Daily salivary cortisol patterns in midlife women with hot flashes

S. D. Reed, K. M. Newton, J. C. Larson, C. Booth-Laforce, N. F. Woods, C. A. Landis, E. Tolentino, Janet Carpenter, E. W. Freeman, H. Joffe, B. D. Anawalt, K. A. Guthrie

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: Diurnal salivary cortisol patterns in healthy adults are well established but have not been studied in midlife women with hot flashes. We hypothesized that frequent hot flashes are associated with aberrant cortisol patterns similar to sleep-deficient individuals. Design: Cross-sectional. Participants: A total of 306 women, ages 40-62, randomized to a behavioural intervention for hot flashes. Measurements: Baseline comparisons of cortisol geometric means (nmol/l) from four daily time points averaged over two consecutive days plus other calculated cortisol measures were made between groups defined by baseline: (i) mean daily hot flash frequency tertile (≤5·5, N = 103; >5·5-8·8, N = 103; >8·8, N = 100) and (ii) selected characteristics. Repeated-measures linear regression models of log-transformed cortisol evaluated group differences, adjusting for covariates. Results: Women were 67% White and 24% African American, with 7·6 (SD 3·9) hot flashes per day. Salivary cortisol geometric means (nmol/l) among all women were as follows: 75·0 (SD 44·8) total, 8·6 (SD 5·6) wake, 10·0 (SD 7·5) wake +30 min, 3·7 (SD 3·3) early afternoon and 1·6 (SD 1·8) bedtime. Wake + 30-minute values showed an 18% median rise from wake values (interquartile range -24 to 96%), and means varied by hot flash frequency tertile, from lowest to highest: 11·4(SD 7·3), 10·3 (SD 6·5) and 8·6 (SD 7·8), respectively, P = 0·003. Beside the early afternoon value (P = 0·02), cortisol values did not vary by hot flash frequency. Conclusion: Taken together, these findings suggest that high frequency of moderate-to-severe hot flashes may be associated with subtle abnormalities in cortisol concentrations - a pattern consistent with chronic sleep disturbance.

Original languageEnglish (US)
JournalClinical Endocrinology
DOIs
StateAccepted/In press - 2016

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Hot Flashes
Hydrocortisone
Linear Models
Sleep
African Americans

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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Reed, S. D., Newton, K. M., Larson, J. C., Booth-Laforce, C., Woods, N. F., Landis, C. A., ... Guthrie, K. A. (Accepted/In press). Daily salivary cortisol patterns in midlife women with hot flashes. Clinical Endocrinology. https://doi.org/10.1111/cen.12995

Daily salivary cortisol patterns in midlife women with hot flashes. / Reed, S. D.; Newton, K. M.; Larson, J. C.; Booth-Laforce, C.; Woods, N. F.; Landis, C. A.; Tolentino, E.; Carpenter, Janet; Freeman, E. W.; Joffe, H.; Anawalt, B. D.; Guthrie, K. A.

In: Clinical Endocrinology, 2016.

Research output: Contribution to journalArticle

Reed, SD, Newton, KM, Larson, JC, Booth-Laforce, C, Woods, NF, Landis, CA, Tolentino, E, Carpenter, J, Freeman, EW, Joffe, H, Anawalt, BD & Guthrie, KA 2016, 'Daily salivary cortisol patterns in midlife women with hot flashes', Clinical Endocrinology. https://doi.org/10.1111/cen.12995
Reed SD, Newton KM, Larson JC, Booth-Laforce C, Woods NF, Landis CA et al. Daily salivary cortisol patterns in midlife women with hot flashes. Clinical Endocrinology. 2016. https://doi.org/10.1111/cen.12995
Reed, S. D. ; Newton, K. M. ; Larson, J. C. ; Booth-Laforce, C. ; Woods, N. F. ; Landis, C. A. ; Tolentino, E. ; Carpenter, Janet ; Freeman, E. W. ; Joffe, H. ; Anawalt, B. D. ; Guthrie, K. A. / Daily salivary cortisol patterns in midlife women with hot flashes. In: Clinical Endocrinology. 2016.
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AU - Reed, S. D.

