日间皮质醇节律减弱与虚弱有关：一项对 745 名 65 至 90 岁老年人的横断面研究。
Blunted diurnal cortisol pattern is associated with frailty: a cross-sectional study of 745 participants aged 65 to 90 years.
机构信息
Institute of Epidemiology II (H.J., R.T.E., B.T., A.P., M.H., K.-H.L.), Helmholtz Zentrum München, German Research Centre for Environmental Health, 85764 Neuherberg, Germany; Medizinische Klinik und Poliklinik IV (M.B., M.R.), Klinikum der Ludwig-Maximilians-Universität München, 80336 Munich, Germany; and Department of Psychosomatic Medicine and Psychotherapy (K.-H.L.), Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany.
出版信息
J Clin Endocrinol Metab. 2014 Mar;99(3):E464-8. doi: 10.1210/jc.2013-3079. Epub 2014 Feb 24.
BACKGROUND
The role of neuroendocrine alterations in the etiology of frailty syndrome is still poorly understood. Hypothalamic-pituitary-adrenal axis dysregulation is a plausible candidate pathway contributing to frailty. Thus, we sought to examine the associations of diurnal cortisol secretion with frailty in older adults.
METHODS
A cross-sectional analysis was conducted among 745 study participants (age 65-90 years, mean age 75.1 years) of the population-based KORA Age study. Associations between salivary cortisol measures at awakening (morning 1 [M1]), 30 minutes after awakening (M2), and evening (E) and frailty criteria were determined.
RESULTS
Lower cortisol levels in the first morning sample (M1) (P = .18) and M2 (P = .14) and increased E levels (P = .004) were observed in prefrail (35.17%, n = 262) and frail (3.36%, n = 25) individuals, in a dose-response manner. Frailty was strongly associated with smaller ratios of morning to evening levels; M1 to E ratio (P = .02) and M2 to E ratio (P = .003). Higher evening cortisol levels were associated with a 24% increased risk of a prefrail state (odds ratio, 1.22; 95% confidence interval, 1.03-1.44). A smaller morning to evening ratio was associated with an increased risk of low grip strength (1.42, 1.09-1.86) and gait speed (1.31, 1.02-1.68).
CONCLUSION
Frailty status is associated with blunted cortisol reactivity as demonstrated by lower morning and higher evening salivary cortisol levels.
背景
神经内分泌改变在衰弱综合征的发病机制中的作用仍知之甚少。下丘脑-垂体-肾上腺轴失调是导致衰弱的一个合理候选途径。因此，我们试图研究老年人日间皮质醇分泌与衰弱的关系。
方法
在基于人群的 KORA 年龄研究中，对 745 名研究参与者（年龄 65-90 岁，平均年龄 75.1 岁）进行了横断面分析。确定唾液皮质醇测量值在觉醒时（早晨 1 [M1]）、觉醒后 30 分钟（M2）和傍晚（E）与衰弱标准之间的关系。
结果
在衰弱前期（35.17%，n=262）和衰弱期（3.36%，n=25）个体中，早晨（M1）（P=0.18）和 M2 （P=0.14）的皮质醇水平较低，以及 E 水平升高（P=0.004），呈剂量反应关系。衰弱与早晨与傍晚水平的比值较小密切相关；M1 与 E 的比值（P=0.02）和 M2 与 E 的比值（P=0.003）。傍晚皮质醇水平升高与衰弱前期状态的风险增加 24%相关（优势比，1.22；95%置信区间，1.03-1.44）。早晨与傍晚比值较小与握力降低（1.42，1.09-1.86）和步速降低（1.31，1.02-1.68）的风险增加相关。
结论
衰弱状态与皮质醇反应迟钝有关，表现为早晨和傍晚唾液皮质醇水平较低。
Zotero 插件