Long-term Reliability of Diurnal Intraocular Pressure Patterns in Healthy Asians

PURPOSE: To determine the long-term repeatability of diurnal intraocular pressure (IOP) patterns in healthy Asian subjects without glaucoma. METHODS: Twenty-three eyes in 23 healthy Asian subjects without glaucoma underwent diurnal IOP measurements using Goldmann applanation tonometry every 2 hours from 9 AM to 11 PM during two visits that were 8 weeks apart. To validate repeatability between visits, we calculated intra-class correlation coefficients (ICCs) mean IOP, peak IOP, minimum IOP, and IOP fluctuation at each time point and expressed the results as the difference between peak IOP and minimum IOP or as the standard deviation of all diurnal IOP values in the diurnal IOP curve. RESULTS: IOP repeatability was excellent at all time points, with ICCs ranging from 0.812 to 0.946 (p < 0.001). The 9 AM IOP showed the best repeatability between visits (ICCs, 0.946). Repeatability of mean IOP, peak IOP, and minimum IOP was also excellent (ICCs ranging from 0.899 to 0.929). However, IOP fluctuations showed poor repeatability, with an ICC lower than 0.15. CONCLUSIONS: Long-term repeatability of diurnal IOP patterns in healthy Asian subjects was excellent. These findings suggest that IOP measurements at standardized times of the day will be useful for assessing the effectiveness of glaucoma therapy.

Functional connectivity of suprachiasmatic nucleus in major depressive episodes patients with morn-ing heavy night light rhythm / 中华行为医学与脑科学杂志

Objective To explore the variations of functional connectivity in depressive episode pa-tients with diurnal rhythm.Methods Totaly 44 patients with depressive episode with diurnal rhythm(rhythm group),58 patients with depressive episode without diurnal rhythm(non-rhythm group)and 56 matched healthy volunteer controls(healthy group)were scanned with 3.0 T MRI Scanner.Functional connectivity (FC)were calculated between suprachiasmatic nucleus(SCN)and whole brain regions.According to results of ANOVA,group-wise two sample t-test was completed.Correlation analysis were conducted between FC of significant difference brain regions and the score of Hamilton rating scale(HAMD-24)for depression.Results The brain regions showing differences among three groups were located in the left medial superior frontal gy-rus(MNI:x=0,y=39,z=51; K=14)and right cerebellum crus 1(MNI:x=39,y=-48,z=-36; K=18) (P<0.05,Alphasim).Compared with non-rhythm group,the FC of rhythm group showed significantly in-creased in the left medial superior frontal gyrus and right triangular inferior frontal gyrus(MNI:x=39,y=27, z=27;K=10)(P<0.05,Alphasim).Compared with healthy group,the FC of non-rhythm group showed sig-nificantly decreased in left medial superior frontal gyrus(P<0.05,Alphasim).Positive correlation was found be-tween FC in left medial superior frontal gyrus and despair score of HAMD-24(r= 0.31,P= 0.041). Conclusion The synergistic increase in SCN and prefrontal activity in patients with depressive episodes with morning heavy night light rhythm which may be involved in the formation mechanism of the diurnal rhythm.

Amplitude of low frequency fluctuation in depressive patients with diurnal rhythm: a resting-state fMRI study / 中华行为医学与脑科学杂志

Objective To explore the energy feature of the spontaneous neural activity in depressive patients with diurnal rhythm.Methods Twenty depressive patients with diurnal rhythm,20 depressive patients without diurnal rhythm and 20 gender-,age-,education-matched healthy controls were scanned with 3.0 T MRI Scanner.According to Results of ANOVA,group-wise two sample t-test was completed.The correlation analysis were conducted between ALFF of significant difference brain regions and the score of Hamilton rating scale for depression.Results The brain regions showing significant differences among three groups were located in the right parahippocampal gyrus(MNI:18,-36,-9;K=136),left parietal lobe(MNI:-54,-45,42;K=86),left cerebellum crus(MNI:-84,-60,36;K=86) and right cerebellum crus(MNI:9,-78,-36;K=91)(P0.05).Conclusion The diurnal rhythm observed in depression may be associated with aberrant activity of parahippocampal gyrus.

