1
|
Schaefer JK, Engert V, Valk SL, Singer T, Puhlmann LM. Mapping pathways to neuronal atrophy in healthy, mid-aged adults: From chronic stress to systemic inflammation to neurodegeneration? Brain Behav Immun Health 2024; 38:100781. [PMID: 38725445 PMCID: PMC11081785 DOI: 10.1016/j.bbih.2024.100781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/27/2024] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
Growing evidence implicates systemic inflammation in the loss of structural brain integrity in natural ageing and disorder development. Chronic stress and glucocorticoid exposure can potentiate inflammatory processes and may also be linked to neuronal atrophy, particularly in the hippocampus and the human neocortex. To improve understanding of emerging maladaptive interactions between stress and inflammation, this study examined evidence for glucocorticoid- and inflammation-mediated neurodegeneration in healthy mid-aged adults. N = 169 healthy adults (mean age = 39.4, 64.5% female) were sampled from the general population in the context of the ReSource Project. Stress, inflammation and neuronal atrophy were quantified using physiological indices of chronic stress (hair cortisol (HCC) and cortisone (HEC) concentration), systemic inflammation (interleukin-6 (IL-6), high-sensitive C-reactive protein (hs-CRP)), the systemic inflammation index (SII), hippocampal volume (HCV) and cortical thickness (CT) in regions of interest. Structural equation models were used to examine evidence for pathways from stress and inflammation to neuronal atrophy. Model fit indices indicated good representation of stress, inflammation, and neurological data through the constructed models (CT model: robust RMSEA = 0.041, robust χ2 = 910.90; HCV model: robust RMSEA <0.001, robust χ2 = 40.95). Among inflammatory indices, only the SII was positively associated with hair cortisol as one indicator of chronic stress (β = 0.18, p < 0.05). Direct and indirect pathways from chronic stress and systemic inflammation to cortical thickness or hippocampal volume were non-significant. In exploratory analysis, the SII was inversely related to mean cortical thickness. Our results emphasize the importance of considering the multidimensionality of systemic inflammation and chronic stress, with various indicators that may represent different aspects of the systemic reaction. We conclude that inflammation and glucocorticoid-mediated neurodegeneration indicated by IL-6 and hs-CRP and HCC and HEC may only emerge during advanced ageing and disorder processes, still the SII could be a promising candidate for detecting associations between inflammation and neurodegeneration in younger and healthy samples. Future work should examine these pathways in prospective longitudinal designs, for which the present investigation serves as a baseline.
Collapse
Affiliation(s)
- Julia K. Schaefer
- Cognitive Neuropsychology, Department of Psychology, Ludwig-Maximilians-Universität München, Germany
| | - Veronika Engert
- Research Group “Social Stress and Family Health”, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Clinic, Friedrich-Schiller University, Jena, Germany
| | - Sofie L. Valk
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, FZ Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Tania Singer
- Social Neuroscience Lab, Max Planck Society, Berlin, Germany
| | - Lara M.C. Puhlmann
- Research Group “Social Stress and Family Health”, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| |
Collapse
|
2
|
Bilodeau-Houle A, Raymond C, Marin MF. It's all in the hair: Association between changes in hair cortisol concentrations in reaction to the COVID-19 pandemic and post-traumatic stress symptoms in children over time. Psychoneuroendocrinology 2024; 164:107019. [PMID: 38518705 DOI: 10.1016/j.psyneuen.2024.107019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/26/2024] [Accepted: 03/07/2024] [Indexed: 03/24/2024]
Abstract
After exposure to a stressful/traumatic event, some individuals will develop post-traumatic stress symptoms (PTSS). In adults, low cortisol levels appear to be a risk factor for the development of PTSS. Indeed, both lower pre-trauma cortisol levels and low cortisol levels in the aftermath of a traumatic event have been associated with greater PTSS. In contrast, studies conducted in children showed that elevated cortisol levels shortly after trauma exposure are associated with more severe post-traumatic stress symptomatology. The few studies that have examined how pre-trauma cortisol levels predict PTSS in children have found no effect. Given that a pandemic can induce PTSS in certain individuals, we investigated whether cortisol secretion prior to and in the early stages of the COVID-19 pandemic in Quebec (Canada) predicted PTSS in children. In June 2020, we collected a hair sample from 71 children (8-15 y/o, M = 11.65; 54.93% girls) without a history of psychopathology or exposure to previous traumatic events. Hair samples allowed us to derive cumulative measures of cortisol levels for the months prior to (from mid-December 2019 to mid-March 2020) and at the beginning of the pandemic (from mid-March 2020 to mid-June 2020). PTSS were assessed every 3 months between June 2020 (T1) and March 2021 (T4). The results showed that a greater increase in hair cortisol at the beginning of the pandemic predicted less PTSS at T1, with an increase in these symptoms over time. This study highlights the utility of using hair cortisol during future chronic stressful events to better understand its association with the evolution of distress.
