercise training, the use of CAR within the exercise and sports sciences is currently limited and is a potentially underutilized variable. Therefore, the purpose of this review was to collate studies that incorporate both exercise and CAR, in an effort to better understand (a) whether CAR is a useful marker for monitoring exercise stress and (b) how CAR may be most appropriately used in future research. METHODS A systematic review of the literature was conducted, following PRISMA guidelines. Searches were conducted using PubMed, SportDISCUS, Scopus, and PsychInfo databases, using search terms related toCAR and exercise and physical activity. RESULTS 10,292 articles were identified in the initial search, with 32 studies included in the final analysis. No studies investigated the effects of laboratory-controlled exercise on CAR. Variable effects were observed, possibly due to inconsistencies in study design, methodology, population, and CAR analysis. The available literature suggests a threshold of exercise may be required to alter the HPA axis and affect CAR. Moreover, CAR may represent a combination of previous exercise load and upcoming stress, making current interpretation of field-based observational research challenging. CONCLUSIONS More research is needed to fully elucidate the influence of exercise on CAR and address a number of gaps in the literature, including controlling exercise load, consistent sample collection, and CAR calculation and analysis.
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Affiliation(s)
- Travis Anderson
- University of North Carolina at Greensboro, Greensboro, NC 27412 USA
| | - Laurie Wideman
- University of North Carolina at Greensboro, Greensboro, NC 27412 USA
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22
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Liu L, Aleksandrowicz E, Schönsiegel F, Gröner D, Bauer N, Nwaeburu CC, Zhao Z, Gladkich J, Hoppe-Tichy T, Yefenof E, Hackert T, Strobel O, Herr I. Dexamethasone mediates pancreatic cancer progression by glucocorticoid receptor, TGFβ and JNK/AP-1. Cell Death Dis 2017; 8:e3064. [PMID: 28981109 PMCID: PMC5680577 DOI: 10.1038/cddis.2017.455] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 08/04/2017] [Accepted: 08/09/2017] [Indexed: 01/08/2023]
Abstract
Glucocorticoids such as dexamethasone are widely co-prescribed with cytotoxic therapy because of their proapoptotic effects in lymphoid cancer, reduction of inflammation and edema and additional benefits. Concerns about glucocorticoid-induced therapy resistance, enhanced metastasis and reduced survival of patients are largely not considered. We analyzed dexamethasone-induced tumor progression in three established and one primary human pancreatic ductal adenocarcinoma (PDA) cell lines and in PDA tissue from patients and xenografts by FACS and western blot analysis, immunohistochemistry, MTT and wound assay, colony and spheroid formation, EMSA and in vivo tumor growth and metastasis of tumor xenografts on chicken eggs and mice. Dexamethasone in concentrations observed in plasma of patients favored epithelial–mesenchymal transition, self-renewal potential and cancer progression. Ras/JNK signaling, enhanced expression of TGFβ, vimentin, Notch-1 and SOX-2 and the inhibition of E-cadherin occurred. This was confirmed in patient and xenograft tissue, where dexamethasone induced tumor proliferation, gemcitabine resistance and metastasis. Inhibition of each TGFβ receptor-I, glucocorticoid receptor or JNK signaling partially reversed the dexamethasone-mediated effects, suggesting a complex signaling network. These data reveal that dexamethasone mediates progression by membrane effects and binding to glucocorticoid receptor.
