CONTEXT: The pituitary-adrenal axis had historically been considered a representative model for circadian rhythms. A recently developed portable collection device provided the opportunity to evaluate free cortisol profiles using the microdialysis approach in individuals free to conduct their day-to-day activities in their own surroundings.
METHODS: Two separate experiments were conducted in healthy male volunteers - ten-minutely total and subcutaneous free cortisol were measured for 24-hour period in one and twenty-minutely subcutaneous free cortisol for 72 consecutive hours in free-living individuals in the other experiment.
RESULTS: The characteristic circadian rhythm was evident in both serum total and subcutaneous free cortisol with the lowest levels being achieved and maintained in the hours surrounding sleep onset with peak levels occurring in every individual around waking. In all free-living individuals, the circadian rhythm was consistent across 72-hours despite a wide range of activities. All participants also showed increased cortisol following the consumption of lunch. The lowest levels during all 24 hour periods were observed during the hours following lights switch-off, at the onset of sleep.
CONCLUSIONS: This is the first study to show up to three consecutive 24-hour measurements of subcutaneous free cortisol in healthy individuals. This, we believe is a landmark study that paves the way for ambulatory monitoring of free cortisol profiles continuously up to a period of 72 hours in a free-living individual going about their day to day activities whether in health or in diseases involving the HPA axis.