Altered cortisol response to psychologic stress in breast cancer survivors with persistent fatigue
Altered cortisol response to psychologic stress in breast cancer survivors with persistent fatigue
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DOI：
10.1097/01.psy.0000155666.55034.c6
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发表时间：
2005-03-01
影响因子：
3.3
通讯作者：
Aziz, N
中科院分区：
文献类型：
--
作者：
Bower, JE;Ganz, PA;Aziz, N
目的：疲劳是癌症患者和幸存者最常见和最痛苦的症状之一。然而，癌症相关疲劳的病因尚未确定。在之前的研究中，我们发现与非疲劳的对照受试者相比，疲劳的乳腺癌幸存者早晨血清皮质醇水平和昼夜皮质醇节律发生了变化。当前研究的目的是评估疲劳和非疲劳幸存者的皮质醇对所有实验性心理压力源的反应。方法：参与者包括 27 名乳腺癌幸存者（11 名疲劳者，16 名非疲劳者）。所有人都至少在 3 年前完成了癌症治疗，目前身体健康，没有复发的证据。在 90 分钟的下午会议中进行了标准化实验室压力源特里尔社会压力测试 (TSST)。在整个过程中，每隔 15 分钟收集一次唾液样本和自主测量（心率、血压）。结果：与非疲劳幸存者相比，疲劳幸存者对压力源的皮质醇反应显着减弱，控制了抑郁和其他潜在的混杂因素 (p < .05)。没有观察到自主神经测量的差异。结论：这些结果与我们早期的发现一起表明，患有持久疲劳的乳腺癌幸存者下丘脑-垂体-肾上腺 (HPA) 轴反应性失调。尽管样本量很小，但结果表明，关注 HPA 轴可能对于理解与癌症相关的疲劳很重要。
Objective: Fatigue is one of the most common and distressing symptoms experienced by cancer patients and survivors. However, the etiology of cancer-related fatigue has not been determined. In previous studies, we have shown alterations in morning serum cortisol levels and diurnal cortisol rhythms in fatigued breast cancer survivors compared with nonfatigued control subjects. The purpose of the current study was to evaluate cortisol responses to ail experimental psychologic stressor in fatigued and nonfatigued survivors. Methods: Participants included 27 breast cancer survivors (11 fatigued, 16 nonfatigued). All had completed cancer treatment at least 3 years previously and were Currently healthy with no evidence of recurrence. A standardized laboratory stressor, the Trier Social Stress Test (TSST), was administered during a 90-minute afternoon session. Saliva samples and autonomic measures (heart rate, blood pressure) were collected at 15-minute intervals throughout the session. Results: Fatigued survivors showed a significantly blunted cortisol response to the stressor compared with nonfatigued survivors, controlling for depression and other potential confounds (p < .05). No differences in autonomic measures were observed. Conclusions: These results, together with our earlier findings, Suggest a dysregulation in hypothalamic-pituitary-adrenal (HPA) axis responsiveness among breast cancer survivors with enduring fatigue. Although the sample size was small, results suggest that attention to the HPA axis may be important for understanding cancer-related fatigue.