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Affiliation(s)
- Li Liu
- Section Surgical Research, Molecular OncoSurgery, University of Heidelberg, Heidelberg, Germany.,Department of General Surgery, University of Heidelberg, Heidelberg, Germany
| | - Ewa Aleksandrowicz
- Section Surgical Research, Molecular OncoSurgery, University of Heidelberg, Heidelberg, Germany.,Department of General Surgery, University of Heidelberg, Heidelberg, Germany
| | - Frank Schönsiegel
- Section Surgical Research, Molecular OncoSurgery, University of Heidelberg, Heidelberg, Germany.,Department of General Surgery, University of Heidelberg, Heidelberg, Germany
| | - Daniel Gröner
- Section Surgical Research, Molecular OncoSurgery, University of Heidelberg, Heidelberg, Germany.,Department of General Surgery, University of Heidelberg, Heidelberg, Germany
| | - Nathalie Bauer
- Section Surgical Research, Molecular OncoSurgery, University of Heidelberg, Heidelberg, Germany.,Department of General Surgery, University of Heidelberg, Heidelberg, Germany
| | - Clifford C Nwaeburu
- Section Surgical Research, Molecular OncoSurgery, University of Heidelberg, Heidelberg, Germany.,Department of General Surgery, University of Heidelberg, Heidelberg, Germany
| | - Zhefu Zhao
- Section Surgical Research, Molecular OncoSurgery, University of Heidelberg, Heidelberg, Germany.,Department of General Surgery, University of Heidelberg, Heidelberg, Germany
| | - Jury Gladkich
- Section Surgical Research, Molecular OncoSurgery, University of Heidelberg, Heidelberg, Germany.,Department of General Surgery, University of Heidelberg, Heidelberg, Germany
| | | | - Eitan Yefenof
- The Lautenberg Center for Immunology and Cancer Research, IMRIC, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Thilo Hackert
- Department of General Surgery, University of Heidelberg, Heidelberg, Germany
| | - Oliver Strobel
- Department of General Surgery, University of Heidelberg, Heidelberg, Germany
| | - Ingrid Herr
- Section Surgical Research, Molecular OncoSurgery, University of Heidelberg, Heidelberg, Germany.,Department of General Surgery, University of Heidelberg, Heidelberg, Germany
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23
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Grynderup MB, Nabe-Nielsen K, Lange T, Conway PM, Bonde JP, Garde AH, Gullander M, Kaerlev L, Persson R, Rugulies R, Vammen MA, Høgh A, Hansen ÅM. The associations between workplace bullying, salivary cortisol, and long-term sickness absence: a longitudinal study. BMC Public Health 2017; 17:710. [PMID: 28915867 PMCID: PMC5602853 DOI: 10.1186/s12889-017-4716-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 09/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Workplace stressors, such as bullying, are strongly related to subsequent long-term sickness absence, but little is known of the possible physiological mechanisms linking workplace stressors and sickness absence. The primary aim of this study was to investigate to what extent cortisol levels were associated with subsequent sickness absence and if cortisol mediated the association between workplace bullying and sickness absence. We additionally investigated possible bidirectional associations between bullying, cortisol, and long-term sickness absence. METHODS Participants came from two Danish cohort studies, the "Psychosocial RIsk factors for Stress and MEntal disease" (PRISME) cohort and the "Workplace Bullying and Harassment" (WBH) cohort (n = 5418). Information about exposure to workplace bullying and morning and evening salivary cortisol was collected at three time points with approximately two years in between. After each data collection, all participants were followed for two years in registers, and cases with long-term sickness absence lasting 30 or more consecutive days were identified. The association between cortisol levels and subsequent sickness absence was assessed by logistic regression, while the extent to which the association between bullying and sickness absence was mediated by cortisol was quantified through natural direct and indirect effects. RESULTS High evening cortisol was associated with a decreased risk of sickness absence (OR = 0.82, 95% CI = 0.68-0.99), but we did not find that high morning cortisol levels (OR = 0.98, 95% CI = 0.81-1.18) or high morning-to-evening slope (OR = 0.99, 95% CI = 0.82-1.18) were associated with subsequent sickness absence. We also tested for reverse causation and found that long-term sickness absence, but not salivary cortisol, was a strong risk factor for subsequent workplace bullying. There was no indication that cortisol mediated the association between workplace bullying and sickness absence. CONCLUSION We found no straightforward and simple association between cortisol and long-term sickness absence. Furthermore, the association between workplace bullying and long-term sickness absence was not mediated by cortisol.
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Affiliation(s)
- Matias Brødsgaard Grynderup
- Department of Public Health, Centre for Health and Society, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
| | - Kirsten Nabe-Nielsen
- Department of Public Health, Centre for Health and Society, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Theis Lange
- Department of Public Health, Centre for Health and Society, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.,Center for Statistical Science, Peking University, No.5 Yiheyuan Road Haidian District, 100871, Beijing, People's Republic of China
| | - Paul Maurice Conway
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Frederiksberg and Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Anne Helene Garde
- Department of Public Health, Centre for Health and Society, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.,The National Research Centre for the Working Environment, Lersø Parkalle 105, 2100, Copenhagen Ø, Denmark
| | - Maria Gullander
- Department of Public Health, Centre for Health and Society, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Linda Kaerlev
- Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
| | - Roger Persson
- Department of Psychology, Lund University, Box 213, 221 00, Lund, Sweden.,Division of Occupational and Environmental Medicine, Lund University, SUS, 221 85, Lund, Sweden
| | - Reiner Rugulies
- Department of Public Health, Centre for Health and Society, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.,Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark.,The National Research Centre for the Working Environment, Lersø Parkalle 105, 2100, Copenhagen Ø, Denmark
| | - Marianne Agergaard Vammen
- Department of Occupational and Environmental Medicine, Frederiksberg and Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Annie Høgh
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark
| | - Åse Marie Hansen
- Department of Public Health, Centre for Health and Society, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.,The National Research Centre for the Working Environment, Lersø Parkalle 105, 2100, Copenhagen Ø, Denmark
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24
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Abstract
Stress, in the form of test anxiety, inhibits examination performance essential to nursing success. Salivary cortisol, a biomarker of stress, was obtained before 3 examinations and 1 nursing didactic class from a sample of baccalaureate nursing students in a midwestern US university. Significant differences were found between cortisol sampling events and by junior or senior status. These findings suggest that diverse examinations and program level yield differences in stress for students.
