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Fingernail and toenail clippings as a non-invasive measure of chronic cortisol levels in adult cancer survivors

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Abstract

Purpose

Cancer survivors are at greater risk of comorbidities and functional decline due to physiological and psychological stress which can be measured by salivary cortisol. If saliva is used, multiple samples must be collected to accurately quantify long-term stress; however, fingernail (FN) and toenail (TN) clippings offer an opportunity to measure retrospective cortisol levels in a non-invasive manner.

Methods

Three sets of FN and TN clippings were collected at 12-month intervals in conjunction with saliva samples from cancer survivors (n = 109) participating in two clinical trials. FN and TN samples were stored at room temperature (RT); a subset underwent additional processing and freezing before analysis. Cortisol levels were determined via enzyme immunoassay, and correlation coefficients were generated to determine overall correspondence of the individual measures.

Results

Matched RT and frozen samples were highly correlated for TN (r = 0.950, p = 5.44 × 10−37) and FN (r = 0.784, p = 1.05 × 10−10). Correlations between RT FN and TN were statistically significant (r = 0.621, p = 3.61 × 10− 17), as were frozen FN and TN (r = 0.310, p = 0.0283). RT, but not frozen TN and FN correlated with salivary cortisol (r = 0.580, p = 1.65 × 10− 16 and r = 0.287, p = 0.00042 for TN and FN, respectively).

Conclusions

FN and TN cortisol levels correlate with salivary cortisol in adult cancer survivors and may offer a less invasive and convenient means for measuring chronic cortisol levels.

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Funding

The study was funded by National Cancer Institute R21 CA182508, P30 CA13148, and R25 CA047888; UAB Comprehensive Cancer Center (P30AR050948); Center for Clinical Translational Science (UL1TR001417); UAB Diabetes Research Center (P30 DK079626); and American Institute for Cancer Research: Diana Dyer Cancer Survivors’ Nutrition Research Endowment.

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Authors and Affiliations

  1. Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), WTI 102V, 1824 6th Ave S, Birmingham, AL, 35294, USA

    Andrew D. Frugé, Yuko Tsuruta, Kelley Smith-Johnston, Douglas R. Moellering & Wendy Demark-Wahnefried

  2. Department of Health Behavior, UAB, Birmingham, AL, USA

    Mallory G. Cases

  3. Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Carrie R. Howell

Authors
  1. Andrew D. Frugé
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  2. Mallory G. Cases
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  3. Carrie R. Howell
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  4. Yuko Tsuruta
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  5. Kelley Smith-Johnston
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  6. Douglas R. Moellering
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  7. Wendy Demark-Wahnefried
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Corresponding author

Correspondence to Andrew D. Frugé.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all individual participants included in the study.

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Frugé, A.D., Cases, M.G., Howell, C.R. et al. Fingernail and toenail clippings as a non-invasive measure of chronic cortisol levels in adult cancer survivors. Cancer Causes Control 29, 185–191 (2018). https://doi.org/10.1007/s10552-017-0989-5

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  • DOI: https://doi.org/10.1007/s10552-017-0989-5

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