Evaluation of stress reactions during upper gastrointestinal endoscopy in elderly patients: assessment of mental stress using chromogranin A
Objective: Salivary chromogranin A (CgA) was recently reported to be a useful marker of mental stress. In this study, mental stress during upper gastrointestinal endoscopy was evaluated by measuring salivary CgA levels in young and elderly subjects. Methods: The subjects were 9 healthy subjects aged...
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| Published in | The Journal of Medical Investigation Vol. 54; no. 1,2; pp. 140 - 145 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Japan
The University of Tokushima Faculty of Medicine
2007
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1343-1420 1349-6867 |
| DOI | 10.2152/jmi.54.140 |
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| Abstract | Objective: Salivary chromogranin A (CgA) was recently reported to be a useful marker of mental stress. In this study, mental stress during upper gastrointestinal endoscopy was evaluated by measuring salivary CgA levels in young and elderly subjects. Methods: The subjects were 9 healthy subjects aged less than 50 years (young group) and 15 subjects aged 70 years or older (elderly group). The heart rate, blood pressure, blood oxygen saturation level, and salivary CgA concentration were measured before and after upper gastrointestinal endoscopy and compared. Results: In the young group, the CgA level decreased significantly (p<0.05) during endoscopy compared with the level during rest before endoscopy. In the elderly group, it also decreased significantly (p<0.05) during endoscopy compared with the level during rest before endoscopy. However, CgA levels were significantly higher (p<0.05) in the elderly group than in the young group both before and during endoscopy. The decrease in CgA levels was significantly greater (p<0.05) in the young group than in the elderly group. Conclusions: In this study, mental stress associated with endoscopy appears to be higher in elderly subjects than in younger subjects. Attention to complications due to increased stress is considered to be necessary in elderly patients during endoscopy. J. Med. Invest. 54: 140-145, February, 2007 |
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| AbstractList | Salivary chromogranin A (CgA) was recently reported to be a useful marker of mental stress. In this study, mental stress during upper gastrointestinal endoscopy was evaluated by measuring salivary CgA levels in young and elderly subjects.
The subjects were 9 healthy subjects aged less than 50 years (young group) and 15 subjects aged 70 years or older (elderly group). The heart rate, blood pressure, blood oxygen saturation level, and salivary CgA concentration were measured before and after upper gastrointestinal endoscopy and compared.
In the young group, the CgA level decreased significantly (p<0.05) during endoscopy compared with the level during rest before endoscopy. In the elderly group, it also decreased significantly (p<0.05) during endoscopy compared with the level during rest before endoscopy. However, CgA levels were significantly higher (p<0.05) in the elderly group than in the young group both before and during endoscopy. The decrease in CgA levels was significantly greater (p<0.05) in the young group than in the elderly group.
In this study, mental stress associated with endoscopy appears to be higher in elderly subjects than in younger subjects. Attention to complications due to increased stress is considered to be necessary in elderly patients during endoscopy. Objective: Salivary chromogranin A (CgA) was recently reported to be a useful marker of mental stress. In this study, mental stress during upper gastrointestinal endoscopy was evaluated by measuring salivary CgA levels in young and elderly subjects. Methods: The subjects were 9 healthy subjects aged less than 50 years (young group) and 15 subjects aged 70 years or older (elderly group). The heart rate, blood pressure, blood oxygen saturation level, and salivary CgA concentration were measured before and after upper gastrointestinal endoscopy and compared. Results: In the young group, the CgA level decreased significantly (p<0.05) during endoscopy compared with the