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Jensen MA, Garde AH, Kristiansen J, Nabe-Nielsen K, Hansen ÅM. The effect of the number of consecutive night shifts on diurnal rhythms in cortisol, melatonin and heart rate variability (HRV): a systematic review of field studies. Int Arch Occup Environ Health 2015; 89:531-45. [PMID: 26464315 DOI: 10.1007/s00420-015-1093-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 09/28/2015] [Indexed: 04/24/2023]
Abstract
PURPOSE The purpose of this review is to summarize the current knowledge from field studies on how many consecutive night shifts are required for adaptation of diurnal rhythms in cortisol, melatonin and heart rate variability (HRV) to night work. METHODS A systematic search of the databases PubMed and Web of Science resulted in 18 studies selected for review. RESULTS Cortisol was measured in five studies, melatonin in 11 studies and HRV in four studies. Diurnal rhythms were assessed by use of several different measures based on three to eight samples per day for cortisol and melatonin and 24-h recordings for HRV. Most of the studies in the review were small studies with less than 30 participants, and most studies evaluated diurnal rhythms after only two consecutive night shifts whereas only six studies used seven or more consecutive night shifts. The majority of studies found that adaptation to night work had not occurred after two consecutive night shifts, whereas a small number found evidence for full adaptation after seven consecutive night shifts based on diurnal rhythms in cortisol and melatonin. CONCLUSION There are methodological differences in the field studies analyzing diurnal rhythms and large diversity in the occupational fields studied. Nevertheless, we conclude that diurnal rhythms in cortisol, melatonin and HRV are not adapted to night work after 1-3 consecutive night shifts. Studies are needed to establish how many consecutive night shifts are needed for full adaptation of diurnal rhythms to night work.
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Affiliation(s)
- Marie Aarrebo Jensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, København K, Denmark.
| | - Anne Helene Garde
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, København Ø, Denmark
| | - Jesper Kristiansen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, København Ø, Denmark
| | - Kirsten Nabe-Nielsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, København K, Denmark
| | - Åse Marie Hansen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, København K, Denmark.,National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, København Ø, Denmark
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26
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Stokholm ZA, Hansen ÅM, Grynderup MB, Bonde JP, Christensen KL, Frederiksen TW, Lund SP, Vestergaard JM, Kolstad HA. Recent and long-term occupational noise exposure and salivary cortisol level. Psychoneuroendocrinology 2014; 39:21-32. [PMID: 24275001 DOI: 10.1016/j.psyneuen.2013.09.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 09/26/2013] [Accepted: 09/30/2013] [Indexed: 11/18/2022]
Abstract
Environmental and occupational noise exposure have been related to increased risk of cardiovascular disease, hypothetically mediated by stress-activation of the hypothalamic-pituitary-adrenal (HPA) axis. The objective of this study was to investigate the relation between recent and long-term occupational noise exposure and cortisol level measured off work to assess a possible sustained HPA-axis effect. We included 501 industrial, finance, and service workers who were followed for 24h during work, leisure, and sleep. Ambient occupational noise exposure levels were recorded every 5s by personal dosimeters and we calculated the full-shift LAEq value and estimated duration and cumulative exposure based on their work histories since 1980. For 332 workers who kept a log-book on the use of hearing protection devices (HPD), we subtracted 10 dB from every noise recording obtained during HPD use and estimated the noise level at the ear. Salivary cortisol concentration was measured at 20.00 h, the following day at awakening, and 30 min after awakening on average 5, 14 and 14.5h after finishing work. The mean ambient noise exposure level was 79.9 dB(A) [range: 55.0-98.9] and the mean estimated level at the ear 77.7 dB(A) [range: 55.0-94.2]. In linear and mixed regression models that adjusted for age, sex, current smoking, heavy alcohol consumption, personal income, BMI, leisure-time noise exposure level, time since occupational noise exposure ceased, awakening time, and time of saliva sampling, we observed no statistically significant exposure response relation between recent, or long-term ambient occupational noise exposure level and any cortisol parameter off work. This was neither the case for recent noise level at the ear. To conclude, neither recent nor long-term occupational noise exposure levels were associated with increased cortisol level off work. Thus, our results do not indicate that a sustained activation of the HPA axis, as measured by cortisol, is involved in the causal pathway between occupational noise exposure and cardiovascular disease.
