Cortisol levels in scalp hair of patients with structural heart disease

Younge, John O.; Wester, Vincent L.; Rossum, Elisabeth F.C. van; Gotink, Rinske A.; Wery, Machteld F.; Utens, Elisabeth M. W. J.; Hunink, M. G. Myriam; Roos‐Hesselink, Jolien W.

doi:10.1016/j.ijcard.2015.02.005

Cited by 31 publications

(31 citation statements)

References 40 publications

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“…We found that in both adult and pediatric obese patients, HCC are increased compared to non-obese healthy controls (29,30). Furthermore, HCC positively correlates with BMI in multiple other studies (21,28,31,32,33,34). Together, these results strongly suggest that increased long-term cortisol exposure is associated with increased adiposity.…”

Section: Cardiometabolic Statussupporting

confidence: 66%

“…The decrease was present in both treatment arms, and since no placebo group was present, a conclusion about the cause of the observed decrease cannot be drawn. In contrast, in a randomized clinical trial involving 261 patients with structural heart disease, we observed no difference in between patient who underwent a mindfulness based stress reduction intervention, compared to patients who were assigned to the control group, although the whole study population on average showed a decrease in HCC during the study (32). Future studies will show if, and which behavioral and medical interventions are capable of modulating longterm cortisol exposure as measured with HCC.…”

Section: Future Directionscontrasting

confidence: 62%

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Clinical applications of cortisol measurements in hair

Wester

Rossum

2015

European Journal of Endocrinology

175

141

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Cortisol measurements in blood, saliva and urine are frequently used to examine the hypothalamus-pituitary-adrenal (HPA) axis in clinical practice and in research. However, cortisol levels are subject to variations due to acute stress, the diurnal rhythm and pulsatile secretion. Cortisol measurements in body fluids are not always a reflection of long-term cortisol exposure. The analysis of cortisol in scalp hair is a relatively novel method to measure cumulative cortisol exposure over months up to years. Over the past years, hair cortisol concentrations (HCC) have been examined in association with a large number of somatic and mental health conditions. HCC can be used to evaluate disturbances of the HPA axis, including Cushing's syndrome, and to evaluate hydrocortisone treatment. Using HCC, retrospective timelines of cortisol exposure can be created which can be of value in diagnosing cyclic hypercortisolism. HCC have also been shown to increase with psychological stressors, including major life events, as well as physical stressors, such as endurance exercise and shift work. Initial studies show that HCC may be increased in depression, but decreased in general anxiety disorder. In posttraumatic stress disorder, changes in HCC seem to be dependent on the type of traumatic experience and the time since traumatization. Increased hair cortisol is consistently linked to obesity, metabolic syndrome and cardiovascular disease. Potentially, HCC could form a future marker for cardiovascular risk stratification, as well as serve as a treatment target.

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Section: Cardiometabolic Statussupporting

confidence: 66%

Section: Future Directionscontrasting

confidence: 62%

Clinical applications of cortisol measurements in hair

Wester

Rossum

2015

European Journal of Endocrinology

175

141

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“…Patients were instructed to walk the greatest distance they could in 6 minutes. Secondary outcome measures were physical parameters (blood pressure, respiratory rate, and heart rate), blood sampling laboratory test (N-terminal pro-brain natriuretic peptide (NT-proBNP) measured from peripheral venous blood samples), and hair cortisol as a biomarker of stress using ELISA as previously described [28]. Details on lab procedures can be found in the 3-month article [24].…”

Section: Methodsmentioning

confidence: 99%

Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial

et al. 2017

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There is increasing evidence that mindfulness can reduce stress, and thereby affect other psychological and physiological outcomes as well. Earlier, we reported the direct 3-month results of an online modified mindfulness-based stress reduction training in patients with heart disease, and now we evaluate the effect at 12-month follow-up. 324 patients (mean age 43.2 years, 53.7% male) were randomized in a 2:1 ratio to additional 3-month online mindfulness training or to usual care alone. The primary outcome was exercise capacity measured with the 6 minute walk test (6MWT). Secondary outcomes were blood pressure, heart rate, respiratory rate, NT-proBNP, cortisol levels (scalp hair sample), mental and physical functioning (SF-36), anxiety and depression (HADS), perceived stress (PSS), and social support (PSSS12). Differences between groups on the repeated outcome measures were analyzed with linear mixed models. At 12-months follow-up, participants showed a trend significant improvement exercise capacity (6MWT: 17.9 meters, p = 0.055) compared to UC. Cohen’s D showed significant but small improvement on exercise capacity (d = 0.22; 95%CI 0.05 to 0.39), systolic blood pressure (d = 0.19; 95%CI 0.03 to 0.36), mental functioning (d = 0.22; 95%CI 0.05 to 0.38) and depressive symptomatology (d = 0.18; 95%CI 0.02 to 0.35). All other outcome measures did not change statistically significantly. In the as-treated analysis, systolic blood pressure decreased significantly with 5.5 mmHg (p = 0.045; d = 0.23 (95%CI 0.05–0.41)). Online mindfulness training shows favorable albeit small long-term effects on exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology in patients with heart disease and might therefore be a beneficial addition to current clinical care.Trial registration: www.trialregister.nl NTR3453

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“…In past studies, cortisol profiles have been measured in saliva, urine or hair and have been used as a biomarker to evaluate stress and endocrine disorders [10,15,16]. Salivary cortisol profiles were initially considered to be a better index of adrenocortical active hormone than serum cortisol, though in recent years almost all cortisol sources and extraction methods have been challenged due to the high cost and low reliability of said methods [17].…”

Section: Discussionmentioning

confidence: 99%

“…Saliva cortisol, for its high sensitivity, was used as the standard to validate the data of teeth cortisol. Immunoassay is the most common approach for analyzing cortisol in human saliva, hair or serum [2,[14][15][16]. However, there is currently no methodological report.…”

Section: Cortisol Assaymentioning

confidence: 99%

Embedded Dental Cortisol Content: A Pilot Study

G¹,

Jeong²

2016

Endocrinol Metab Syndr

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Objective: This study tests the feasibility and validity of analyzing cortisol levels within human teeth and the possibility of any potential gender differences. Methods:As a precursor, to confirm the general presence and existence of cortisol within teeth, six healthy supernumerary teeth were initially extracted and examined following the ELISA method. After confirming that cortisol was in fact present within human teeth, we began the main experiment. In order to examine any potential gender differences, twenty-one extracted wisdom teeth were collected from subjects (11 male and 10 female) within the age range of 27-29 yrs. Results:The results showed irrefutable proof of the existence of cortisol within the dentin of the teeth. Observations revealed that gender had no significant impact upon a subject's dental cortisol levels (p>0.05), suggesting that cortisol in teeth can be used as an unbiased and reliable means of studying stress.Conclusions: This is the first report on extraction and analysis of cortisol levels in hard tissues, such as teeth, leading to the discovery of a novel biomarker that can be used when studying chronic stress. Practical application of this study can be used postmortem to assess cortisol levels in patients suffering from prolonged disorders, including patients having undergone chemotherapy treatments, when hair cortisol analysis proved to be problematic.

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Cortisol levels in scalp hair of patients with structural heart disease

Cited by 31 publications

References 40 publications

Clinical applications of cortisol measurements in hair

Clinical applications of cortisol measurements in hair

Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial

Embedded Dental Cortisol Content: A Pilot Study

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