AU - Newton, K. M.

AU - Larson, J. C.

AU - Booth-Laforce, C.

AU - Woods, N. F.

AU - Landis, C. A.

AU - Tolentino, E.

AU - Carpenter, Janet

AU - Freeman, E. W.

AU - Joffe, H.

AU - Anawalt, B. D.

AU - Guthrie, K. A.

PY - 2016

Y1 - 2016

N2 - Objective: Diurnal salivary cortisol patterns in healthy adults are well established but have not been studied in midlife women with hot flashes. We hypothesized that frequent hot flashes are associated with aberrant cortisol patterns similar to sleep-deficient individuals. Design: Cross-sectional. Participants: A total of 306 women, ages 40-62, randomized to a behavioural intervention for hot flashes. Measurements: Baseline comparisons of cortisol geometric means (nmol/l) from four daily time points averaged over two consecutive days plus other calculated cortisol measures were made between groups defined by baseline: (i) mean daily hot flash frequency tertile (≤5·5, N = 103; >5·5-8·8, N = 103; >8·8, N = 100) and (ii) selected characteristics. Repeated-measures linear regression models of log-transformed cortisol evaluated group differences, adjusting for covariates. Results: Women were 67% White and 24% African American, with 7·6 (SD 3·9) hot flashes per day. Salivary cortisol geometric means (nmol/l) among all women were as follows: 75·0 (SD 44·8) total, 8·6 (SD 5·6) wake, 10·0 (SD 7·5) wake +30 min, 3·7 (SD 3·3) early afternoon and 1·6 (SD 1·8) bedtime. Wake + 30-minute values showed an 18% median rise from wake values (interquartile range -24 to 96%), and means varied by hot flash frequency tertile, from lowest to highest: 11·4(SD 7·3), 10·3 (SD 6·5) and 8·6 (SD 7·8), respectively, P = 0·003. Beside the early afternoon value (P = 0·02), cortisol values did not vary by hot flash frequency. Conclusion: Taken together, these findings suggest that high frequency of moderate-to-severe hot flashes may be associated with subtle abnormalities in cortisol concentrations - a pattern consistent with chronic sleep disturbance.

AB - Objective: Diurnal salivary cortisol patterns in healthy adults are well established but have not been studied in midlife women with hot flashes. We hypothesized that frequent hot flashes are associated with aberrant cortisol patterns similar to sleep-deficient individuals. Design: Cross-sectional. Participants: A total of 306 women, ages 40-62, randomized to a behavioural intervention for hot flashes. Measurements: Baseline comparisons of cortisol geometric means (nmol/l) from four daily time points averaged over two consecutive days plus other calculated cortisol measures were made between groups defined by baseline: (i) mean daily hot flash frequency tertile (≤5·5, N = 103; >5·5-8·8, N = 103; >8·8, N = 100) and (ii) selected characteristics. Repeated-measures linear regression models of log-transformed cortisol evaluated group differences, adjusting for covariates. Results: Women were 67% White and 24% African American, with 7·6 (SD 3·9) hot flashes per day. Salivary cortisol geometric means (nmol/l) among all women were as follows: 75·0 (SD 44·8) total, 8·6 (SD 5·6) wake, 10·0 (SD 7·5) wake +30 min, 3·7 (SD 3·3) early afternoon and 1·6 (SD 1·8) bedtime. Wake + 30-minute values showed an 18% median rise from wake values (interquartile range -24 to 96%), and means varied by hot flash frequency tertile, from lowest to highest: 11·4(SD 7·3), 10·3 (SD 6·5) and 8·6 (SD 7·8), respectively, P = 0·003. Beside the early afternoon value (P = 0·02), cortisol values did not vary by hot flash frequency. Conclusion: Taken together, these findings suggest that high frequency of moderate-to-severe hot flashes may be associated with subtle abnormalities in cortisol concentrations - a pattern consistent with chronic sleep disturbance.

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