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Affiliation(s)
- Zara Ann Stokholm
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark.
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, 2100 Copenhagen Ø, Denmark; Department of Public Health, University of Copenhagen, 1014 Copenhagen K, Denmark
| | - Matias Brødsgaard Grynderup
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, 2400 Copenhagen NV, Denmark
| | - Kent Lodberg Christensen
- Department of Internal Medicine and Cardiology A, Aarhus University Hospital, 8000 Aarhus C, Denmark
| | - Thomas Winther Frederiksen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark
| | - Søren Peter Lund
- National Research Centre for the Working Environment, 2100 Copenhagen Ø, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8000 Aarhus C, Denmark
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Díaz MM, Bocanegra OL, Teixeira RR, Tavares M, Soares SS, Espindola FS. The Relationship Between the Cortisol Awakening Response, Mood States, and Performance. J Strength Cond Res 2013; 27:1340-8. [DOI: 10.1519/jsc.0b013e318267a612] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Olbrich D, Dittmar M. The cortisol awakening response is related with PERIOD1 clock gene expression in older women. Exp Gerontol 2012; 47:527-33. [DOI: 10.1016/j.exger.2012.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 03/05/2012] [Accepted: 04/30/2012] [Indexed: 10/28/2022]
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Hanneman SK, Cox CD, Green KE, Kang DH. Estimating intra- and inter-assay variability in salivary cortisol. Biol Res Nurs 2011; 13:243-50. [PMID: 21498487 DOI: 10.1177/1099800411404061] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Investigators commonly assess intra- and inter-assay coefficients of variation (CVs) to estimate the precision of salivary cortisol enzyme immunoassay (EIA). However, little guidance is available as to which samples to use for CV assessment. The purposes of this methodological study were to compare differences in intra- and inter-assay CVs (a) among controls, standards, and/or unknown samples; and (b) between fresh and previously frozen saliva. A total of 174 duplicates (controls = 58, standards = 48, and unknowns = 68) were tested. The unknowns were from 34 students; all student saliva was assayed as both fresh and frozen samples. All samples were assayed in duplicate, using a commercial salivary cortisol EIA kit, by the same technician with the same equipment. A priori criteria for intra- and inter-assay CV, respectively, were ≤ 4% and ≤ 7%, and a was .05 for CV differences. Mean intra-assay CVs for controls, standards, unknowns, and combined samples were ≤ 2.5%, and mean inter-assay CVs were ≤ 2.8%. Mean intra-assay CVs were 2.2% for fresh saliva and 1.5% for frozen samples. Comparisons showed no significant differences in intra- or inter-assay CV among controls, standards, and/or unknown samples. Inter-assay CV was significantly different between fresh and previously frozen saliva (p = .043), with fresh saliva CV higher than frozen; the difference was not meaningful because all evaluations showed minimal measurement error. In conclusion, results indicate that estimation of precision can be achieved by testing of controls, standards, or unknowns and with either fresh or frozen saliva in this population.
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Affiliation(s)
- Sandra K Hanneman
- Bioscience Laboratory, Center for Nursing Research, School of Nursing, The University of Texas Health Science Center, Houston, TX, USA.
