Automated Chemiluminescent Hair Cortisol Measurement and Its Association with Acute Myocardial Infarction: A Case-Control Study in Latin American Adults

Abstract

Background: Chronic and psychosocial stresses are the emerging factors linked to cardiovascular disease. Assessment of cortisol levels in hair can serve as an indicator of an individual’s exposure to prolonged stressful events. For its evaluation, mass spectrometry is the reference method. However, because of its limitations for clinical laboratories, an automated chemiluminescent method was developed in our laboratory. The objective of the study is to evaluate the hair cortisol levels measured by an automated method and its association with psychosocial stress and cardiometabolic risk factors in a Latin American population. Materials and Methods: Hair samples were obtained from 56 consecutive patients hospitalized with an ST‑segment elevation acute myocardial infarction (STEMI) and 56 consecutive controls randomly recruited in routine consultation. Perceived stress and social support were evaluated by the validated questionnaires. Hair cortisol was measured by an automated chemiluminescent method. Glycemia and lipoprotein profile were measured in serum samples. Results: Hair cortisol was significantly higher in patients than in controls (175 [40–424] vs. 60.5 [40–155] pg of cortisol/mg of hair [P < 0.001]). Hair cortisol was not related to age or body mass index; however, it was related to glycemia (r = 0.461, P < 0.001) and triglycerides/high‑density lipoprotein cholesterol (TGs/ HDL‑c) index (r = 0.398, P = 0.001). Perceived stress was related to hair cortisol (r = 0.425, P < 0.001), age (r = 0.321, P = 0.01), and social support (r = −0.208, P = 0.028). TGs/HDL‑c index and perceived stress partially explain hair cortisol variation ([F = 8.69, P = 0.004] and [F = 24.9, P < 0.001], respectively). Conclusion: We observed higher hair cortisol concentrations, measured by an automated method, in STEMI patients than in controls in a Latin American population. In addition, it was related to perceived stress and cardiometabolic parameters.