Variación diurna del cortisol y su relación con estrés, optimismo y estrategias de afrontamiento en mujeres con cáncer de mama / Diurnal cortisol variation and its relationship with stress, optimism and coping strategies in women with breast cancer / Variação diurna do cortisol e sua relação com o estresse: otimismo e estratégias de enfrentamento em mulheres com câncer de mama

El ritmo diurno del cortisol se ha visto alterado en los pacientes con cáncer. Factores como el avance de la enfermedad y los niveles de estrés se han considerado para explicar esta condición; sin embargo, los resultados no son claros. El objetivo de este estudio fue evaluar y determinar si existen diferencias en los niveles de cortisol en mujeres con cáncer de mama en diferentes estadios, y analizar la relación entre los niveles de cortisol y el estrés, el optimismo y las estrategias de afrontamiento. Se recolectaron muestras de cortisol salival durante dos días, y se aplicaron cuestionarios psicológicos de estrés percibido (PSS), optimismo disposicional (LOT-R) y estrategias de afrontamiento (MAC) a 17 mujeres con cáncer de mama en estadio I, II y III. Los resultados muestran que las pacientes con cáncer de mama en los tres estadios presentan un ritmo diurno de cortisol normal y no difieren significativamente en los niveles de cortisol. Respecto a las variables psicológicas, solo difieren en la variable de optimismo. Las estrategias de afrontamiento espíritu de lucha y evitación cognitiva son las variables que tienen más influencia en los niveles de cortisol, y explican un 55% de la varianza. Se discuten las implicaciones de estos resultados.

Diurnal cortisol rhythm has been altered in patients with cancer. Factors such as disease progression and stress levels are regarded as possible causes to explain this condition, however results are not clear. The aim of this study was to assess and determine whether there are differences in cortisol levels in women with breast cancer in different stages and analyze the relationship between cortisol levels and stress, optimism and coping strategies. Salivary cortisol samples were collected for two days and psychological questionnaires of perceived stress (PSS), dispositional optimism (LOT-R) and coping strategies (MAC) were administered to 17 breast cancer women in stage I, II and III of the disease. The results show that patients with breast cancer in the three stages have a normal diurnal cortisol rhythm and do not differ significantly in cortisol levels. Regarding the psychological variables, they differ only in optimism. Coping strategies such as fighting spirit and cognitive avoidance are the variables that have more influence on cortisol levels, explaining 55% of variance. The implications of these results are discussed.

O ritmo diurno do cortisol vem sendo visto alterado nos pacientes com câncer. Fatores como o avanço da doença e os níveis de estresse estão sendo considerados para explicar essa condição; contudo, os resultados não são claros. O objetivo deste estudo foi avaliar e determinar se existem diferenças nos níveis de cortisol em mulheres com câncer de mama de diferentes estágios, bem como analisar estratégias de enfrentamento. Foram coletadas amostras de cortisol salival durante dois dias e aplicados questionários psicológicos de estresse percebido, otimismo disposicional e estratégias de enfrentamento a 17 mulheres com câncer de mama em estágio I, II e III. Os resultados mostram que as pacientes com esse câncer nos três estágios apresentam um ritmo diurno de cortisol normal e não se diferenciam significativamente na variável de otimismo. A respeito das variáveis psicológicas, só diferem na variável de otimismo. As estratégias de enfrentamento -espírito de luta e evitação cognitiva- são as variáveis que têm mais influência nos níveis de cortisol e explicam 55% da variação. Discutem-se as implicações desses resultados.

Controlled study on the diurnal variation of neuroendocrine rhythm in depressed patients / 中华行为医学与脑科学杂志

