title: The diagnostic value of endothelial function as a potential sensor of fatigue in health.
abstract: OBJECTIVE
  Many epidemiological research studies have shown that vital exhaustion and psychosocial factors are associated with the occurrence of cerebrocardiovascular disease (CCVD). Fatigue is thought to induce endothelial dysfunction and may be linked to the occurrence of CCVD; however, no studies have investigated this potential link. We studied to determine the effect of fatigue on endothelial function in healthy subjects with no traditional CCVD risk factors or potential confounding factors to be controlled.
  
  
  METHODS
  Peripheral arterial tonometry (PAT) was used to evaluate endothelial function. The influence of the following parameters on endothelial function was analyzed in 74 office workers without traditional CCVD risk factors at health check-ups: endothelial function before and after work, subjective fatigue, lifestyle factors such as sleeping time, and psychosocial factors such as depression and social support.
  
  
  RESULTS
  Twenty-five subjects (33.8%) had low endothelial function; reactive hyperemia (RH)-PAT index <1.67, even though no abnormalities were reported in the health check-ups. There was no significant difference in endothelial function before versus after labor. Of note, endothelial function was associated with the individual's level of subjective fatigue (t = 2.98, P = 0.008) and showed a daily fluctuation, sometimes to a pathological degree (<1.67).
  
  
  CONCLUSIONS
  We showed that, even in healthy people, endothelial function fluctuates diurnally, with an interaction between the individual's cognitive fatigue and the environment, sometimes to a pathological degree. Based on these findings, we suggest that endothelial function is an objective assessment tool of fatigue in healthy individuals.
authors.affiliation: Department of Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Kagoshima Prefecture, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Ohno
authors.forename: Teruto
authors.initials: T
authors.lastname: Hashiguchi
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Maenosono
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Yamashita
authors.forename: Yukio
authors.initials: Y
authors.lastname: Taira
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Minowa
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kato
authors.forename: Ko-Ichi
authors.initials: K
authors.lastname: Kawahara
authors.forename: Ikuro
authors.initials: I
authors.lastname: Maruyama
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000503:physiopathology; D003863:Depression / Q000175:diagnosis; D004730:Endothelium, Vascular / Q000502:physiology*; D005221:Fatigue / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006304:Health Status; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008019:Life Style; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D012890:Sleep / Q000502:physiology; D012944:Social Support; D055815:Young Adult
references.citation: N Engl J Med. 1990 Jul 5;323(1):27-36
references.pmid: 2113184
references.citation: J Cardiovasc Med (Hagerstown). 2008 Apr;9(4):356-62
references.pmid: 18334889
references.citation: Psychol Bull. 2006 May;132(3):327-53
references.pmid: 16719565
references.citation: Arterioscler Thromb Vasc Biol. 2003 Feb 1;23(2):168-75
references.pmid: 12588755
references.citation: Psychosom Med. 1994 Jul-Aug;56(4):281-7
references.pmid: 7972608
references.citation: Stroke. 2006 May;37(5):1232-6
references.pmid: 16601213
references.citation: J Psychosom Res. 2006 Jun;60(6):585-93
references.pmid: 16731233
references.citation: Cerebrovasc Dis. 2005;20(4):245-50
references.pmid: 16123544
references.citation: Hypertension. 2004 Aug;44(2):134-9
references.pmid: 15249547
references.citation: Assessment. 2000 Mar;7(1):17-36
references.pmid: 10668003
references.citation: Environ Health Perspect. 2004 Dec;112(17):1645-53
references.pmid: 15579407
references.citation: Nurs Diagn. 1996 Apr-Jun;7(2):51-62
references.pmid: 8716946
references.citation: Lancet. 1986 Feb 8;1(8476):307-10
references.pmid: 2868172
references.citation: Am J Physiol Regul Integr Comp Physiol. 2004 Feb;286(2):R233-49
references.pmid: 14707008
references.citation: J Am Coll Cardiol. 2003 May 21;41(10):1761-8
references.pmid: 12767662
references.citation: Sleep Med Rev. 2006 Feb;10(1):63-76
references.pmid: 16376590
references.citation: Vasc Med. 2007 Feb;12(1):13-6
references.pmid: 17451088
references.citation: Fundam Clin Pharmacol. 2009 Jun;23(3):331-7
references.pmid: 19469804
references.citation: Cardiovasc Diabetol. 2006 Feb 23;5:4
references.pmid: 16504104
references.citation: Hypertension. 2007 Apr;49(4):748-60
references.pmid: 17309954
references.citation: Ind Health. 2007 Apr;45(2):237-46
references.pmid: 17485868
references.citation: Circulation. 2000 Apr 25;101(16):1899-906
references.pmid: 10779454
references.citation: Curr Vasc Pharmacol. 2009 Apr;7(2):209-24
references.pmid: 19356004
references.citation: J Interv Card Electrophysiol. 2006 Dec;17(3):199-203
references.pmid: 17333367
references.citation: J Psychosom Res. 2004 Feb;56(2):157-70
references.pmid: 15016573
references.citation: J Exp Med. 2007 Oct 29;204(11):2693-704
references.pmid: 17954570
references.citation: Vascul Pharmacol. 2007 May;46(5):318-20
references.pmid: 17229595
references.citation: Arterioscler Thromb Vasc Biol. 2007 Oct;27(10):2113-9
references.pmid: 17717291
references.citation: J Cardiovasc Pharmacol. 2004 May;43(5):698-705
references.pmid: 15071358
references.citation: Circulation. 2004 Feb 10;109(5):613-9
references.pmid: 14769683
references.citation: Prev Med. 1980 Jul;9(4):469-83
references.pmid: 7403016
references.citation: J Affect Disord. 2004 Dec;83(2-3):191-8
references.pmid: 15555713
references.citation: Circulation. 2008 May 13;117(19):2467-74
references.pmid: 18458169
references.citation: Am Heart J. 2003 Jul;146(1):168-74
references.pmid: 12851627
references.citation: N Engl J Med. 1994 May 19;330(20):1431-8
references.pmid: 8159199
references.citation: Oncol Nurs Forum. 2003 Sep-Oct;30(5):823-30
references.pmid: 12949595
references.citation: Health Qual Life Outcomes. 2007 Jul 02;5:36
references.pmid: 17605783
references.citation: Eur Respir J. 2006 Feb;27(2):328-33
references.pmid: 16452588
references.citation: Curr Cardiol Rep. 2009 Mar;11(2):133-40
references.pmid: 19236829
references.citation: QJM. 2007 Oct;100(10):617-27
references.pmid: 17921196
references.citation: J Affect Disord. 2005 Sep;88(1):93-8
references.pmid: 16040127
references.citation: Psychosomatics. 2008 May-Jun;49(3):230-4
references.pmid: 18448778