Progression in intima media thickness—the significance of hormonal biomarkers of chronic stress

HLA–DRB1 and persistent chronic inflammation contribute to cardiovascular events and cardiovascular mortality in patients with rheumatoid arthritis

“…Another point of potential concern in this study was that most patients from our series were exposed to a significant mean dose of corticosteroids. This is particularly worrisome because corticosteroid level may be a risk factor for atherosclerosis, although no relationship between corticotherapy and atherosclerosis in RA as measured by carotid IMT has been found in previous studies (13,44,45), and the association between cortisol and the carotid artery IMT progression in the general population remains unclear (46,47). Finally, RA is a polygenic disease and the potential effect of other genes different from those of the HLA-DRB1 region in the accelerated atherosclerosis observed in patients with RA needs to be addressed.…”

Testosterone, dihydrotestosterone and estradiol are differentially associated with carotid intima-media thickness and the presence of carotid plaque in men with and without coronary artery disease

“…Cross sectional studies have demonstrated an inverse association between T with CIMT and carotid plaque [10][11][12][13][14], while others have shown no association [15]. One longitudinal study demonstrated no association between T and progression of CIMT or plaque area, while another showed an inverse relationship [13,16]. Furthermore, T is metabolised by 5 α-reductase into the more potent androgen receptor ligand, dihydrotestosterone (DHT), and by aromatase into estradiol (E2), a ligand for estrogen receptors [17].…”

State of the Science: Salivary Biomarker Utilization for Stress Research

“…For example, the link between psychosocial stress and development of cardiovascular disease has provided a model of stress-health impact that involves the cascading responses of neuro-endocrinal and immunological responses to stress. 12,20,24,[28][29][30] The stress response is regulated by two primary neuroendocrine systems: the hypothalamus-pituitaryadrenocortical (HPA) axis and sympathetic adrenomedullary (SAM) systems. 31) Psychological stress increases HPA activity and, subsequently, elevates the level of cortisol in circulation.…”

“…12,30) The HPA axis and autonomic nervous system responses to stress manifest in lowering immune function as shown by numerous studies for the last three decades. Chronic psychosocial stress, such as job strain, low socioeconomic status, and caregiver stress are related to the impairments of immune function, 12,30) which are linked to the development of health conditions such as atherosclerosis, 21,28,30,47) and cancer. 15,16) Salivary immunoglobulin A (IgA) and lysozyme were inversely correlated with self-reported level of stress, suggesting their utility aspotential stress biomarkers.…”

“…When urine samples were collected along with saliva, similar time intervals were used for levels of cortisol as well as epinephrine and norepinephrine. 28) When the time series was not chosen, sampling time for saliva cortisol was usually in the morning.…”