Evaluation of cortisol and telomere length measurements in ethnically diverse women with breast cancer using culturally sensitive methods

Abstract

The under-representation of ethnic minority participants, who are more likely to be socially disadvantaged in biomedical research, limits generalizability of results and reductions in health disparities. To facilitate investigations of how social disadvantage Bgets under the skin,^this pilot study evaluated low-intensity methods for collecting hair and saliva samples from multiethnic breast cancer survivors (N = 70) and analysis of biomarkers of chronic stress (cortisol levels) and biological age (telomere length). Methods allowed for easy self-collection of hair (for cortisol) and saliva (for telomere lengths) samples that were highly stable for shipment and long-term storage. Measuring cortisol in hair as a biomarker of chronic stress was found to overcome many of the limitations of salivary cortisol measurements, and the coefficient of variation obtained using an ELISA-based approach to measure cortisol was within acceptable standards (16%). Telomere length measurements obtained using a qPCR approach had a coefficient of variation of <10% when the DNA extracted from the saliva biospecimens was of sufficient quantity and quality (84%). The overall response rate was 47%; rates were 32% for African-Americans, 39% for Latinas, 40% for Asians, and 82% for non-Latina Whites. Self-collection of hair and saliva overcame cultural and logistical barriers associated with collection of blood. Results support the use of these biospecimen collection and analysis methods among ethnically diverse and disadvantaged populations to identify biopsychosocial pathways of health disparities. Our tools should stimulate research to better understand how social disadvantage Bgets under the skin^and increase participation of ethnic minorities in biomedical research.

Telomere Homeostasis: Interplay with Magnesium

“…These observations are in keeping with the finding that telomere length has been shown to negatively correlate with increased cortisol responsiveness [93], anxiety and depression [94,95], lower socio-economic status [96], chronic low-grade inflammation, a higher frequency of adverse early life events [97,98], and adult daily life stressors [99]. For example, Alzheimer’s dementia (AD) and cardiovascular disease are characterised by mitochondrial dysfunction and increased ROS production [100,101], while also being associated with accelerated telomere shortening [102,103].…”

Participant-Centered Strategies for Overcoming Barriers to Biospecimen Collection among Spanish-Speaking Latina Breast Cancer Survivors

“…To measure chronic stress and premature aging, we selected biomarkers that could be obtained from minimally invasive biospecimens of saliva and hair. The selection of these less invasive biospecimens was based on the prior experience of the researchers, input from the CHWs and organizational leaders, and the scientific literature (29)(30)(31)(32). CHWs were not licensed phlebotomists so could not collect blood samples.…”

Collecting Hair Samples for Hair Cortisol Analysis in African Americans

“…The hair cortisol findings from our study are limited and could only be generalized to other older adults and persons with chronic conditions. Generally, hair cortisol levels in persons with chronic conditions (diabetes, cardiovascular) and mood disorders are higher than those without chronic conditions 9,16 . Another study of community-dwelling African American older adults reported cortisol ranges from 0.93 to 6.36 pg/mg, which was lower than the range in our study 16 .…”

“…Generally, hair cortisol levels in persons with chronic conditions (diabetes, cardiovascular) and mood disorders are higher than those without chronic conditions 9,16 . Another study of community-dwelling African American older adults reported cortisol ranges from 0.93 to 6.36 pg/mg, which was lower than the range in our study 16 . Another study of a sample of multiethnic older adults with cardiovascular disease reported a median cortisol level of 22.1 pg/mg, similar to the findings of this study.…”

“…Future applications of the techniques outlined in this paper should include teaching the participant the twist and gently pull procedure, enabling them to collect their own hair samples. Self-sample collection has been done in African American women with breast cancer and was considered more acceptable 16 . However, the response rate for African American women providing a hair sample was poor in the breast cancer study.…”