Objective To study the function and diurnal variation of hypothalamic-pituitary-adrenal (HPA) axis and hypothalamic-pituitary-thyroid(HPT) axis,and the relationship with clinical characteristics of di-urnal rhythm in depressed patients. Methods Forty-nine depressed patients met diagnostic DSM-Ⅳ criteria and thirty-eight normal controls were collected. The plasma levels of cortisol (CORT), adrenocorticotropic hormone (ACTH), T3, T4, thyroid-stimulating hormone (TSH) at 7 am and 7 pm were measured by radioimmunoassay, then the results concemed were compared among the depressed groups with and without diurnal variation and control group by multivariate analysis of variance. Results The plasma level of morning CORT, morning and evening TSH ((365.94±120.78) nmol/L; (6.24±2.47)μIU/ml; (6.68±2.42)μIU/ml; respectively) were respective-ly higher than those of control group((284.91±83.39) nmol/L; (3.82±1.75)μIU/ml;(4.01±1.69)μIU/ ml, P<0.05). The plasma levels of morning and evening T4 were significantly lower than those of control group(P <0.05). The CORT morning-evening difference variable distinguished between depressed and control group (P< 0.001),but no significant differences could be found between the depressed groups with and without diurnal varia-tion. There were no significant differences in the CORT, T3, T4, TSH morning-evening difference variable between various clinical subtypes of depressed patient (unipolar/bipolar; psychotic/nonpsychotic). Conclusion Abnormal CORT morning-evening difference variable was observed in the depressed patients compared with normal controls,and may be used as a special trait mark of depressed group.

Diurnal Variation of Pulse Wave Velocity Assessed Non-Invasively by Applanation Tonometry in Young Healthy Men

PURPOSE: Pulse wave velocity (PWV) is at least partially controlled by vascular tone. Vascular tone and underlying physiological processes such as sympathetic activity, plasma catecholamin, and cortisol levels have been shown to follow diurnal variations. MATERIALS AMD METHODS: Carotid-to-radial PWV was non-invasively assessed by applanation tonometry in 21 young (26.5+/-2.3 years) healthy men at three different time points (8:00hr, 12:00hr, 17:00hr) during a day. Additionally, heart rate, systolic, diastolic and mean blood pressure, and radial pulse pressure were assessed at the same time points. RESULTS: The mean PWV was significantly higher at 8:00 hr compared with the mean PWV assessed at later time points. No significant differences were found between mean PWV at 12:00 hr and at 17:00hr. When PWV was corrected for blood pressure, the difference between values at 8:00hr and 12:00hr was no longer significant. Systolic, diastolic and mean blood pressure were significantly lower at 17:00hr compared with those at 8:00hr. CONCLUSION: A small but significant diurnal variation of PWV was observed in young healthy men, which might have been caused at least partly by variations of blood pressure. This finding could be of value, when PWV is used in human research. Thus, in longitudinal investigations the measurements should be performed at similar time points in the course of a day, in order to obtain comparable data. Additionally, our observations ought to be of assistance to studies in which novel pharmacological compounds with activity on the vasculature are investigated.

Salivary Cortisol and DHEA Levels in the Korean Population: Age-Related Differences, Diurnal Rhythm, and Correlations with Serum Levels

PURPOSE: The primary objective of this study was to examine the changes of basal cortisol and DHEA levels present in saliva and serum with age, and to determine the correlation coefficients of steroid concentrations between saliva and serum. The secondary objective was to obtain a standard diurnal rhythm of salivary cortisol and DHEA in the Korean population. MATERIALS AND METHODS: For the first objective, saliva and blood samples were collected between 10 and 11 AM from 359 volunteers ranging from 21 to 69 years old (167 men and 192 women). For the second objective, four saliva samples (post-awakening, 11AM, 4PM, and bedtime) were collected throughout a day from 78 volunteers (42 women and 36 men) ranging from 20 to 40 years old. Cortisol and DHEA levels were measured using a radioimmunoassay (RIA). RESULTS: The morning cortisol and DHEA levels, and the age-related steroid decline patterns were similar in both genders. Serum cortisol levels significantly decreased around forty years of age (p < 0.001, when compared with people in their 20s), and linear regression analysis with age showed a significant declining pattern (slope= -2.29, t= -4.297, p < 0.001). However, salivary cortisol levels did not change significantly with age, but showed a tendency towards decline (slope= -0.0078, t= -0.389, p=0.697). The relative cortisol ratio of serum to saliva was 3.4 - 4.5% and the ratio increased with age (slope=0.051, t=3.61, p < 0.001). DHEA levels also declined with age in saliva (slope= -0.007, t= -3.76, p < 0.001) and serum (slope= -0.197 t= -4.88, p < 0.001). In particular, DHEA levels in saliva and serum did not start to significantly decrease until ages in the 40s, but then decreased significantly further at ages in the 50s (p < 0.001, when compared with the 40s age group) and 60s (p < 0.001, when compared with the 50 age group). The relative DHEA ratio of serum to saliva was similar throughout the ages examined (slop = 0.0016, t = 0.344, p = 0.73). On the other hand, cortisol and DHEA levels in saliva reflected well those in serum (r = 0.59 and 0.86, respectively, p < 0.001). The highest salivary cortisol levels appeared just after awakening (about two fold higher than the 11 AM level), decreased throughout the day, and reached the lowest levels at bedtime (p < 0.001, when compared with PM cortisol levels). The highest salivary DHEA levels also appeared after awakening (about 1.5 fold higher than the 11 AM level) and decreased by 11AM (p < 0.001). DHEA levels did not decrease further until bedtime (p=0.11, when compared with PM DHEA levels). CONCLUSION: This study showed that cortisol and DHEA levels change with age and that the negative slope of DHEA was steeper than that of cortisol in saliva and serum. As the cortisol and DHEA levels in saliva reflected those in serum, the measurement of steroid levels in saliva provide a useful and practical tool to evaluate adrenal functions, which are essential for clinical diagnosis.