level during rest before endoscopy. In the elderly group, it also decreased significantly (p<0.05) during endoscopy compared with the level during rest before endoscopy. However, CgA levels were significantly higher (p<0.05) in the elderly group than in the young group both before and during endoscopy. The decrease in CgA levels was significantly greater (p<0.05) in the young group than in the elderly group. Conclusions: In this study, mental stress associated with endoscopy appears to be higher in elderly subjects than in younger subjects. Attention to complications due to increased stress is considered to be necessary in elderly patients during endoscopy. J. Med. Invest. 54: 140-145, February, 2007 Salivary chromogranin A (CgA) was recently reported to be a useful marker of mental stress. In this study, mental stress during upper gastrointestinal endoscopy was evaluated by measuring salivary CgA levels in young and elderly subjects.OBJECTIVESalivary chromogranin A (CgA) was recently reported to be a useful marker of mental stress. In this study, mental stress during upper gastrointestinal endoscopy was evaluated by measuring salivary CgA levels in young and elderly subjects.The subjects were 9 healthy subjects aged less than 50 years (young group) and 15 subjects aged 70 years or older (elderly group). The heart rate, blood pressure, blood oxygen saturation level, and salivary CgA concentration were measured before and after upper gastrointestinal endoscopy and compared.METHODSThe subjects were 9 healthy subjects aged less than 50 years (young group) and 15 subjects aged 70 years or older (elderly group). The heart rate, blood pressure, blood oxygen saturation level, and salivary CgA concentration were measured before and after upper gastrointestinal endoscopy and compared.In the young group, the CgA level decreased significantly (p<0.05) during endoscopy compared with the level during rest before endoscopy. In the elderly group, it also decreased significantly (p<0.05) during endoscopy compared with the level during rest before endoscopy. However, CgA levels were significantly higher (p<0.05) in the elderly group than in the young group both before and during endoscopy. The decrease in CgA levels was significantly greater (p<0.05) in the young group than in the elderly group.RESULTSIn the young group, the CgA level decreased significantly (p<0.05) during endoscopy compared with the level during rest before endoscopy. In the elderly group, it also decreased significantly (p<0.05) during endoscopy compared with the level during rest before endoscopy. However, CgA levels were significantly higher (p<0.05) in the elderly group than in the young group both before and during endoscopy. The decrease in CgA levels was significantly greater (p<0.05) in the young group than in the elderly group.In this study, mental stress associated with endoscopy appears to be higher in elderly subjects than in younger subjects. Attention to complications due to increased stress is considered to be necessary in elderly patients during endoscopy.CONCLUSIONSIn this study, mental stress associated with endoscopy appears to be higher in elderly subjects than in younger subjects. Attention to complications due to increased stress is considered to be necessary in elderly patients during endoscopy. |
| Author | Niki, Miyako Motoba, Hideki Mori, Toshifumi Fujimoto, Sayuri Ito, Susumu Nomura, Masahiro Ieishi, Kiyoshi Ikefuji, Hiroyuki |
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| Cites_doi | 10.2220/biomedres.27.11 10.1016/S0016-5107(82)73101-3 10.1007/s005350070018 10.1111/j.1440-1746.1998.tb00738.x 10.1111/j.1443-1661.2005.00457.x 10.1161/01.HYP.29.2.613 10.1080/14769670600909594 10.1056/NEJM198409203111204 10.1007/0-306-46837-9_11 10.1074/jbc.M101545200 10.1016/0016-5085(80)90861-6 10.1016/S0167-8760(02)00067-3 10.1016/j.ijgo.2005.09.011 10.1111/j.1443-1661.2007.00691.x 10.1002/j.0022-0337.2003.67.10.tb03701.x 10.1152/ajpendo.1991.260.2.E243 |