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Raff H. Utility of salivary cortisol measurements in Cushing's syndrome and adrenal insufficiency. J Clin Endocrinol Metab 2009; 94:3647-55. [PMID: 19602555 DOI: 10.1210/jc.2009-1166] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT The measurement of cortisol in saliva is a simple, reproducible, and reliable test to evaluate the normal and disordered control of the hypothalamic-pituitary-adrenal (HPA) axis. There are a variety of simple methods to obtain saliva samples without stress, making this a robust test applicable to many different experimental and clinical situations. EVIDENCE ACQUISITION Ovid Medline and PubMed from 1950 to present were searched using the following strategies: [<saliva or salivary>and<cortisol or hydrocortisone>and<Cushing or Cushing's>] and [<saliva or salivary>and<cortisol or hydrocortisone>and<adrenal insufficiency or hypoadrenalism or hypopituitarism or Addison's disease>]. The bibliographies of all relevant citations were evaluated for any additional appropriate citations. EVIDENCE SYNTHESIS Measurement of an elevated late-night (2300 to 2400 h) salivary cortisol has a greater than 90% sensitivity and specificity for the diagnosis of endogenous Cushing's syndrome. Late-night salivary cortisol measurements are also useful to monitor patients for remission and/or recurrence after pituitary surgery for Cushing's disease. Because it is a surrogate for plasma free cortisol, the measurement of salivary cortisol may be useful during an ACTH stimulation test in patients with increased plasma binding protein concentrations due to increased estrogen, or decreased plasma binding protein concentrations during critical illness. Most reference laboratories now offer salivary cortisol testing. CONCLUSIONS It is expected that the use of the measurement of salivary cortisol will become routine in the evaluation of patients with disorders of the HPA axis.
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Affiliation(s)
- Hershel Raff
- Endocrine Research Laboratory, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin 53215, USA.
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Hansen AM, Larsen AD, Rugulies R, Garde AH, Knudsen LE. A Review of the Effect of the Psychosocial Working Environment on Physiological Changes in Blood and Urine. Basic Clin Pharmacol Toxicol 2009; 105:73-83. [PMID: 19563453 DOI: 10.1111/j.1742-7843.2009.00444.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ase M Hansen
- National Research Centre for the Working Environment (NRCWE), Copenhagen, Denmark.
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Backé EM, Kaul G, Klussmann A, Liebers F, Thim C, Massbeck P, Steinberg U. Assessment of salivary cortisol as stress marker in ambulance service personnel: comparison between shifts working on mobile intensive care unit and patient transport ambulance. Int Arch Occup Environ Health 2009; 82:1057-64. [PMID: 19533163 DOI: 10.1007/s00420-009-0428-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Accepted: 05/07/2009] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to describe and compare salivary cortisol of ambulance personnel on days with different work demands as well as to correlate the individual perception of demands to the physiological outcome cortisol. METHODS Diurnal cortisol profiles on a day in emergency service and on a day in patient transport were monitored for 24 subjects working in an urban ambulance station. Changes of cortisol were also observed during 42 operations in emergency service and 24 operations in patient transport and were compared to the individual perception of physical and emotional demands. RESULTS Rise of cortisol in the morning on days in emergency service was significantly higher than in patient transport suggesting adjustment to forthcoming demanding tasks. There were only few situations with strong endocrine reaction in emergency service as well as in patient transport. The magnitude of this reaction was not related to the individual perception of demand. CONCLUSION Ambulance service personnel seem to be used to critical situations. There was few awareness of the "physiological" stress response indicating that stress is probably not perceived in work situations characterised by routines.
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Affiliation(s)
- Eva M Backé
- Federal Institute of Occupational Health and Safety (BAuA), Nöldnerstrasse 40-42, Berlin, Germany.
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Persson R, Hansen AM, Ohlsson K, Balogh I, Nordander C, Orbaek P. Physiological and psychological reactions to work in men and women with identical job tasks. Eur J Appl Physiol 2008; 105:595-606. [PMID: 19030870 DOI: 10.1007/s00421-008-0939-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2008] [Indexed: 11/30/2022]
Abstract
Differences in physiological functioning in the hypothalamus-pituitary-adrenal cortex axis and the autonomic nervous system have been suggested to contribute to many of the health differences that may be observed between men and women as well as being relevant for the development of musculoskeletal pain. To clarify whether men and women with identical work tasks reacted differently when doing work known to induce musculoskeletal pain, ratings and physiological measurements were obtained at work start (15:30) and at the end of the workshift (22:30) on 17 men and 20 women. Men showed a larger decrease in perceived energy levels during the workshift but there were no differences between men and women as regards cortisol, adrenaline, noradrenaline, heart-rate activation, perceived stress, pain and physical exertion. In conclusion, differential physiological activation during the workshift seem to be an unlikely mechanism for explaining gender differences in pain associated with exposure to awkward and repetitive movements.
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Affiliation(s)
- Roger Persson
- National Research Centre for the Working Environment, Copenhagen, Denmark.
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