Salivary Cortisol and DHEA Levels in the Korean Population: Age-Related Differences, Diurnal Rhythm, and Correlations with Serum Levels

PURPOSE: The primary objective of this study was to examine the changes of basal cortisol and DHEA levels present in saliva and serum with age, and to determine the correlation coefficients of steroid concentrations between saliva and serum. The secondary objective was to obtain a standard diurnal rhythm of salivary cortisol and DHEA in the Korean population. MATERIALS AND METHODS: For the first objective, saliva and blood samples were collected between 10 and 11 AM from 359 volunteers ranging from 21 to 69 years old (167 men and 192 women). For the second objective, four saliva samples (post-awakening, 11AM, 4PM, and bedtime) were collected throughout a day from 78 volunteers (42 women and 36 men) ranging from 20 to 40 years old. Cortisol and DHEA levels were measured using a radioimmunoassay (RIA). RESULTS: The morning cortisol and DHEA levels, and the age-related steroid decline patterns were similar in both genders. Serum cortisol levels significantly decreased around forty years of age (p < 0.001, when compared with people in their 20s), and linear regression analysis with age showed a significant declining pattern (slope= -2.29, t= -4.297, p < 0.001). However, salivary cortisol levels did not change significantly with age, but showed a tendency towards decline (slope= -0.0078, t= -0.389, p=0.697). The relative cortisol ratio of serum to saliva was 3.4 - 4.5% and the ratio increased with age (slope=0.051, t=3.61, p < 0.001). DHEA levels also declined with age in saliva (slope= -0.007, t= -3.76, p < 0.001) and serum (slope= -0.197 t= -4.88, p < 0.001). In particular, DHEA levels in saliva and serum did not start to significantly decrease until ages in the 40s, but then decreased significantly further at ages in the 50s (p < 0.001, when compared with the 40s age group) and 60s (p < 0.001, when compared with the 50 age group). The relative DHEA ratio of serum to saliva was similar throughout the ages examined (slop = 0.0016, t = 0.344, p = 0.73). On the other hand, cortisol and DHEA levels in saliva reflected well those in serum (r = 0.59 and 0.86, respectively, p < 0.001). The highest salivary cortisol levels appeared just after awakening (about two fold higher than the 11 AM level), decreased throughout the day, and reached the lowest levels at bedtime (p < 0.001, when compared with PM cortisol levels). The highest salivary DHEA levels also appeared after awakening (about 1.5 fold higher than the 11 AM level) and decreased by 11AM (p < 0.001). DHEA levels did not decrease further until bedtime (p=0.11, when compared with PM DHEA levels). CONCLUSION: This study showed that cortisol and DHEA levels change with age and that the negative slope of DHEA was steeper than that of cortisol in saliva and serum. As the cortisol and DHEA levels in saliva reflected those in serum, the measurement of steroid levels in saliva provide a useful and practical tool to evaluate adrenal functions, which are essential for clinical diagnosis.