Individual variation in diurnal cortisol in patients with knee osteoarthritis: Clinical correlates.
Individual variation in diurnal cortisol in patients with knee osteoarthritis: Clinical correlates.
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膝骨关节炎患者皮质醇昼夜变化的个体差异：临床相关性。
DOI：
10.1016/j.ijpsycho.2021.06.004
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Edwards RR
中科院分区：
文献类型：
--
作者：
Paschali M;Lazaridou A;Paschalis T;Moradian JR;Sadora J;Vilsmark ES;Edwards RR
皮质醇觉醒反应（CAR）是下丘脑-垂体-肾上腺（HPA）轴调节的核心生物标志物。然而，迄今为止，慢性疼痛患者HPA轴功能的研究很少，结果也不明确。本研究的目的是调查CAR与疼痛相关结局之间的相关性，并调查膝关节骨关节炎（KOA）患者的潜在性别差异。在这项横断面研究中，KOA患者（N = 96）完成了评估疼痛和心理社会因素的自我报告问卷，并进行了定量感觉测试（QST），以评估压力疼痛阈值（PPT）。另外，收集唾液皮质醇样品（N = 60）以在6个时间点（觉醒、觉醒后15分钟和30分钟、4PM、9 PM和就寝时间）评估HPA轴功能。通过检查从觉醒到觉醒后30分钟唾液皮质醇的增加来计算CAR，并通过计算皮质醇相对于地面的曲线下面积（AUCG）来计算总的觉醒后皮质醇浓度。与CAR相对正常的患者相比，CAR相对钝化的患者的焦虑水平显着较高，PPT较低。同样，与AUCG相对正常的患者相比，AUCG相对降低的患者具有显著更高的疼痛干扰和焦虑水平。PPT与CAR、AUCG呈正相关，与疼痛程度、焦虑呈负相关。男性KOA患者的焦虑水平显著低于女性KOA患者，PPT水平显著高于女性，CAR和AUCG水平显著高于女性。中介分析结果显示，PPT对性别与AUCG之间的关系有显著的间接影响。这项研究的结果表明，神经内分泌因素，如CAR和AUCG可能有助于KOA患者疼痛相关结局的个体差异。此外，我们的研究结果显示，早晨HPA激活和疼痛相关结果的幅度存在性别差异。最后，我们的研究结果表明，觉醒后皮质醇浓度和疼痛感知之间存在性别依赖关系。未来的研究应该在不同的疼痛人群中检查这些关联。
The cortisol awakening response (CAR) is a core biomarker of hypothalamic-pituitary-adrenal (HPA) axis regulation. To date, however, studies of HPA-axis function amongst patients with chronic pain are scarce and show equivocal results. The objectives of this study were to investigate the association between CAR and pain-related outcomes and to investigate potential sex differences in patients with knee osteoarthritis (KOA). In this cross-sectional study, KOA patients (N = 96) completed self-report questionnaires assessing pain and psychosocial factors and underwent Quantitative Sensory Testing (QST) to assess pressure pain threshold (PPT). Additionally, salivary cortisol samples (N = 60) were collected to assess HPA-axis function at 6 time points (awakening, 15- and 30-minutes post-awakening, 4PM, 9PM and bedtime). The CAR was calculated by examining increases in salivary cortisol from awakening to 30min post awakening and the total post-awakening cortisol concentration by calculating the lower areas under the curve of cortisol with respect to ground (AUCG). Patients with a relatively blunted CAR had significantly higher anxiety levels and lower PPT than patients with relatively normal CAR. Similarly, patients with a relatively reduced AUCG had significantly higher pain interference and anxiety levels compared to patients with relatively normal AUCG. PPT was positively correlated with CAR and AUCG and negatively correlated with pain severity and anxiety. Men with KOA had significantly lower anxiety, higher PPT and higher CAR and AUCG than women with KOA. Mediation analysis results revealed a significant indirect effect of PPT on the relationship between sex and AUCG. The findings of this study suggest that neuroendocrine factors such as CAR and AUCG may contribute to individual differences in pain-related outcomes in patients with KOA. Additionally, our results show sex differences in the magnitude of morning HPA activation and pain-related outcomes. Finally, our findings are suggestive of a sex-dependent relationship between post-awakening cortisol concentrations and pain perception. Future research should examine these associations across various pain populations.
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影响因子：
7.4
作者：
Kuehl, Linn K.;Michaux, Gilles P.;Anton, Fernand
通讯作者：
Anton, Fernand
影响因子：
3.7
作者：
Pruessner, JC;Kirschbaum, C;Hellhammer, DH
通讯作者：
Hellhammer, DH
影响因子：
6.1
作者：
Pruessner, JC;Wolf, OT;Kirschbaum, C
通讯作者：
Kirschbaum, C
评估NIH工具箱中自我报告的负面影响。
影响因子：
11.3
作者：
Pilkonis, Paul A.;Choi, Seung W.;Salsman, John M.;Butt, Zeeshan;Moore, Tara L.;Lawrence, Suzanne M.;Zill, Nicholas;Cyranowski, Jill M.;Kelly, Morgen A. R.;Knox, Sarah S.;Cella, David
通讯作者：
Cella, David
影响因子：
3.3
作者：
Kudielka, BM;Broderick, JE;Kirschbaum, C
通讯作者：
Kirschbaum, C