Cortisol secretion and fatigue: Associations in a community based cohort
Cortisol secretion and fatigue: Associations in a community based cohort
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DOI：
10.1016/j.psyneuen.2009.05.001
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发表时间：
2009-11-01
影响因子：
3.7
通讯作者：
Kivimaki, Mika
中科院分区：
文献类型：
--
作者：
Kumari, Meena;Badrick, Ellena;Kivimaki, Mika
疲劳与下丘脑-垂体-肾上腺（HPA）轴活动减少之间的关系已被描述。然而，疲劳和下丘脑活动之间的时间关联仍存在争议。我们对4299名居住在社区的成年人（平均年龄61岁）进行了纵向队列研究，研究了皮质醇分泌的改变是否在疲劳的发展中起作用，或者这种变化是否会在疲劳后发生。在Whitehall II研究的第7阶段（2003-2004年），从清醒、清醒+ 0.5、2.5、8、12小时和就寝时间收集的唾液样本中测量皮质醇分泌。在Whitehall II研究的第6阶段（2001年）、第7阶段和第8阶段（2006年）测量了疲劳程度。研究了皮质醇分泌的三个要素：清醒皮质醇、皮质醇觉醒反应和皮质醇分泌的日斜率。疲劳是用短表36的活力子量表来确定的。测量了各种各样的协变量。我们发现在第6阶段测量的疲劳与第7阶段的皮质醇分泌无关。在第7阶段，低醒时皮质醇水平和每日皮质醇分泌的平缓斜率与疲劳相关，独立于协变量。在第7阶段低疲劳或无疲劳的参与者中，较低的皮质醇水平和较平缓的皮质醇分泌斜率与第8阶段新发疲劳相关（例如，最低和最高的皮质醇水平的比值比为1.50；95%置信区间为1.08，调整所有协变量后为2.09）。总之，我们发现低醒时唾液皮质醇和皮质醇分泌的平缓斜率与疲劳有关。皮质醇也与未来的疲劳发作有关，这表明皮质醇分泌的变化是病因性的，或者发生在疲劳发生的早期。(C) 2009年Elsevier Ltd.出版
The association between fatigue and reduced activity in the hypothalamo-pituitary-adrenal (HPA) axis has been described. However the temporal association between fatigue and HPA activity is under debate. We examine whether alterations in cortisol secretion play a role in the development of fatigue or whether changes occur later as a consequence of fatigue in a longitudinal cohort study of 4299 community dwelling adults (mean age 61). Cortisol secretion was measured from saliva samples collected waking, waking + 0.5, 2.5, 8, 12 h and bedtime at phase 7 (2003-2004) of the Whitehall II study. Fatigue was measured at phase 6 (2001), phase 7 and phase 8 (2006) of the Whitehall II study. Three elements of secretion were examined: waking cortisol, the cortisol awakening response and diurnal slope in cortisol secretion. Fatigue was determined using the vitality sub-scale of the Short Form-36. A wide variety of co-variates were measured. We find that fatigue measured at phase 6 was not associated with cortisol secretion at phase 7. At phase 7, low waking cortisol levels and a flat slope in diurnal cortisol secretion were associated with fatigue independently of co-variates. In participants low or free of fatigue at phase 7 low waking cortisol and flatter slope in cortisol secretion were associated with new-onset fatigue at phase 8 (for example, odds ratio for lowest vs. highest tertile of waking cortisol 1.50; 95% confidence intervals, 1.08, 2.09 after adjusting for all co-variates). In conclusion, we find that low waking salivary cortisol and a flat slope in cortisol secretion is associated with fatigue. Cortisol is also associated with future onset of fatigue suggesting that changes in cortisol secretion are etiologic or occur early in the genesis of fatigue. (C) 2009 Published by Elsevier Ltd.