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Maher P, Healy M, Laird E, Marunica Karšaj J, Gao W, Zgaga L. The determination of endogenous steroids in hair and fur: A systematic review of methodologies. J Steroid Biochem Mol Biol 2025; 246:106649. [PMID: 39613195 DOI: 10.1016/j.jsbmb.2024.106649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 11/21/2024] [Accepted: 11/25/2024] [Indexed: 12/01/2024]
Abstract
BACKGROUND Endogenous steroid hormone assessment is essential for clinical practice. These hormones are typically measured in blood. More recently, measurement of steroids in hair samples has been gaining in popularity, so we have reviewed the methodologies used for this to-date. METHODS Ovid Medline, CINAHL, Psychinfo, and EMBASE were searched to identify manuscripts that analysed cortisol, testosterone, androstenedione, 17-hydroxyprogesterone (17OHP), dehydroepiandrosterone sulphate (DHEAS), and/or 25-hydroxyvitamin D (25(OH)D), in hair or fur. Data related to sampling and measurement procedures were extracted and analysed. RESULTS The systematic review included a total of 180 papers, with 82 % published in the past 8 years; 67 % were human and 33 % animal studies. Cortisol was by far the most common analyte. Incomplete reporting on sample harvest, preparation, and measurement procedures was common. Typically, samples were collected from posterior vertex of humans or back/neck of animals, weighing between 11 and 50 mg (with a range of 1.25-1000 mg). Samples were usually stored at room temperature, often using aluminium foil. Isopropanol was the most common cleaning solution. Hair was normally powdered or segmented prior to extraction. Extraction was typically carried out over 18-24 hours using methanol. Validation and precision information was provided in 47 % of studies. CONCLUSIONS This systematic review highlights the lack of standardisation in the analysis of endogenous steroids in hair. Reporting was typically incomplete, and assay validations were partial or absent. Together, these limit the value of these exciting new methods and hold back transition to clinical use.
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Affiliation(s)
- Padraig Maher
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Ireland; Biochemistry Department, Centre for Laboratory Medicine and Molecular Pathology, St. James's Hospital, Dublin, Ireland
| | - Martin Healy
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland; School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Eamon Laird
- Department of Nutritional Sciences, Atlantic Technological University (ATU) Sligo, Ireland; School of Nursing & Midwifery, Trinity College Dublin, Ireland
| | - Jelena Marunica Karšaj
- Department of Rheumatology, Physical Medicine and Rehabilitation, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Wei Gao
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - Lina Zgaga
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Ireland; School of Medicine, Trinity College Dublin, Dublin, Ireland.
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Chen Y, Künzel RG, Sanchez SE, Rondon MB, Pinto NI, Sanchez E, Kirschbaum C, Valeri L, Koenen KC, Gelaye B. The association between pre-pregnancy and first-trimester hair cortisol and preterm birth: a causal inference model. Eur J Epidemiol 2024; 39:1391-1400. [PMID: 39661097 PMCID: PMC11680651 DOI: 10.1007/s10654-024-01174-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 10/27/2024] [Indexed: 12/12/2024]
Abstract
Adverse life events and chronic psychological distress before and during pregnancy have frequently been associated with preterm birth but the biological underpinnings remain unclear. We investigated the association between corticosteroid levels in pre-pregnancy and first-trimester hair and the risk of preterm birth. We followed N = 1,807 pregnant women from a prospective pre-birth cohort study in Lima, Perú. Hair samples were taken at the end of the first pregnancy trimester. The two most proximal 3 cm segments to the scalp (representing pre-pregnancy and first-trimester) were analyzed to obtain hair cortisol and cortisone concentrations (HCC and HCNC). Preterm birth was defined as birth < 37 completed gestational weeks. We constructed four generalized propensity scores for pre-pregnancy and first-trimester HCC and HCNC to create corresponding inverse probability weights before fitting marginal structural models for estimating the effect of HCC and HCNC on preterm birth risk. Pre-pregnancy Log HCC was not independently associated with preterm birth risk (RR = 0.97; 95%CI: 0.79, 1.19), nor was pre-pregnancy Log HCNC (RR = 0.84; 95%CI: 0.58, 1.20). In the first trimester, a one SD increase in Log HCC was associated with a 37% increased risk of preterm birth (95%CI: 1.11, 1.69), whereas Log HCNC was not significantly associated with preterm birth risk (RR = 1.20; 95%CI: 0.87, 1.65). Our findings show that chronic corticosteroid levels in early pregnancy are causally linked to preterm birth risk in pregnant Peruvian women. This finding contributes to understanding the biological underpinnings of preterm birth better to enhance its prevention.