Collapse
Affiliation(s)
- Alexe Bilodeau-Houle
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec H2X 3P2, Canada; Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, Quebec H1N 3V2, Canada
| | - Catherine Raymond
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec H2X 3P2, Canada; Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, Quebec H1N 3V2, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec H2X 3P2, Canada; Research Center of the Institut universitaire en santé mentale de Montréal, Montreal, Quebec H1N 3V2, Canada.
| |
Collapse
|
3
|
Berger É, Larose MP, Capuano F, Letarte MJ, Geoffroy MC, Lupien S, Brendgen M, Boivin M, Vitaro F, Tremblay R, Masse B, Côté S, Ouellet-Morin I. Hair steroid before and after COVID-19 in preschoolers: the moderation of family characteristics. Psychoneuroendocrinology 2024; 166:107072. [PMID: 38733756 DOI: 10.1016/j.psyneuen.2024.107072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/01/2024] [Accepted: 05/05/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Frequent or prolonged exposure to stressors may jeopardize young children's health. The onset of the COVID-19 pandemic, coupled with disruptions in daily routines and social isolation resulting from public health preventive measures, have raised concerns about its potential impact on children' experienced stress, particularly for young children and vulnerable families. However, whether the pandemic was accompanied by changes in physiological stress remains unknown as perceived stress is not a good proxy of physiological stress. This study examined if preschoolers showed increasing hair steroid concentrations following the onset of the COVID-19 pandemic and whether family characteristics may have exacerbated or buffered these changes. METHODS 136 preschoolers (2-4 years) provided hair for steroid measurement (cortisol, dehydroepiandrosterone (DHEA), cortisone, cortisol-to-DHEA ratio, cortisol-to-cortisone ratio) in October-November 2019 (T0) and in July-August 2020 (T1). A 2-centimeter hair segment was analyzed, reflecting steroid production over the two months leading up to collection. Family income, conflict resolution and lack of cohesion, as well as parents' COVID-19 stress were reported by parents. Linear mixed models for repeated measures and Bayes factors were used. RESULTS No significant changes were noted from before to after the onset of the COVID-19 pandemic for most hair steroids. However, a moderating role of family conflict resolution was noted. Children living with parents with a better ability to resolve conflicts had lower levels of DHEA compared to those who had more difficulty managing conflicts. Additionally, lower levels of family cohesion and income were linked to some steroids, especially DHEA, suggesting that these factors may relate to children's physiological stress. Finally, boys had higher DHEA levels than girls. CONCLUSION Our findings suggest that stress biomarkers were comparable from before to during the COVID-19 pandemic. This observation holds true despite the pandemic being perceived by many as a novel, unpredictable, and potentially threatening event. Findings further suggest that family characteristics are associated with hair steroid, especially DHEA, which deserves further investigation.
Collapse
Affiliation(s)
- Éloise Berger
- School of Criminology, University of Montreal, Montreal, Canada; Research Center of the Montreal Mental Health University Institute, Montreal, Canada
| | - Marie-Pier Larose
- INVEST Flagship Research Center/Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - France Capuano
- Department of Education and Specialized Training, University of Quebec at Montreal, Montreal, Canada
| | | | - Marie-Claude Geoffroy
- Department of Psychiatry McGill University, Montreal, Canada; McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, Montreal, Canada
| | - Sonia Lupien
- Research Center of the Montreal Mental Health University Institute, Montreal, Canada; Centre for Studies on Human Stress, Department Psychiatry, University of Montreal, Montreal, Canada
| | - Mara Brendgen
- Department of Psychology, University of Quebec at Montreal, Montreal, Canada; Ste Justine Hospital Research Centre, Montreal, Canada
| | - Michel Boivin
- School of Psychology, Laval University, Quebec City, Canada
| | - Frank Vitaro
- School of Psychoeducation, University of Montreal, Montreal, Canada; Research Group on Child Maladjustment, Université de Montréal, Montreal, Canada
| | - Richard Tremblay
- Department of Pediatrics and Psychology, University of Montreal, Montreal, Canada
| | - Benoît Masse
- School of Public Health, University of Montreal, Montreal, Canada
| | - Sylvana Côté
- Research Group on Child Maladjustment, Université de Montréal, Montreal, Canada; School of Public Health, University of Montreal, Montreal, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal, Montreal, Canada; Research Center of the Montreal Mental Health University Institute, Montreal, Canada.