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| References | 9. Cryer PE, Wortsman J, Shah SD, Nowak RM, Deftos LJ: Plasma chromogranin A as a marker of sympathochromaffin activity in humans. Am J Physiol 260 (2 Pt 1): E243-6, 1991 13. Toda M, Morimoto K, Nagasawa S, Kitamura K: Change in salivary physiological stress markers by spa bathing. Biomed Res 27: 11-4, 2006 5. Rostykus PS, McDonald GB, Albert RK: Upper intestinal endoscopy induces hypoxemia in patients with obstructive pulmonary disease. Gastroenterology 78: 488-91, 1980 12. Kanamaru Y, Kikukawa A, Shimamura K: Salivary chromogranin-A as a marker of psychological stress during a cognitive test battery in humans. Stress 9: 127-31, 2006 17. Hatanaka Y, Miyakoshi Y: Effect of karaoke on stress response. Shidax Research 3 (in Japanese): 14-21, 2003 11. Kanno T, Asada N, Yanase H, Iwanaga T, Yanaihara N: Salivary secretion of chromogranin A. Control by autonomic nervous system. Adv Exp Med Biol 482: 143-51, 2000 16. Nakayama H, Sohara T, Takata Y: A survey of long-distance truck driver fatigue. A graduation thesis in department of transportation engineering and socio-technology 113-4, 2003 (in Japanese) 18. Tsubouchi H, Shimoya K, Hayashi S, Toda M, Morimoto K, Murata Y: Effect of coffee intake on blood flow and maternal stress during the third trimester of pregnancy. Int J Gynaecol Obstet 92: 19-22, 2006 6. Hayashi T, Nomura M, Honda H, Tezuka K, Torisu R, Takeuchi Y, Nakaya Y, Ito S: Evaluation of autonomic nervous function during upper gastrointestinal endoscopy using heart rate variability. J Gastroenterol 35: 815-23, 2000 19. Saijyo T, Nomura M, Nakaya Y, Saito K, Kondo Y, Yukinaka M, Shimizu I, Ito S: Assessment of autonomic nervous activity during gastrointestinal endoscopy: analysis of blood pressure variability by tonometry. J Gastroenterol Hepatol 13: 816-20, 1998 1. Uemura E, Nomura M, Uehara K, Sawa Y, Nakaya Y, Ito S: Relationship between pulse wave velocity and circulatory hemodynamics during upper gastrointestinal endoscopy. Digestive Endoscopy 17: 73-80, 2005 15. Nakane H, Asami O, Yamada Y, Ohira H: Effect of negative air ions on computer operation, anxiety and salivary chromogranin A-like immunoreactivity. Int J Psychophysiol 46: 85-9, 2002 8. Ely D, Caplea A, Dunphy G, Daneshvar H, Turner M, Milsted A, Takiyyudin M: Spontaneously hypertensive rat Y chromosome increases indexes of sympathetic nervous system activity. Hypertension 29: 613-8, 1997 10. Ng V, Koh D, Mok BY, Chia SE, Lim LP: Salivary biomarkers associated with academic assessment stress among dental undergraduates. J Dent Educ 67: 1091-4, 2003 2. Niki M, Nomura M, Yasuda M, Torisu T, Ito S: Examination of respiratory and circulatory dynamics during examination using thin gastrointestinal endoscope in advanced age subjects. Digestive Endoscopy 19, 2007 (in press) 4. Rozen P, Fireman Z, Gilat T: The causes of hypoxemia in elderly patients during endoscopy. Gastrointest Endosc 28: 243-6, 1982 7. O’Connor DT, Bernstein KN: Radioimmunoassay of chromogranin A in plasma as a measure of exocytotic sympathoadrenal activity in normal subjects and patients with pheochromocytoma. N Engl J Med 311: 764-70, 1984 3. Palmer ED: The abnormal upper gastrointestinal vagovagal reflexes that affect the heart. Am J Gastroenterol 66: 513-22, 1976 14. Jiang Q, Taupenot L, Mahata SK, Mahata M, O’Connor DT, Miles LA, Parmer RJ: Proteolytic cleavage of chromogranin A (CgA) by plasmin. Selective liberation of a specific bioactive CgA fragment that regulates catecholamine release. J Biol Chem 276: 25022-9, 2001 11 12 13 14 (8) 1997; 29 15 16 17 18 19 1 2 3 4 5 6 7 9 10 |
| References_xml | – reference: 17. Hatanaka Y, Miyakoshi Y: Effect of karaoke on stress response. Shidax Research 3 (in Japanese): 14-21, 2003 – reference: 6. Hayashi T, Nomura M, Honda H, Tezuka K, Torisu R, Takeuchi Y, Nakaya Y, Ito S: Evaluation of autonomic nervous function during upper gastrointestinal endoscopy using heart rate variability. J Gastroenterol 35: 815-23, 2000 – reference: 1. Uemura E, Nomura M, Uehara K, Sawa Y, Nakaya Y, Ito S: Relationship between pulse wave velocity and circulatory hemodynamics during upper gastrointestinal endoscopy. Digestive Endoscopy 17: 73-80, 2005 – reference: 2. Niki M, Nomura M, Yasuda M, Torisu T, Ito S: Examination of respiratory and circulatory dynamics during examination using thin gastrointestinal endoscope in advanced age subjects. Digestive Endoscopy 19, 2007 (in press) – reference: 7. O’Connor DT, Bernstein KN: Radioimmunoassay of chromogranin A in plasma as a