Diurnal cortisol decline is related to coronary calcification: CARDIA study
Diurnal cortisol decline is related to coronary calcification: CARDIA study
复制标题
DOI：
10.1097/01.psy.0000244071.42939.0e
复制
发表时间：
2006-09-01
影响因子：
3.3
通讯作者：
Seeman, Teresa
中科院分区：
文献类型：
--
作者：
Matthews, Karen;Schwartz, Joseph;Seeman, Teresa
目的：慢性应激可能是冠心病的一个危险因素，并与下丘脑-垂体-肾上腺（HPA）轴的失调有关。我们检验了HPA轴失调的两个标志物，即平均水平升高（曲线下面积，校正清醒时间）和唾液皮质醇昼夜下降与冠状动脉钙化（CaC）相关的假设。方法：718名黑人和白色中年人参加了一项年轻人冠状动脉风险发展的辅助研究，在一整天内提供了6份唾液皮质醇样本，并测量了CaC。结果：任何钙化的患病率都很低，在辅助研究的参与者中为8.1%，其中白色男性的比例最高。平均皮质醇没有区分组，平均值= 2.15和2.08。在一天的过程中，那些有任何CaC的人每小时皮质醇下降约6%，而那些没有CaC的人每小时下降超过8%（p <0.003）。在性别种族组、年龄、吸烟、糖尿病治疗、收缩压、记录的甘油三酯、平均皮质醇和受教育程度调整后，斜率得分在最平坦四分位数的人比其余四分位数的人患CaC的可能性更大（比值比= 2.58; 95%置信区间= 1.26 - 5.30）。结论：我们的研究结果与HPA轴失调可能影响动脉粥样硬化风险的假设一致。
Objective: Chronic stress may be a risk factor for coronary heart disease and is associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. We tested the hypotheses that two markers of HPA axis dysregulation, elevated average level (area under the curve, adjusted for time awake) and diurnal decline of salivary cortisol, were associated with presence of coronary calcification (CaC). Method: Seven hundred eighteen black and white middle-aged adults enrolled in an ancillary study of Coronary Artery Risk Development in Young Adults provided six salivary cortisol samples throughout one full day and had measurements of CaC. Results: The prevalence of any calcification was low, 8.1% in the participants of the ancillary study, with white men having the highest proportion. Average cortisol did not differentiate groups, means = 2.15 and 2.08. Those with any CaC declined approximately 6% per hour in cortisol over the course of the day, whereas those with no CaC declined more than 8% per hour (p < .003). Those persons with slope scores in the flattest quartile had a greater likelihood of any CaC than did those in the remaining quartiles adjusted for sex-race group, age, smoking, treatment for diabetes, systolic blood pressure, logged triglycerides, average cortisol, and educational attainment (odds ratio = 2.58; 95% confidence interval = 1.26-5.30). Conclusions: Our results are consistent with the hypothesis that HPA axis dysregulation may affect risk for atherosclerosis.