MSc, Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Ludolf-Krehl-Strasse 7-11, 68167 Mannheim, Germany.
Psychosom Med. 2010 Apr;72(3):281-9. doi: 10.1097/PSY.0b013e3181d35065. Epub 2010 Feb 26.
Everyday stressors elicit adaptive changes in the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system. Data on the relationship between these two systems under real-life conditions are sparse. We, therefore, sought to examine the association between HRV and salivary cortisol, which were recorded simultaneously in a stress-exposed, prospective, occupational cohort.
The study population comprised 88 nurses. We recorded heart rate (HR) and HRV during 301 working shifts. Participants provided salivary cortisol samples at the beginning of their work shift and every 2 hours thereafter. Samples were collected during three investigation periods spread over 9 months. Change scores for cortisol were calculated as deviations from the expected circadian baseline. Change scores from the grand diurnal mean in the time domain-based root mean square of successive differences served to index alterations in HRV. To account for the temporal delay between changes in HR/HRV and changes in salivary cortisol, the latter were compared with the changes in HR/HRV observed 15 minutes to 45 minutes before the cortisol sampling.
During periods of high stress as indexed by high cortisol levels, we found significant associations between cortisol levels and HR (r = .48, p < .001) and HRV (r = -.28, p = .05). However, during low stress periods, these associations were attenuated and became nonsignificant.
These data suggest a relative independence in the regulation of the HPA axis and the autonomic nervous system in response to everyday stressors but synchrony of both systems in highly stressful situations.
日常压力源会引起下丘脑-垂体-肾上腺（HPA）轴和自主神经系统的适应性变化。关于这两个系统在现实生活条件下的关系的数据很少。因此，我们试图研究心率变异性（HRV）与唾液皮质醇之间的关系，这两种方法在应激暴露的前瞻性职业队列中同时进行记录。
研究人群包括 88 名护士。我们在 301 个工作班次中记录了心率（HR）和 HRV。参与者在工作班次开始时以及此后每 2 小时提供唾液皮质醇样本。样本在 9 个月内的三个调查期间收集。皮质醇的变化分数计算为与预期昼夜基线的偏差。基于时域的连续差异均方根的昼夜均值的变化分数用于指示 HRV 的变化。为了说明 HR/HRV 和唾液皮质醇变化之间的时间延迟，将后者与皮质醇采样前 15 分钟至 45 分钟观察到的 HR/HRV 变化进行比较。
在以高皮质醇水平为指标的高压力期间，我们发现皮质醇水平与 HR（r =.48，p <.001）和 HRV（r = -.28，p =.05）之间存在显著相关性。然而，在低压力期间，这些相关性减弱且变得不显著。
这些数据表明，HPA 轴和自主神经系统在应对日常压力源时的调节具有相对独立性，但在高度应激情况下，两个系统具有同步性。
