The cortisol awakening response and the metabolic syndrome in a population-based sample of middle-aged men and women

Bengtsson, Inger; Lissner, Lauren; Ljung, Thomas; Rosengren, Annika; Thelle, Dag S.; Währborg, Peter

doi:10.1016/j.metabol.2009.10.024

Cited by 18 publications

(17 citation statements)

References 44 publications

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“…A blunted CAR, as part of an impaired HPA axis profile, has even been suggested as an additional marker of metabolic vulnerability (Lasikiewicz et al, 2008). Accordingly, most previous studies found a blunted CAR to be associated with higher metabolic risk (Bruehl et al, 2009;Lamers et al, 2013;Lasikiewicz et al, 2008) although not all results are consistent (Bengtsson et al, 2010;Kajantie et al, 2004). In line with the majority of the previous studies, we found that higher CAR values were associated with lower diastolic and systolic blood pressure values.…”

Section: Discussionsupporting

confidence: 89%

“…Importantly, a blunted rather than a high CAR has been associated with unfavorable metabolic risk profiles in (Lasikiewicz et al, 2008;Rosmond and Björntorp, 2000), in patients with type 2 diabetes (Bruehl et al, 2009), hypertension (Wirtz et al, 2007) and depression (Lamers et al, 2013), although not all studies concur (Bengtsson et al, 2010;Kajantie et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

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Hair cortisol and cortisol awakening response are associated with criteria of the metabolic syndrome in opposite directions

Kuehl

Hinkelmann

Muhtz

et al. 2015

Psychoneuroendocrinology

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Hair cortisol and cortisol awakening response are associated with criteria of the metabolic syndrome in opposite directions

Kuehl

Hinkelmann

Muhtz

et al. 2015

Psychoneuroendocrinology

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“…43 Moreover, memory deficits and cognitive impairments are a common feature in ED, 41 44 and a shorter time span between sampling points was therefore desirable to facilitate remembering to perform the next sample, which would thereby increase compliance with sampling instructions. Collecting only two samples was, however, a limitation to the study since three or more samples are recommended to fully cover the awakening response.…”

Section: Methodological Considerationsmentioning

confidence: 99%

Long-term follow-up of cortisol awakening response in patients treated for stress-related exhaustion

2012

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ObjectivesStudies on hypothalamus–pituitary–adrenal (HPA) axis activity in stress-related exhaustion and burnout have revealed incongruent results, and few longitudinal studies on clinical populations have been performed. This study was designed to investigate differences in HPA axis activity between patients with stress-related exhaustion and healthy controls and to investigate longitudinal changes in HPA axis activity in the patient group as they entered a multimodal treatment programme.DesignHPA axis activity was assessed through the cortisol awakening response (CAR). Salivary cortisol was sampled at awakening and after 15 min. Follow-up measurements were performed in the patient group after 3, 6, 12 and 18 months.SettingAn outpatient clinic specialising in stress-related illness.ParticipantsPatients with clinically diagnosed stress-related exhaustion (n=162) and healthy controls (n=79).Primary and secondary outcome measuresThe primary measure was CAR measured as the difference between the two salivary cortisol samples. Changes in CAR during follow-up were related to changes in symptoms of burnout, depression and anxiety.ResultsPatients showed similar CAR as the controls and their CAR did not change significantly during treatment. No association was found between CAR and symptom development during treatment.ConclusionsThe authors conclude that CAR does not seem to discriminate clinically defined patients with exhaustion from healthy controls and it appears not to change during treatment. CAR, measured as salivary cortisol, at awakening and after 15 min, is thus not a valid marker for stress-related exhaustion.

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“…The clustering of these factors is called the metabolic syndrome, and may be at least partially due to dysregulation of the neuroendocrine system (Rosmond, 2005; Walker, 2006; Anagnostis et al, 2009). To date, studies investigating the relationship between cortisol and the metabolic syndrome have yielded mixed results, with some studies showing an association with hypercortisolism (Steptoe et al, 2004; Boyle et al, 2007; Vogelzangs and Penninx, 2007; Weigensberg et al, 2008; Stalder et al, 2013), some showing hypocortisolism (Bengtsson et al, 2010; Ljung et al, 2012; Champaneri et al, 2013) and some showing no association (Filipovský et al, 1996; Rosmond, 2005; Walker, 2006; Anagnostis et al, 2009; Abraham et al, 2013). …”

Section: Introductionmentioning

confidence: 99%

“…Mind-body therapies may aid in this process (Bengtsson et al, 2010; Woodyard, 2011; Ljung et al, 2012; Champaneri et al, 2013). Yoga interventions have demonstrated improved cortisol and stress outcomes in diverse populations.…”

Section: Introductionmentioning

confidence: 99%

Effect of restorative yoga vs. stretching on diurnal cortisol dynamics and psychosocial outcomes in individuals with the metabolic syndrome: The PRYSMS randomized controlled trial

Corey

Epel

Schembri

et al. 2014

Psychoneuroendocrinology

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Purpose Chronic stimulation and dysregulation of the neuroendocrine system by stress may cause metabolic abnormalities. We estimated how much cortisol and psychosocial outcomes improved with a restorative yoga (relaxation) versus a low impact stretching intervention for individuals with the metabolic syndrome. Methods We conducted a 1-year multi-center randomized controlled trial (6-month intervention and 6-month maintenance phase) of restorative yoga vs. stretching. Participants completed surveys to assess depression, social support, positive affect, and stress at baseline, 6 months and 12 months. For each assessment, we collected saliva at four points daily for three days and collected response to dexamethasone on the fourth day for analysis of diurnal cortisol dynamics. We analyzed our data using multivariate regression models, controlling for study site, medications (antidepressants, hormone therapy), body mass index, and baseline cortisol values. Results Psychosocial outcome measures were available for 171 study participants at baseline, 140 at 6 months, and 132 at the 1 year. Complete cortisol data were available for 136 of 171 study participants (72 in restorative yoga and 64 in stretching) and were only available at baseline and 6 months. At 6 months, the stretching group had decreased cortisol at waking and bedtime compared to the restorative yoga group, The pattern of changes in stress mirrored this improvement, with the stretching group showing reductions in chronic stress severity and perseverative thoughts about their stress. Perceived stress decreased by 1.5 points (−0.4; 3.3, p=0.11) at 6 months, and by 2.0 points (0.1; 3.9, p=0.04) at 1 year in the stretching compared to restorative yoga groups. Post hoc analyses suggest that in the stretching group only, perceived increases in social support (particularly feelings of belonging), but not changes in stress were related to improved cortisol dynamics. Conclusions We found significant decreases in salivary cortisol, chronic stress severity, and stress perception in the stretching group compared to the restorative yoga group. Group support during the interactive stretch classes may have contributed to these changes.

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The cortisol awakening response and the metabolic syndrome in a population-based sample of middle-aged men and women

Cited by 18 publications

References 44 publications

Hair cortisol and cortisol awakening response are associated with criteria of the metabolic syndrome in opposite directions

Hair cortisol and cortisol awakening response are associated with criteria of the metabolic syndrome in opposite directions

Long-term follow-up of cortisol awakening response in patients treated for stress-related exhaustion

Effect of restorative yoga vs. stretching on diurnal cortisol dynamics and psychosocial outcomes in individuals with the metabolic syndrome: The PRYSMS randomized controlled trial

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