Low- and High-Altitude Cortisol Awakening Responses Differ Between AMS-Prone and AMS-Resistant Mountaineers.

Details

Ressource 1Download: Kayser manuscript cortisol author version.pdf (471.04 [Ko])
State: Public
Version: Author's accepted manuscript
License: All rights reserved
Serval ID
serval:BIB_EC217EF82D2C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Low- and High-Altitude Cortisol Awakening Responses Differ Between AMS-Prone and AMS-Resistant Mountaineers.
Journal
High altitude medicine & biology
Author(s)
Estoppey J., Léger B., Vuistiner P., Sartori C., Kayser B.
ISSN
1557-8682 (Electronic)
ISSN-L
1527-0297
Publication state
Published
Issued date
12/2019
Peer-reviewed
Oui
Volume
20
Number
4
Pages
344-351
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Background:
Mechanisms underlying acute mountain sickness (AMS) remain unclear. Corticosteroids are effective for prevention and treatment suggesting a role for deficient endogenous cortisol. The cortisol awakening response (CAR), the increase in cortisol secretion over the first 30-45 minutes after morning awakening, better reflects the hypothalamic-pituitary-adrenal (HPA) axis than single cortisol measurements. We hypothesized that CAR may be altered in AMS-prone persons.
Methods:
Upon arrival at 4554 m (high altitude [HA]), 81 mountaineers agreed to participate. The following morning, they gave three saliva samples after awakening (S1: 0 minute, S2: 30 minutes, S3: 45 minutes). AMS was scored with the 1993 Lake Louise Score (LLS, cut-off ≥5). Minimally 4 weeks after descent, saliva was recollected by 58 of 81 participants at low altitude (LA); 382 ± 309 m, mean ± standard deviation). Cortisol was quantified by immunoassay. Three cortisol indices were analyzed: first sample on awakening (S1), CAR (area under curve with respect to S1) and total post awaking cortisol (area under the curve from ground [AUC-G]).
Results:
AMS prevalence was 30%. At HA compared to LA, S1 (450 ± 190 vs. 288 ± 159 ng/dL, p < 0.001) and AUC-G (387 ± 137 vs. 276 ± 114 ng/dL·min, p < 0.001) were greater, but CAR was not (50 ± 100 vs. 60 ± 81 ng/dL·min, p = 0.550). AMS+ compared to AMS- participants had higher S1 both at HA (495 ± 209 vs. 384 ± 176 ng/dL, p = 0.016) and LA (354 ± 160 vs. 253 ± 142 ng/dL, p = 0.015) and lower CAR at LA (24 ± 87 vs. 79 ± 72 ng/dL·min, p = 0.013). AUC-G was similar in both groups at HA and LA.
Conclusions:
Some indices of salivary cortisol response upon awakening differ between AMS+ and AMS-, both at HA and LA, suggesting a link between HPA-axis homeostasis and AMS.
Keywords
HPA, adrenal, corticosteroids, hypobaria, hypoxia
Pubmed
Web of science
Open Access
Yes
Create date
25/07/2019 13:53
Last modification date
12/01/2020 7:20
Usage data