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Affiliation(s)
- Yinxian Chen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, GA, 30322, Atlanta, USA
| | - Richard G Künzel
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- Katholische Universität Eichstätt-Ingolstadt, 85072, Eichstätt, Germany.
| | - Sixto E Sanchez
- Facultad de Medicina Humana, Universidad de San Martin de Porres, Instituto de Investigación, Lima, 15024, Perú
- Asociación Civil Proyectos en Salud, Lima, 15024, Perú
| | | | - Nelida I Pinto
- Facultad de Medicina Humana, Universidad de San Martin de Porres, Instituto de Investigación, Lima, 15024, Perú
| | - Elena Sanchez
- Asociación Civil Proyectos en Salud, Lima, 15024, Perú
| | | | - Linda Valeri
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, 10032, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Department of Psychiatry, The Chester M. Pierce M.D. Division of Global Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
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Chen Y, Künzel RG, Sanchez SE, Rondon MB, Pinto NI, Sanchez E, Kirschbaum C, Valeri L, Koenen KC, Gelaye B. The Association Between Pre-Pregnancy and First-Trimester Hair Cortisol and Preterm Birth: A Causal Inference Model. RESEARCH SQUARE 2024:rs.3.rs-4095921. [PMID: 38746291 PMCID: PMC11092793 DOI: 10.21203/rs.3.rs-4095921/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background Adverse life events and chronic psychological distress before and during pregnancy have frequently been associated with preterm birth (PTB) but the biological underpinnings remain unclear. We investigated the association between corticosteroid levels in pre-pregnancy and first-trimester hair and the risk of PTB. Methods We followed 1,808 pregnant women from a prospective pre-birth cohort study in Lima, Perú. Hair samples were taken at the end of the first pregnancy trimester. The two most proximal 3cm segments to the scalp (representing pre-pregnancy and first-trimester) were analyzed to obtain hair cortisol and cortisone concentrations (HCC and HCNC). PTB was defined as birth < 37 completed gestational weeks. We constructed four generalized propensity scores for pre-pregnancy and first-trimester HCC and HCNC to create corresponding inverse probability weights before fitting marginal structural models for estimating the effect of HCC and HCNC on PTB risk. Results Pre-pregnancy Log HCC was not independently associated with PTB risk (RR = 0.97; 95%CI: 0.79, 1.19). In contrast, one SD increase from the mean first-trimester Log HCC was independently associated with a 37% (95%CI: 1.11, 1.69) increased risk of PTB. Although imprecise, pre-pregnancy Log HCNC was negatively associated with PTB risk (RR = 0.84; 95%CI: 0.58, 1.20), whereas the association between first-trimester Log HCNC and PTB risk was positive (RR = 1.20; 95%CI: 0.87, 1.65). Conclusions Our findings show that chronic corticosteroid levels in early pregnancy are causally linked to PTB risk in pregnant Peruvian women. This finding contributes to understanding the biological underpinnings of PTB better to enhance PTB prevention.
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Stromájer GP, Csima M, Iváncsik R, Varga B, Takács K, Stromájer-Rácz T. Stress and Anxiety among High School Adolescents: Correlations between Physiological and Psychological Indicators in a Longitudinal Follow-Up Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1548. [PMID: 37761509 PMCID: PMC10529881 DOI: 10.3390/children10091548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
Mental and psychological disorders are serious health problems worldwide. Anxiety among high school students can affect school performance, relationships, and family life. OBJECTIVE Our aim is to understand the anxiety levels and associated factors among high school students and compare the results of psychological tests measuring anxiety with the cortisol levels obtained from biological sampling. METHOD In our longitudinal follow-up study, we involved 125 individuals in May 2019. Validated measurement tools were used during questionnaire data collection, including the State-Trait Anxiety Inventory, Clear Communication Scale, Multiple Social Perceived Support Scale, and related HBSC questions. As objective data, we collected hair samples for cortisol level measurement. RESULTS At the end of the school year, the anxiety levels measured by psychological tests were significantly higher (p = 0.001) compared to the anxiety levels at the beginning of the next school year. Anxiety levels were higher among girls and were influenced by the type of school and parental expectations. Both state anxiety and trait anxiety showed a strong correlation with psychosomatic symptoms (p < 0.001) and anxiety arising from school expectations (p < 0.05). The changes in cortisol levels did not follow the changes in psychological tests. Cortisol level increased (p = 0.01) in the second sample.
