Relationship between the cortisol awakening response and other features of the diurnal cortisol rhythm: The Multi-Ethnic Study of Atherosclerosis

PSYCHONEUROENDOCRINOLOGY

卷:38

Article

Golden, Sherita Hill^1,2  Sanchez, Brisa N.³  Wu, Meihua³  Champaneri, Shivam¹  Roux, Ana V. Diez⁴  Seeman, Teresa⁵  Wand, Gary S.¹ 

[1] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA

[2] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[3] Univ Michigan, Sch Publ Hlth, Dept Biostat, Ann Arbor, MI 48109 USA

[4] Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA

[5] Univ Calif Los Angeles, David Geffen Sch Med, Div Geriatr, Los Angeles, CA 90095 USA

关键词: Cortisol awakening response (CAR);    Hypothalamic-pituitary-adrenal (HPA) axis;    Diurnal cortisol;    Correlation;    Population-based study;   

DOI  :  10.1016/j.psyneuen.2013.06.032

来源: Elsevier

【 摘 要 】

Cumulative cortisol burden is known to influence neuropsychiatric and metabolic disorders. To better understand the relationship between daily cortisol exposure and measures of the diurnal circadian cortisol rhythm, we examined the cross-sectional association of the cortisol awakening response (CAR) with wake-up cortisol, bedtime cortisol, diurnal slope, and total cortisol area under the curve (AUC). Up to 18 salivary cortisol samples were collected over 3 days from 935 White, Hispanic, and Black individuals (mean age 65 +/- 9.8 years) in the Multi-Ethnic Study of Atherosclerosis. Outcome measures included awakening cortisol, CAR (awakening to 30 min post-awakening), early decline (30 min to 2 h post-awakening), late decline (2 h post-awakening to bedtime), and the corresponding AUCs. Total cortisol AUC was a summary measure of cumulative cortisol exposure. Higher CAR was associated with significantly lower wake-up cortisol (beta = -0.56; 95% CI: -0.59 to -0.53) and a higher early decline AUC (beta = 0.38; 95% CI: 0.34-0.42) but was not associated with total cortisol AUC (beta = 0.04; 95% CI: -0.01 to 0.09), or other diurnal cortisol curve components following multivariable adjustment. Total cortisol AUC was significantly and positively associated with wake-up cortisol (beta = 0.36; 95% CI: 0.32-0.40), bedtime cortisol (beta= 0.61; 95% CI: 0.58-0.64), and other AUC measures, following multivariable adjustment. Associations were similar by sex, race/ethnicity, and age categories. We conclude that bedtime cortisol showed the strongest correlation with total cortisol AUC, suggesting it may be a marker of daily cortisol exposure. (C) 2013 Elsevier Ltd. All rights reserved.

【 授权许可】

Free