The cortisol awakening response in relation to objective and subjective measures of waking in the morning
The cortisol awakening response in relation to objective and subjective measures of waking in the morning
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DOI：
10.1016/j.psyneuen.2007.10.001
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发表时间：
2008-01-01
影响因子：
3.7
通讯作者：
Steptoe, Andrew
中科院分区：
文献类型：
--
作者：
Dockray, Samantha;Bhattacharyya, Mimi R.;Steptoe, Andrew
唾液皮质醇唤醒反应（CAR）的研究可能会被早上醒来和获得“清醒”唾液样本之间的延迟所混淆。我们使用腕动仪提供清醒时间的客观信息，并研究了采集清醒样本的延迟对CAR的影响。研究了83名因疑似冠状动脉疾病而转诊至医院的男性和女性（平均年龄61.30岁）。分别在清醒时和15、30分钟后采集唾液样本。由活动记录仪定义的清醒时间与报告的清醒时间之间的平均间隔为6.12±（sd）。14.8分钟，55.4%没有延迟。清醒唾液样本在自我报告清醒后平均为5.78 +/- 15.0 min，在客观清醒后平均为12.24 +/- 20.3 min。在醒来和采样之间延迟bbb15分钟（平均14.46 +/- 6.34 nmol/l）的参与者中，清醒时的皮质醇值显著高于零延迟（平均10.45 +/- 6.41 nmol/l）或1-15分钟延迟（平均11.51 +/- 5.99 nmol/l, p = 0.043）的参与者。在睡眠延迟15分钟的受试者中，皮质醇在醒来后15 - 30分钟内没有增加。从客观定义的清醒时间到报告的样本时间，0分钟和1-15分钟延迟的参与者之间的CAR没有差异。一小部分（14.7%）没有延迟唾液采样的参与者在醒来后30分钟内皮质醇没有增加。这些CAR无应答者在睡眠模式、清醒时间、临床或药物特征方面与其余患者没有差异，但更有可能具有较高的社会经济地位（p = 0.009）。我们的结论是，醒来和获得“清醒”皮质醇样本之间的长时间延迟将导致误导性的CAR结果，但延迟15分钟可能没有问题。少数人在醒来后没有延迟唾液取样，但仍未显示CAR阳性。(C) 2007 Elsevier Ltd.版权所有。
Studies of the salivary cortisol awakening response (CAR) may be confounded by delays between waking in the morning and obtaining the 'waking' salivary sample. We used wrist actigraphy to provide objective information about waking time, and studied the influence of delays in taking the waking sample on the CAR. Eighty-three men and women (mean age 61.30 years) who were referred to hospital with suspected coronary artery disease were studied. Saliva samples were obtained on waking and 15 and 30 min later. The mean interval between waking defined by actigraphy and reported waking time was 6.12 +/- (S.D.) 14.8 min, with 55.4% having no delay. The waking saliva sample was obtained an average 5.78 +/- 15.0 min after self-reported waking, and 12.24 +/- 20.3 min after objective waking. The waking cortisol value was significantly higher in participants who had a delay between waking and sampling > 15 min (mean 14.46 +/- 6.34 nmol/l) than in those with zero (mean 10.45 +/- 6.41 nmol/l) or 1-15 min delays (mean 11.51 +/- 5.99 nmol/l, p = 0.043). Cortisol did not increase between 15 and 30 min after waking in those who delayed > 15 min. There were no differences in CAR between participants with zero and 1-15 min delays from objectively defined waking to reported sample times. A small proportion (14.7%) of participants who did not delay saliva sampling showed no increase in cortisol over the 30 min after waking. These CAR nonresponders did not differ from the remainder on sleep patterns, waking time, clinical or medication characteristics, but were more likely to be of higher socioeconomic status (p = 0.009). We conclude that Long delays between waking and obtaining 'waking' cortisol samples will lead to misleading CAR results, but that delays up to 15 min may not be problematic. A small minority of individuals do not show a positive CAR despite not delaying saliva sampling after waking. (C) 2007 Elsevier Ltd. All rights reserved.