Ghiciuc Cristina Mihaela, Cozma-Dima Corina Lucia, Pasquali Vittorio, Renzi Paolo, Simeoni Simona, Lupusoru Catalina Elena, Patacchioli Francesca Romana
Department of Pharmacology, School of Medicine, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania.
Neuro Endocrinol Lett. 2011;32(4):475-80.
Because the cortisol awakening response (CAR) has received increasing attention as a useful index of adrenocortical activity, the primary objective of this study was to investigate the presence of an awakening response for various salivary biomarkers of adrenocortical activity, including dehydroepiandrosterone-sulphate (DHEA-S), which acts as a cortisol antagonist, and α-amylase, which is a predictor of circulating catecholamine activity. Salivary biological indicators are considered to be valuable markers of hypothalamus-pituitary-adrenal (HPA) axis diurnal activity.
In an attempt to overcome problems associated with non-adherence to the requested sampling protocol, only young, healthy males with a physiological CAR value (defined as a 50% increase in salivary cortisol within 30 min after waking) were included in the study (67 out of 102 who initially enrolled met this criterion).
Our results suggested that, as is already known for cortisol, DHEA-S and α-amylase have significant awakening responses. In addition, daily profile of salivary cortisol, α-amylase and DHEA-S fluctuations were analysed. Significant correlations were found between salivary cortisol, DHEA-S and α-amylase levels. The results showed that cortisol and DHEA-S concentrations were inversely correlated with α-amylase levels.
This correlation confirmed the distinctiveness of the two regulatory systems: salivary cortisol and DHEA-S concentrations reflect the activity of the HPA axis, whereas α-amylase activity is more closely related to sympathetic activity. In addition, the present study emphasizes the potential value of saliva collection (which is both easy and stress-free) in monitoring changes of adrenal function, confirming that multiple sampling (especially within 1 h after awakening) is necessary to reliably characterise biomarker activity when investigating neuroendocrine changes under various conditions.
由于皮质醇觉醒反应（CAR）作为肾上腺皮质活动的有用指标受到越来越多的关注，本研究的主要目的是调查肾上腺皮质活动的各种唾液生物标志物是否存在觉醒反应，这些生物标志物包括作为皮质醇拮抗剂的硫酸脱氢表雄酮（DHEA-S）以及作为循环儿茶酚胺活性预测指标的α-淀粉酶。唾液生物指标被认为是下丘脑-垂体-肾上腺（HPA）轴昼夜活动的有价值标志物。
为了克服与不遵守要求的采样方案相关的问题，本研究仅纳入了具有生理性CAR值（定义为醒来后30分钟内唾液皮质醇增加50%）的年轻健康男性（最初招募的102人中，有67人符合该标准）。
我们的结果表明，正如皮质醇已知的那样，DHEA-S和α-淀粉酶具有显著的觉醒反应。此外，还分析了唾液皮质醇、α-淀粉酶和DHEA-S波动的每日变化情况。发现唾液皮质醇、DHEA-S和α-淀粉酶水平之间存在显著相关性。结果表明，皮质醇和DHEA-S浓度与α-淀粉酶水平呈负相关。
这种相关性证实了两种调节系统的独特性：唾液皮质醇和DHEA-S浓度反映HPA轴的活动，而α-淀粉酶活性与交感神经活动关系更密切。此外，本研究强调了唾液采集（既简单又无压力）在监测肾上腺功能变化方面的潜在价值，证实了在研究各种条件下的神经内分泌变化时，为可靠地表征生物标志物活性，多次采样（尤其是在醒来后1小时内）是必要的。
