Daily salivary cortisol patterns in midlife women with hot flashes.
Daily salivary cortisol patterns in midlife women with hot flashes.
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患有潮热的中年女性的每日唾液皮质醇模式。
DOI：
10.1111/cen.12995
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发表时间：
2016
影响因子：
3.2
通讯作者：
Guthrie,KA
中科院分区：
文献类型：
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作者：
Reed,SD;Newton,KM;Larson,JC;Booth-LaForce,C;Woods,NF;Landis,CA;Tolentino,E;Carpenter,JS;Freeman,EW;Joffe,H;Anawalt,BD;Guthrie,KA
目的健康成年人的每日唾液皮质醇模式已得到很好的确定，但尚未在患有潮热的中年女性中进行研究。我们假设频繁的潮热与异常的皮质醇模式有关，类似于睡眠不足的个体。设计横断面。参与者共有 306 名年龄 40-62 岁的女性，随机接受针对潮热的行为干预。测量连续两天平均的四个每日时间点的皮质醇几何平均值 (nmol/l) 的基线比较以及其他时间点的基线比较 在基线定义的各组之间进行计算的皮质醇测量：（i）平均每日潮热频率三分位（≤5·5，N = 103；> 5·5–8·8，N = 103；> 8·8，N = 100）和（ii）选定的特征。对数转换皮质醇的重复测量线性回归模型评估了组间差异，调整了协变量。结果女性中 67% 是白人，24% 是非裔美国人，每天有 7·6 (SD 3·9) 次潮热。所有女性的唾液皮质醇几何平均值 (nmol/l) 如下：总计 75·0 (SD 44·8)、清醒时 8·6 (SD 5·6)、清醒时 10·0 (SD 7·5) + 30 分钟、下午早些时候 3·7 (SD 3·3) 和就寝时间 1·6 (SD 1·8)。唤醒 + 30 分钟值显示，唤醒值中位数上升 18%（四分位数范围 -24 至 96%），平均值随潮热频率三分位数变化，从最低到最高：分别为 11·4（SD 7·3）、10·3（SD 6·5）和 8·6（SD 7·8），P= 0·003。除了下午早些时候的值（P = 0·02）之外，皮质醇值不随潮热频率而变化。结论综上所述，这些研究结果表明，中度至重度潮热的高频率可能与皮质醇浓度的微妙异常有关，这种模式与慢性睡眠障碍一致。
ObjectiveDiurnal salivary cortisol patterns in healthy adults are well established but have not been studied in midlife women with hot flashes. We hypothesized that frequent hot flashes are associated with aberrant cortisol patterns similar to sleep‐deficient individuals.DesignCross‐sectional.ParticipantsA total of 306 women, ages 40–62, randomized to a behavioural intervention for hot flashes.MeasurementsBaseline comparisons of cortisol geometric means (nmol/l) from four daily time points averaged over two consecutive days plus other calculated cortisol measures were made between groups defined by baseline: (i) mean daily hot flash frequency tertile (≤5·5,N= 103; >5·5–8·8,N= 103; >8·8,N= 100) and (ii) selected characteristics. Repeated‐measures linear regression models of log‐transformed cortisol evaluated group differences, adjusting for covariates.ResultsWomen were 67% White and 24% African American, with 7·6 (SD 3·9) hot flashes per day. Salivary cortisol geometric means (nmol/l) among all women were as follows: 75·0 (SD 44·8) total, 8·6 (SD 5·6) wake, 10·0 (SD 7·5) wake +30 min, 3·7 (SD 3·3) early afternoon and 1·6 (SD 1·8) bedtime. Wake + 30‐minute values showed an 18% median rise from wake values (interquartile range −24 to 96%), and means varied by hot flash frequency tertile, from lowest to highest: 11·4(SD 7·3), 10·3 (SD 6·5) and 8·6 (SD 7·8), respectively,P= 0·003. Beside the early afternoon value (P= 0·02), cortisol values did not vary by hot flash frequency.ConclusionTaken together, these findings suggest that high frequency of moderate‐to‐severe hot flashes may be associated with subtle abnormalities in cortisol concentrations – a pattern consistent with chronic sleep disturbance.