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Diurnal cortisol rhythm and fatigue in breast cancer survivors.
Psychoneuroendocrinology. 2005 Jan; 30(1):92-100.P

Abstract

Approximately 30% of breast cancer survivors report persistent fatigue of unknown origin. We have previously shown that cancer-related fatigue is associated with alterations in immunological parameters and serum cortisol levels in breast cancer survivors. The current study examined the diurnal rhythm of salivary cortisol in fatigued and non-fatigued breast cancer survivors. Salivary cortisol measures were obtained from breast cancer survivors with persistent fatigue (n=13) and a control group of non-fatigued survivors (n=16). Participants collected saliva samples upon awakening and at 1200, 1700, and 2200 h on two consecutive days. Diurnal cortisol slope for each day was determined by linear regression of log-transformed cortisol values on collection time and analyzed using multi-level modeling. Fatigued breast cancer survivors had a significantly flatter cortisol slope than non-fatigued survivors, with a less rapid decline in cortisol levels in the evening hours. At the individual patient level, survivors who reported the highest levels of fatigue also had the flattest cortisol slopes. Group differences remained significant in analyses controlling for demographic and medical factors, daily health behaviors, and other potential confounds (e.g. depressed mood, body mass index). Results suggest a subtle dysregulation in hypothalamic-pituitary-adrenal axis functioning in breast cancer survivors with persistent fatigue.

Authors+Show Affiliations

Cousins Center for Psychoneuroimmunology, UCLA Neuropsychiatric Institute, Los Angeles, CA, USA. jbower@ucla.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15358446

Citation

Bower, Julienne E., et al. "Diurnal Cortisol Rhythm and Fatigue in Breast Cancer Survivors." Psychoneuroendocrinology, vol. 30, no. 1, 2005, pp. 92-100.
Bower JE, Ganz PA, Dickerson SS, et al. Diurnal cortisol rhythm and fatigue in breast cancer survivors. Psychoneuroendocrinology. 2005;30(1):92-100.
Bower, J. E., Ganz, P. A., Dickerson, S. S., Petersen, L., Aziz, N., & Fahey, J. L. (2005). Diurnal cortisol rhythm and fatigue in breast cancer survivors. Psychoneuroendocrinology, 30(1), 92-100.
Bower JE, et al. Diurnal Cortisol Rhythm and Fatigue in Breast Cancer Survivors. Psychoneuroendocrinology. 2005;30(1):92-100. PubMed PMID: 15358446.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diurnal cortisol rhythm and fatigue in breast cancer survivors. AU - Bower,Julienne E, AU - Ganz,Patricia A, AU - Dickerson,Sally S, AU - Petersen,Laura, AU - Aziz,Najib, AU - Fahey,John L, PY - 2003/11/13/received PY - 2004/03/29/revised PY - 2004/06/09/accepted PY - 2004/9/11/pubmed PY - 2004/12/16/medline PY - 2004/9/11/entrez SP - 92 EP - 100 JF - Psychoneuroendocrinology JO - Psychoneuroendocrinology VL - 30 IS - 1 N2 - Approximately 30% of breast cancer survivors report persistent fatigue of unknown origin. We have previously shown that cancer-related fatigue is associated with alterations in immunological parameters and serum cortisol levels in breast cancer survivors. The current study examined the diurnal rhythm of salivary cortisol in fatigued and non-fatigued breast cancer survivors. Salivary cortisol measures were obtained from breast cancer survivors with persistent fatigue (n=13) and a control group of non-fatigued survivors (n=16). Participants collected saliva samples upon awakening and at 1200, 1700, and 2200 h on two consecutive days. Diurnal cortisol slope for each day was determined by linear regression of log-transformed cortisol values on collection time and analyzed using multi-level modeling. Fatigued breast cancer survivors had a significantly flatter cortisol slope than non-fatigued survivors, with a less rapid decline in cortisol levels in the evening hours. At the individual patient level, survivors who reported the highest levels of fatigue also had the flattest cortisol slopes. Group differences remained significant in analyses controlling for demographic and medical factors, daily health behaviors, and other potential confounds (e.g. depressed mood, body mass index). Results suggest a subtle dysregulation in hypothalamic-pituitary-adrenal axis functioning in breast cancer survivors with persistent fatigue. SN - 0306-4530 UR - https://www.unboundmedicine.com/medline/citation/15358446/Diurnal_cortisol_rhythm_and_fatigue_in_breast_cancer_survivors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0306-4530(04)00112-X DB - PRIME DP - Unbound Medicine ER -