| Objectives:To investigate the association between the hair cortisol(COR)level and psychological disorders(anxiety,depression,and burnout)in patients after their first onset of acuter coronary syndrome(ACS).Furthermore,to observe the associations of hair COR level with physical recovery,quality of life,and heart rate variability(HRV)after ACS.Methods:1.The participants were patients with their first ACS who was admitted in the 1st affiliated hospital of Kunming Medical University from March 2015 to December 2017,The written informed consent was obtained from each participant.2.The baseline characteristics of subjects,such as demographic data,smoking and drinking,past medical history,family history of cardiovascular disease,clinical manifestation,diagnosis,were collected at admission.3.The sample of hair was collected at adimission.The hair COR level was measured by high phase liquid chromatograph.4.Burnout,anxiety,and depression of each participants were measured by Copenhagen Burnout Inventorys and Hospital Anxiety and Depression Scale in the period of hospitalization.Meanwile,time and frequency domain HRV measures were obtained by 24-hour ambulatory electrocardiography.5.Participants were followed up at one month and half a year of discharge.Short Physical Performance Battery(SPPB),Medical Outcomes Study 8-item Short-form(SF-8),Seattle Angina Questionnaire(SAQ),HRV indices were measured during the follow-up.6.The statistical analyses were performed using the Stata 10 statistical package.At first,HRV parameters were transformed to their natural logarithm due to skewed distribution.Linear correlation was applied to analyze the correlation between hair COR level and psychological disorders,i.e.burnout,anxiety,and depression.A multiple linear regression model was developed to analyze the association of hair COR level with burnout and other confounding factors.The associations of hair COR level with SPPB,SF-8,and SAQ were also analyzed by multiple linear regression.Generalized estimating equations were used to analyze the association between hair COR level and HRV indices over half a year follow-up.A p<0.05(two-sided)was considered as significant.Results:1.Initially,79 patients were enrolled in this study.Two cases were withdrawn,and 6 cases were excluded because their hair cortisol were not detected.At last,71 cases with complete data participanted this study.2.Linear correlation between burnout and cortisol:r=0.098,p=0.417;Linear correlation between depression and cortisol:r=0.057,p=0.775;The linear correlation between anxiety and cortisol:r=0.153,p=0.388.The results showed no correlation between the psychological disorders and hair cortisol level.3.The hair COR level was not correlated to burnout and most other baseline characteristics except family population(t=2.45,p=0.018).4.The hair COR level was not associated with SPPB at 1 month of discharge:regression coefficient 0.009(95%-CI-0.012?0.031,t=0.85,p= 0.394).5.The hair COR level was not associated with SF-8 physiological score(t=0.57,p=0.566),and SF-8 psychological score(t=1.75,p=0.081).6.The hair COR level was not associated with the five dimensions of SAQ[PL(t=0.31,p=0.757),AS(t=-1.63,p=0.103),AF(t=1.43,p=0.154),TS(t=1.89,p=0.060),DP(t=1.47,p=0.150)].7.The hair COR level was not associated with 1 time domain and 5 frequency domain HRV measures ove half a year follow-up[lnSDNN(Z=0.11,P=0.916),lnTP(Z=0.80,P=0.426),lnHF(Z=0.89,P=0.371),lnLF(Z=0.57,P=0.566),lnVLF(Z=0.39,P=0.696),lnULF(Z=-1.10,P=0.270)].Conclusions:This study showe that:1.There is no evidence that the hair cortisol level does not reflect the degree of burnout,anxiety and depression.2.There is no evidence that the hair cortisol level can not be an objective indicator to evaluate the level of chronic stress.3.There is no evidence that the hair cortisol level can not predict the physical function,quality of life and HRV measures after acute coronary syndrome over half a year follow-up. |
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