Elevated Salivary Cortisol in the Evening in Healthy Elderly Men and Women: Correlation With Bone Mineral Density

Raff, Hershel; Raff, Jonathan L.; Duthie, Edmund H.; Wilson, Charles R.; Sasse, Edward A.; Rudman, Inge W.; Mattson, Dale E.

doi:10.1093/gerona/54.9.m479

Cited by 94 publications

(71 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…41 Small increases in salivary cortisol have been reported to correlate with decreased bone mineral density in elderly subjects, suggesting that these modest elevations have a physiological impact. 42 However, in the present study, salivary cortisol was not associated with BMI, waist circumference, plasma lipids, plasma insulin, or insulin resistance. Nevertheless, based on the well-known actions of glucocorticoids, it seems reasonable to hypothesize that cortisol plays a pathophysiological role in the metabolic syndrome.…”

Section: Kidambi Et Al Adrenal Steroids and The Metabolic Syndromecontrasting

confidence: 76%

Association of Adrenal Steroids With Hypertension and the Metabolic Syndrome in Blacks

et al. 2007

View full text Add to dashboard Cite

Abstract-Blacks have a high prevalence of hypertension and adrenal cortical adenomas/hyperplasia. We evaluated the hypothesis that adrenal steroids are associated with hypertension and the metabolic syndrome in blacks. Ambulatory blood pressures, anthropometric measurements, and measurements of plasma renin activity (PRA), aldosterone, fasting lipids, glucose, and insulin were obtained in 397 subjects (46% hypertensive and 50% female) after discontinuing antihypertensive and lipid-lowering medications. Hypertension was defined as average ambulatory blood pressure Ͼ130/85 mm Hg. Late-night and early morning salivary cortisol, 24-hour urine-free cortisol, and cortisone excretion were measured in a consecutive subsample of 97 subjects (40% hypertensive and 52% female). Compared with normotensive subjects, hypertensive subjects had greater waist circumference and unfavorable lipid profiles, were more insulin resistant, and had lower PRA and higher plasma aldosterone and both late-night and early morning salivary cortisol concentrations. Twenty-four-hour urine-free cortisol and cortisone did not differ. Overall, ambulatory blood pressure was positively correlated with plasma aldosterone (rϭ0.22; PϽ0.0001) and late-night salivary cortisol (rϭ0.23; Pϭ0.03) and inversely correlated with PRA (rϭϪ0.21; PϽ0.001). Plasma aldosterone correlated significantly with waist circumference, total cholesterol, triglycerides, insulin, and the insulin-resistance index. Based on Adult Treatment Panel III criteria, 17% of all of the subjects were classified as having the metabolic syndrome. Plasma aldosterone levels, but not PRA, were elevated in subjects with the metabolic syndrome (Pϭ0.0002). The association of aldosterone with blood pressure, waist circumference, and insulin resistance suggests that aldosterone may contribute to obesity-related hypertension in blacks. In addition, we speculate that relatively high aldosterone and low PRA in these hypertensive individuals may reflect a mild variant of primary aldosteronism. Key Words: aldosterone Ⅲ cortisol Ⅲ hypertension Ⅲ metabolic syndrome Ⅲ insulin resistance Ⅲ plasma renin activity T he prevalence of hypertension in African-Americans is among the highest in the world. In the United States, compared with whites, hypertension is 50% more frequent in blacks. 1,2 Blacks develop hypertension at a young age and have higher rates of hypertension-related deaths and cardiovascular complications including stroke, heart disease, and end-stage renal disease. 2 In both black and white populations, hypertension is frequently associated with centripetal obesity, insulin resistance, and dyslipidemia. [3][4][5] This constellation of risk factors has been termed the metabolic syndrome and is associated with increased cardiovascular disease morbidity and mortality. 6,7 Based on an earlier study of the records of 35 000 consecutive autopsies, an increased prevalence of adrenal cortical adenomas and hyperplasia has been observed in association with essential hypertension, particularly in younger and ...

show abstract

Section: Kidambi Et Al Adrenal Steroids and The Metabolic Syndromecontrasting

confidence: 76%

Association of Adrenal Steroids With Hypertension and the Metabolic Syndrome in Blacks

et al. 2007

View full text Add to dashboard Cite

show abstract

“…A number of potential actions have been recently postulated for DHEA-S on cognition and wellbeing [7]. DHEA-S might moderate the action of glucocorticoids and protect neurons from the neurotoxic effects of glucocorticoids [23]. In this study CM patients had DHEA-S levels not significantly lower than controls; however the cortisol to DHEA-S ratio is significantly higher than controls.…”

Section: Discussionmentioning

confidence: 56%

“…This aspect is of interest, as experimental data suggest that chronic exposure to high levels of corticosteroids can contribute to produce neurotoxic effects [19]. Several mechanisms have been considered to explain corticosteroid-induced neurotoxicity, including metabolic vulnerability of neurons due to oxygen radical generation and impairment of neuronal defences against neurologic insults [20]; in addition, cortisol hypersecretion is regarded as important in the pathophysiology of major depression [21] and has been associated with cognitive dysfunction [22] and also with loss of bone density [23]. A number of potential actions have been recently postulated for DHEA-S on cognition and wellbeing [7].…”

