Clinical Pharmacology Division, Department of Medical Pharmacology, Institute of Medical Sciences, Istanbul University, 34126 Istanbul, Turkey.
Laboratory Technician Department, Heimerer College, 10000 Prishtina, Kosovo.
J Clin Endocrinol Metab. 2023 Aug 18;108(9):2307-2314. doi: 10.1210/clinem/dgad122.
Stress triggers a cascade of reactions that alter the organism's dynamic steady state. There is a scarcity of interventional studies that show cortisol variability upon stress over time in groups of patients with chronic noncommunicable diseases and comorbidities.
We aimed to examine salivary cortisol changes in the cognitive stress response of patients with hypertension and diabetes mellitus (HT&DM) and patients with hypertension (HT) and to determine differences between them.
The study was conducted using a stress test of solving an arithmetic task in 62 patients with HT&DM and HT who were being treated in the outpatient clinic of the Medical Pharmacology and Clinical Pharmacology Department in Istanbul University, Istanbul Medical Faculty Hospital.
There was no statistically significant difference between the HT&DM and HT groups for systolic blood pressure (SBP) and diastolic blood pressure (DBP) values (P = .331 and P = .058). When measured by repeated ANOVA, salivary cortisol level [F (1.842, 60) = 8.771, P < .0001], SBP [F (2.185, 60) = 12.080, P < .0001], DBP [F (2.793, 60) = 6.043, P = .001], and heart rate [F (2.073, 60) = 13.259, P < .0001] were statistically significant for the main effect (time), while the effect of the group × time interaction factor was statistically not significant (P = .773; P = .751; P = .713 and P = .506, respectively).
The arithmetic problem-solving task used with the HT&DM and HT patients was useful as an acute stress test in the laboratory environment. There was no statistically significant difference for group × time interaction factor between the HT&DM and HT groups; however, the salivary cortisol and BP values increased significantly after acute stress within each group.
压力会引发一系列反应，改变机体的动态平衡状态。目前，关于慢性非传染性疾病合并症患者群体在经历一段时间的应激时皮质醇变化的干预性研究较为匮乏。
我们旨在检测高血压合并糖尿病（HT&DM）与单纯高血压（HT）患者在认知应激反应中唾液皮质醇的变化，并确定两组间的差异。
该研究纳入了在伊斯坦布尔大学伊斯坦布尔医学院医学药理学和临床药理学系门诊接受治疗的 62 例 HT&DM 和 HT 患者，采用解决算术任务的应激测试。
HT&DM 组和 HT 组的收缩压（SBP）和舒张压（DBP）值差异无统计学意义（P =.331 和 P =.058）。通过重复方差分析测量，唾液皮质醇水平[F（1.842，60）= 8.771，P <.0001]、SBP [F（2.185，60）= 12.080，P <.0001]、DBP [F（2.793，60）= 6.043，P =.001]和心率[F（2.073，60）= 13.259，P <.0001]的主效应（时间）具有统计学意义，而组×时间交互作用因素的影响无统计学意义（P =.773；P =.751；P =.713 和 P =.506）。
对于 HT&DM 和 HT 患者，使用算术问题解决任务作为实验室环境下的急性应激测试是有效的。HT&DM 组和 HT 组之间组×时间交互作用因素无统计学差异，但每组在急性应激后皮质醇和血压值均显著升高。
