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Salivary cortisol levels, but not salivary α‐amylase levels, are elevated in patients with rheumatoid arthritis irrespective of depression
Author(s) -
Kim HyounAh,
Jeon JaYoung,
Koh BoRam,
Park SatByul,
Suh ChangHee
Publication year - 2016
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12224
Subject(s) - medicine , rheumatoid arthritis , depression (economics) , endocrinology , saliva , beck depression inventory , amylase , hydrocortisone , visual analogue scale , physical therapy , anxiety , psychiatry , biochemistry , chemistry , economics , macroeconomics , enzyme
Abstract Objectives Stress is recognized as an important factor in the etiology of rheumatoid arthritis ( RA ). Therefore, we explored multiple aspects of stress in RA patients. Methods Salivary cortisol and α‐amylase levels were measured as markers of the hypothalamic–pituitary–adrenal axis activity and sympatho‐adrenomedullary system activity, respectively. Depression was assessed by the Beck Depression Inventory ( BDI ) and short‐term analysis of the heart rate variability ( HRV ) was performed to evaluate the autonomic nervous system. Results The salivary cortisol levels of the RA patients were significantly higher than those of the normal controls (NC; 0.12 ± 0.162 μg/ dL vs . 0.068 ± 0.052 μg/ dL , P = 0.006). There was no difference in salivary α‐amylase levels between the RA and the NC. The BDI levels of the RA patients were significantly higher than the NC (13.7 ± 8.9 vs . 6.4 ± 6.9, P < 0.001). Depression was more prevalent in RA patients than in the NC. The salivary cortisol levels were still significantly higher in the RA than the NC after controlling BDI by logistic regression analysis ( P = 0.002). There was no significant difference in the HRV of RA patients and the NC. The evaluation of relationship between stress measures and disease activity markers of RA revealed that only BDI was positively correlated with the visual analogue pain scale. Conclusion Salivary cortisol levels and the BDI of RA patients were higher than those of the NC , and elevated salivary cortisol levels were independent of depression. However, the level of stress may not be correlated with disease activity in RA .