Section: Discussionmentioning

confidence: 99%

Salivary cortisol, dehydroepiandrosteronesulphate (DHEA–S) and testosterone in women with chronic migraine

et al. 2006

View full text Add to dashboard Cite

Hypothalamus–pituitaryadrenal (HPA) axis activity was monitored in 20 women with chronic migraine (CM), previously affected by medication overuse headache (MOH), in comparison to healthy women (20 subjects) by measuring salivary cortisol, testosterone, dehydroepiandrosterone–sulphate (DHEA–S) levels, and their ratios, one week after the end of the MOH rehabilitation procedure. The participants were instructed how to collect saliva samples at home, a procedure that was performed twice a day (08:00 a.m. and 8:00 p.m.). Morning and evening levels of cortisol were significantly increased in CM patients with respect to controls. With regard to the cortisol/DHEA–S ratio, an inverse marker of psycho–physical wellbeing, CM women showed significantly higher values than controls. Moreover, testosterone/cortisol ratios (anabolic/catabolic index of physical performance) were significantly lower in CM patients than in controls. In the present study, CM appears not to be associated with an impairment of cortisol and DHEAS circadian fluctuation; however, CM patients present alterations in HPA axis function that might contribute to metabolic and psychological alterations that have also been associated with CM.

show abstract

“…Hypercortisolism is an obvious potential cause. 137 In patients given glucocorticoids, maximal bone loss occurs at 3-4 months after treatment. 138,139 Since depressed, hypercortisolemic patients have glucocorticoid concentrations that are often equivalent to a patient receiving 10 mg of prednisone for 4 months or longer, the loss of bone in hypercortisolemic depressed patients can be quite severe.…”

Section: Long-term Medical Consequences Of Melancholic Depressionmentioning

confidence: 99%

Organization of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states

2002

View full text Add to dashboard Cite

Stress precipitates depression and alters its natural history. Major depression and the stress response share similar phenomena, mediators and circuitries. Thus, many of the features of major depression potentially reflect dysregulations of the stress response. The stress response itself consists of alterations in levels of anxiety, a loss of cognitive and affective flexibility, activation of the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system, and inhibition of vegetative processes that are likely to impede survival during a life-threatening situation (eg sleep, sexual activity, and endocrine programs for growth and reproduction). Because depression is a heterogeneous illness, we studied two diagnostic subtypes, melancholic and atypical depression. In melancholia, the stress response seems hyperactive, and patients are anxious, dread the future, lose responsiveness to the environment, have insomnia, lose their appetite, and a diurnal variation with depression at its worst in the morning. They also have an activated CRH system and may have diminished activities of the growth hormone and reproductive axes. Patients with atypical depression present with a syndrome that seems the antithesis of melancholia. They are lethargic, fatigued, hyperphagic, hypersomnic, reactive to the environment, and show diurnal variation of depression that is at its best in the morning. In contrast to melancholia, we have advanced several lines of evidence of a down-regulated hypothalamic-pituitary adrenal axis and CRH deficiency in atypical depression, and our data show us that these are of central origin. Given the diversity of effects exerted by CRH and cortisol, the differences in melancholic and atypical depression suggest that studies of depression should examine each subtype separately. In the present paper, we shall first review the mediators and circuitries of the stress system to lay the groundwork for placing in context physiologic and structural alterations in depression that may occur as part of stress system dysfunction. Molecular Psychiatry (2002) 7, 254-275. DOI: 10.1038/sj/mp/4001032 Keywords: atypical depression; corticotropin releasing hormone (CRH); melancholic depression; norepinephrine (NE); stress Stress precipitates major depression and influences its incidence, severity and course. 1,2 The stress response and major depression share many features because of similar brain circuitries and mediators (reviewed in 3-5 ). Each is associated with a diminution of cognitive and affective flexibility, alterations in arousal, and perturbations in neuroendocrine and autonomic function (reviewed in 5 ). Because major depression is a heterogeneous disorder, we focus here on two subtypes, melancholic and atypical depression. Our data and those of others indicate that the principal arousal producing mediators of the stress response, such as the corticotropin releasing hormone (CRH) system, are hyperactive in melancholic depression. 6 Not surprisingly, melan- cholia is associated with anxiety, dread of the ...

show abstract

Elevated Salivary Cortisol in the Evening in Healthy Elderly Men and Women: Correlation With Bone Mineral Density

Cited by 94 publications

References 0 publications

Association of Adrenal Steroids With Hypertension and the Metabolic Syndrome in Blacks

Association of Adrenal Steroids With Hypertension and the Metabolic Syndrome in Blacks

Salivary cortisol, dehydroepiandrosteronesulphate (DHEA–S) and testosterone in women with chronic migraine

Organization of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states

Contact Info

Product

Resources

About