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Affiliation(s)
- Gábor Pál Stromájer
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (G.P.S.); (B.V.); (K.T.)
| | - Melinda Csima
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (M.C.); (R.I.)
| | - Réka Iváncsik
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (M.C.); (R.I.)
| | - Bernadett Varga
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (G.P.S.); (B.V.); (K.T.)
| | - Krisztina Takács
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (G.P.S.); (B.V.); (K.T.)
| | - Tímea Stromájer-Rácz
- Institute of Diagnostic, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary
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Kische H, Voss C, Haring R, Ollmann TM, Pieper L, Kirschbaum C, Beesdo-Baum K. Hair androgen concentrations and depressive disorders in adolescents from the general population. Eur Child Adolesc Psychiatry 2023; 32:1375-1389. [PMID: 35112167 PMCID: PMC10326161 DOI: 10.1007/s00787-021-01929-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/12/2021] [Indexed: 11/26/2022]
Abstract
Although the link between androgens and depression is well established in adults, the effects of cofactors on this association are less clearly understood, particularly in youth. Epidemiological cohort study of adolescents in Dresden, Germany. Analyses comprised data of 985 individuals assessed at baseline and of 512 individuals at 1-year follow-up. We investigated multivariable regression models for cross-sectional and longitudinal associations of hair testosterone, dehydroepiandrosterone (DHEA), and their cortisol ratios with 12-month diagnoses of major depressive disorder (MDD) and MDD without any anxiety disorder assessed with standardized diagnostic interview (DIA-X-5), and with dimensional depression scores (PHQ-9, PROMIS), separately for males and females. The potential moderating effect of social support was determined. Cross-sectional analyses yielded inverse associations of testosterone and DHEA with MDD and MDD without any anxiety disorders in males. In cross-sectional and longitudinal analyses, baseline ratio cortisol/DHEA was significantly, inversely associated to PROMIS-depression in males. Only cross-sectional associations for ratio cortisol/DHEA and PROMIS-depression remained significant after Bonferroni-Holm correction. No robust associations were observed in female participants. Social support exerted no consistent moderating effect on the investigated association. The present observational cohort study showed no consistent association of hair androgen concentrations with depressive disorders in adolescents. However, findings provide some support for the association between the cortisol/DHEA ratio and depression in males. Longitudinal research designs in large samples are needed to understand the interplay between androgens, depression, and developmental and social factors in youth.
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Affiliation(s)
- Hanna Kische
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Catharina Voss
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Robin Haring
- Faculty of Applied Public Health, European University of Applied Sciences, Rostock, Germany
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Theresa Magdalena Ollmann
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Rothe J, Buse J, Uhlmann A, Bodmer B, Kirschbaum C, Hoekstra PJ, Dietrich A, Roessner V. Hair Cortisol and Perceived Stress-Predictors for the Onset of Tics? A European Longitudinal Study on High-Risk Children. Biomedicines 2023; 11:1561. [PMID: 37371656 DOI: 10.3390/biomedicines11061561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/20/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Some retrospective studies suggest that psychosocial stressors trigger the onset of tics. This study examined prospective hypothalamic-pituitary-adrenal (HPA) axis activity and perceived stress prior to tic onset. In the present study, 259 children at high risk for developing tics were assessed for hair cortisol concentration (HCC) and parent-on-child-reported perceived stress four-monthly over a three-year period. We used (i) generalised additive modelling (GAM) to investigate the time effects on HCC (hair samples n = 765) and perceived stress (questionnaires n = 1019) prior to tic onset and (ii) binary logistic regression to predict tic onset in a smaller subsample with at least three consecutive assessments (six to nine months before, two to five months before, and at tic onset). GAM results indicated a non-linear increasing course of HCC in children who developed tics, and a steady HCC course in those without tics, as well as a linear-increasing course of perceived stress in both groups. Logistic regression showed that with a higher HCC in hair samples collected in a range of two to five months before tic onset (which refers to cortisol exposure in a range of four to eight months), the relative likelihood of tic onset rose. Our study suggests increased stress prior to tic onset, as evidenced by higher HCC several months before tic onset.