measure of exocytotic sympathoadrenal activity in normal subjects and patients with pheochromocytoma. N Engl J Med 311: 764-70, 1984 – reference: 3. Palmer ED: The abnormal upper gastrointestinal vagovagal reflexes that affect the heart. Am J Gastroenterol 66: 513-22, 1976 – reference: 8. Ely D, Caplea A, Dunphy G, Daneshvar H, Turner M, Milsted A, Takiyyudin M: Spontaneously hypertensive rat Y chromosome increases indexes of sympathetic nervous system activity. Hypertension 29: 613-8, 1997 – reference: 5. Rostykus PS, McDonald GB, Albert RK: Upper intestinal endoscopy induces hypoxemia in patients with obstructive pulmonary disease. Gastroenterology 78: 488-91, 1980 – reference: 16. Nakayama H, Sohara T, Takata Y: A survey of long-distance truck driver fatigue. A graduation thesis in department of transportation engineering and socio-technology 113-4, 2003 (in Japanese) – reference: 4. Rozen P, Fireman Z, Gilat T: The causes of hypoxemia in elderly patients during endoscopy. Gastrointest Endosc 28: 243-6, 1982 – reference: 9. Cryer PE, Wortsman J, Shah SD, Nowak RM, Deftos LJ: Plasma chromogranin A as a marker of sympathochromaffin activity in humans. Am J Physiol 260 (2 Pt 1): E243-6, 1991 – reference: 15. Nakane H, Asami O, Yamada Y, Ohira H: Effect of negative air ions on computer operation, anxiety and salivary chromogranin A-like immunoreactivity. Int J Psychophysiol 46: 85-9, 2002 – reference: 18. Tsubouchi H, Shimoya K, Hayashi S, Toda M, Morimoto K, Murata Y: Effect of coffee intake on blood flow and maternal stress during the third trimester of pregnancy. Int J Gynaecol Obstet 92: 19-22, 2006 – reference: 13. Toda M, Morimoto K, Nagasawa S, Kitamura K: Change in salivary physiological stress markers by spa bathing. Biomed Res 27: 11-4, 2006 – reference: 14. Jiang Q, Taupenot L, Mahata SK, Mahata M, O’Connor DT, Miles LA, Parmer RJ: Proteolytic cleavage of chromogranin A (CgA) by plasmin. Selective liberation of a specific bioactive CgA fragment that regulates catecholamine release. J Biol Chem 276: 25022-9, 2001 – reference: 11. Kanno T, Asada N, Yanase H, Iwanaga T, Yanaihara N: Salivary secretion of chromogranin A. Control by autonomic nervous system. Adv Exp Med Biol 482: 143-51, 2000 – reference: 12. Kanamaru Y, Kikukawa A, Shimamura K: Salivary chromogranin-A as a marker of psychological stress during a cognitive test battery in humans. Stress 9: 127-31, 2006 – reference: 19. Saijyo T, Nomura M, Nakaya Y, Saito K, Kondo Y, Yukinaka M, Shimizu I, Ito S: Assessment of autonomic nervous activity during gastrointestinal endoscopy: analysis of blood pressure variability by tonometry. J Gastroenterol Hepatol 13: 816-20, 1998 – reference: 10. Ng V, Koh D, Mok BY, Chia SE, Lim LP: Salivary biomarkers associated with academic assessment stress among dental undergraduates. J Dent Educ 67: 1091-4, 2003 – ident: 17 – ident: 3 – ident: 13 doi: 10.2220/biomedres.27.11 – ident: 4 doi: 10.1016/S0016-5107(82)73101-3 – ident: 6 doi: 10.1007/s005350070018 – ident: 19 doi: 10.1111/j.1440-1746.1998.tb00738.x – ident: 1 doi: 10.1111/j.1443-1661.2005.00457.x – volume: 29 start-page: 613 issn: 0194-911X issue: 2 year: 1997 ident: 8 doi: 10.1161/01.HYP.29.2.613 – ident: 12 doi: 10.1080/14769670600909594 – ident: 7 doi: 10.1056/NEJM198409203111204 – ident: 11 doi: 10.1007/0-306-46837-9_11 – ident: 16 – ident: 14 doi: 10.1074/jbc.M101545200 – ident: 5 doi: 10.1016/0016-5085(80)90861-6 – ident: 15 doi: 10.1016/S0167-8760(02)00067-3 – ident: 18 doi: 10.1016/j.ijgo.2005.09.011 – ident: 2 doi: 10.1111/j.1443-1661.2007.00691.x – ident: 10 doi: 10.1002/j.0022-0337.2003.67.10.tb03701.x – ident: 9 doi: 10.1152/ajpendo.1991.260.2.E243 |
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| SubjectTerms | Adult Age Factors Aged Blood Pressure chromogranin A Chromogranin A - analysis elderly patient Endoscopy, Gastrointestinal - psychology Female gastrointestinal endoscopy Heart Rate Humans Male mental stress Middle Aged Oxygen - blood Saliva - chemistry stress Stress, Psychological - diagnosis Stress, Psychological - metabolism |
| Title | Evaluation of stress reactions during upper gastrointestinal endoscopy in elderly patients: assessment of mental stress using chromogranin A |
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