Wüst Stefan, Wolf Jutta, Hellhammer Dirk H., Federenko Ilona, Schommer Nicole, Kirschbaum Clemens
Center for Psychobiological and Psychosomatic Research, University of Trier, Dietrichstrasse 10-11, 54290 Trier, Germany, Email:
Noise Health. 2000;2(7):79-88.
In several recent investigations it could be demonstrated that the free cortisol response to awakening can serve as an useful index of the adrenocortical activity. When measured with strict reference to the time of awakening the assessment of this endocrine response is able to uncover subtle changes in hypothalamus-pituitary-adrenal (HPA) axis activity, which are, for instance, related to persisting pain, burnout and chronic stress. Furthermore, it has been suggested that the HPA axis might serve as an indicator of allostatic load in subjects exposed to prolonged environmental noise. In the present paper four separate studies with a total of 509 adult subjects were combined in order to provide reliable information on normal values for the free cortisol response to awakening. Corresponding with earlier findings, a mean cortisol increase of about 50% within the first 30 minutes after awakening was observed. The intraindividual stability over time was shown to be remarkably high with correlations up to r=.63 (for the area under the response curve). Furthermore, the cortisol rise after awakening is rather consistent, with responder rates of about 75%. Gender significantly influenced early morning free cortisol levels. Although women showed a virtually identical cortisol increase after awakening compared to men, a significantly delayed decrease was observed. Confirming and extending previous findings, the present study strongly suggests that neither age, nor the use of oral contraceptives, habitual smoking, time of awakening, sleep duration or using / not using an alarm clock have a considerable impact on free cortisol levels after awakening. The cortisol awakening response can be assessed under a wide variety of clinical and field settings, since it is non-invasive, inexpensive and easy-to-employ. The present data provide normal values and information on potential confounds which should facilitate investigations into the endocrine consequences of prolonged exposure to environmental noise.
在最近的几项研究中，可以证明觉醒时游离皮质醇反应可作为肾上腺皮质活动的有用指标。严格参照觉醒时间进行测量时，这种内分泌反应的评估能够揭示下丘脑-垂体-肾上腺（HPA）轴活动的细微变化，例如与持续性疼痛、倦怠和慢性应激相关的变化。此外，有人提出HPA轴可能作为长期暴露于环境噪声的受试者中应激负荷的指标。在本文中，四项独立研究共纳入509名成年受试者，以提供关于觉醒时游离皮质醇反应正常值的可靠信息。与早期研究结果一致，观察到觉醒后前30分钟内皮质醇平均升高约50%。个体随时间的稳定性非常高，反应曲线下面积的相关性高达r = 0.63。此外，觉醒后皮质醇升高相当一致，反应率约为75%。性别对清晨游离皮质醇水平有显著影响。尽管与男性相比，女性觉醒后皮质醇升高几乎相同，但观察到其下降明显延迟。本研究证实并扩展了先前的研究结果，强烈表明年龄、口服避孕药的使用、习惯性吸烟、觉醒时间、睡眠时间或是否使用闹钟对觉醒后游离皮质醇水平均无显著影响。皮质醇觉醒反应可在多种临床和现场环境中进行评估，因为它是非侵入性的、成本低廉且易于应用。本研究数据提供了正常值以及关于潜在混杂因素的信息，这将有助于对长期暴露于环境噪声的内分泌后果进行研究。