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Affiliation(s)
- Josefine Rothe
- Department of Child and Adolescent Psychiatry and Psychotherapy, Technische Universität Dresden, 01307 Dresden, Germany
| | - Judith Buse
- Department of Child and Adolescent Psychiatry and Psychotherapy, Technische Universität Dresden, 01307 Dresden, Germany
| | - Anne Uhlmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Technische Universität Dresden, 01307 Dresden, Germany
| | - Benjamin Bodmer
- Department of Child and Adolescent Psychiatry and Psychotherapy, Technische Universität Dresden, 01307 Dresden, Germany
| | - Clemens Kirschbaum
- Department of Psychology, Institute of Biopsychology, Technische Universität Dresden, 01307 Dresden, Germany
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
- Accare Child Study Center, 9723 HE Gronigen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
- Accare Child Study Center, 9723 HE Gronigen, The Netherlands
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Technische Universität Dresden, 01307 Dresden, Germany
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Mycoplasma pneumoniae IgG positivity is associated with tic severity in chronic tic disorders. Brain Behav Immun 2022; 99:281-288. [PMID: 34699932 DOI: 10.1016/j.bbi.2021.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/23/2021] [Accepted: 10/19/2021] [Indexed: 12/28/2022] Open
Abstract
Infectious pathogens may represent an environmental risk factor for chronic tic disorders (CTD). This cross-sectional study aimed to determine whether Mycoplasma pneumoniae (M. pneumoniae) IgG positivity is associated with the presence or severity of tics. We compared M. pneumoniae IgG positivity across three groups: children and adolescents (3-16 years) with CTD (CTD group; n = 302); siblings (3-10 years) of people with CTD who developed tics within a seven-year follow-up period (tic onset group; n = 51); siblings (4-10 years) who did not develop tics within the study period and were ≥10-years-old at their last assessment (unaffected group; n = 88). The relationship between M. pneumoniae IgG positivity and the presence and severity of tics was analysed using multilevel models controlling for site, family relatedness, sex, age, presence of comorbid obsessive-compulsive and/or attention-deficit/hyperactivity disorder and use of psychotropic medication. M. pneumoniae IgG positivity was not associated with the presence of CTD, or the first onset of tics as compared to siblings who remained unaffected. M. pneumoniae IgG positivity was associated with a higher tic severity score within the CTD group (β = 2.64, s.e. = 1.15, p = 0.02). It is possible that M. pneumoniae infection influences tic severity in CTD or, that having more severe tics, increases the risk of infection. However, it is more likely that the association observed in this study reflects a propensity toward enhanced immune responses in people with CTD and that, rather than a causal relationship, infection and greater tic severity are indirectly linked via shared underlying immune mechanisms.
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Abstract
Tic disorders and Tourette syndrome are the most common movement disorders in children and are characterized by movements or vocalizations. Clinically, Tourette syndrome is frequently associated with comorbid psychiatric symptoms. Although dysfunction of cortical–striatal–thalamic–cortical circuits with aberrant neurotransmitter function has been considered the proximate cause of tics, the mechanism underlying this association is unclear. Recently, many studies have been conducted to elucidate the epidemiology, clinical course, comorbid symptoms, and pathophysiology of tic disorders by using laboratory studies, neuroimaging, electrophysiological testing, environmental exposure, and genetic testing. In addition, many researchers have focused on treatment for tics, including behavioral therapy, pharmacological treatment, and surgical treatment. Here, we provide an overview of recent progress on Tourette syndrome.
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Affiliation(s)
- Keisuke Ueda
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Kevin J Black
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
- Department of Neuroscience, Washington University School of Medicine, St Louis, MO, USA
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