| |
Collapse
|
4
|
May AK, Smeeth D, McEwen F, Moghames P, Karam E, Rieder MJ, Elzagallaai AA, van Uum S, Pluess M. Hair hormone data from Syrian refugee children: Perspectives from a two-year longitudinal study. Compr Psychoneuroendocrinol 2024; 18:100231. [PMID: 38645423 PMCID: PMC11026725 DOI: 10.1016/j.cpnec.2024.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
For numerous issues of convenience and acceptability, hair hormone data have been increasingly incorporated in the field of war trauma and forced displacement, allowing retrospective examination of several biological metrics thought to covary with refugees' mental health. As a relatively new research method, however, there remain several complexities and uncertainties surrounding the use of hair hormones, from initial hair sampling to final statistical analysis, many of which are underappreciated in the extant literature, and restrict the potential utility of hair hormones. To promote awareness, we provide a narrative overview of our experiences collecting and analyzing hair hormone data in a large cohort of Syrian refugee children (n = 1594), across two sampling waves spaced 12 months apart. We highlight both the challenges faced, and the promising results obtained thus far, and draw comparisons to other prominent studies in this field. Recommendations are provided to future researchers, with emphasis on longitudinal study designs, thorough collection and reporting of hair-related variables, and careful adherence to current laboratory guidelines and practices.
Collapse
Affiliation(s)
- Andrew K. May
- Department of Psychological Sciences, School of Psychology, University of Surrey, Guildford, UK
| | - Demelza Smeeth
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Fiona McEwen
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Department of War Studies, King's College London, London, UK
| | | | - Elie Karam
- Department of Psychiatry and Clinical Psychology, Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Lebanon
| | - Michael J. Rieder
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Abdelbaset A. Elzagallaai
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Stan van Uum
- Division of Endocrinology and Metabolism, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Michael Pluess
- Department of Psychological Sciences, School of Psychology, University of Surrey, Guildford, UK
| |
Collapse
|
5
|
Peng FJ, Palazzi P, Mezzache S, Adelin E, Bourokba N, Bastien P, Appenzeller BMR. Glucocorticoid hormones in relation to environmental exposure to bisphenols and multiclass pesticides among middle aged-women: Results from hair analysis. Environ Pollut 2024; 348:123839. [PMID: 38522601 DOI: 10.1016/j.envpol.2024.123839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 03/26/2024]
Abstract
Bisphenols and pesticides have been shown to alter circulating glucocorticoids levels in animals, but there is limited human data. Moreover, measurements from biological fluids may not be able to reflect long-term status of non-persistent pollutants and glucocorticoids due to the high variability in their levels. Using hair analysis, we examined the associations between glucocorticoid hormones and environmental exposure to multi-class organic pollutants among a healthy female population aged 25-45 years old. Concentrations of four glucocorticoids, four polychlorinated biphenyl congeners (PCBs), seven polybrominated diphenyl ether congeners (PBDEs), two bisphenols and 140 pesticides and their metabolites were measured in hair samples collected from 196 Chinese women living in urban areas. Due to the low detection frequency of some pollutants, associations were explored only on 54 pollutants, i.e. PCB 180, bisphenol A, bisphenol S and 51 pesticides and their metabolites. Using stability-based Lasso regression, there were associations of cortisol, tetrahydrocortisol, cortisone, and tetrahydrocortisone with 14, 10, 13 and 17 biomarkers of exposure to pollutants, respectively, with bisphenol S, p,p'-dichlorodiphenyldichloroethylene, diethyl phosphate, 3,5,6-trichloro-2-pyridinol, thiamethoxam, imidacloprid, fipronil, tebuconazole, trifluralin, pyraclostrobin and 1-(3,4-dichlorophenyl)-3-methylurea being associated with at least three of the four hormones. There were also associations between cortisone/cortisol molar ratio and pollutants, namely dimethyl phosphate, 3-methyl-4-nitrophenol, carbofuran, λ-cyhalothrin, permethrin, fipronil, flusilazole, prometryn and fenuron. Some of these relationships were confirmed by single-pollutant linear regression analyses. Overall, our results suggest that background level of exposure to bisphenols and currently used pesticides may interfere with the glucocorticoid homeostasis in healthy women.
Collapse
Affiliation(s)
- Feng-Jiao Peng
- Human Biomonitoring Research Unit, Department of Precision Health, Luxembourg Institute of Health, 1 A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Paul Palazzi
- Human Biomonitoring Research Unit, Department of Precision Health, Luxembourg Institute of Health, 1 A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Sakina Mezzache
- L'Oréal Research and Innovation, 1 Avenue Eugène Schueller BP22, 93601, Aulnay Sous Bois, France
| | - Emilie Adelin
- L'Oréal Research and Innovation, 1 Avenue Eugène Schueller BP22, 93601, Aulnay Sous Bois, France
| | - Nasrine Bourokba
- L'Oréal Research and Innovation, Biopolis Drive, Synapse, 138623, Singapore
| | - Philippe Bastien
- L'Oréal Research and Innovation, 1 Avenue Eugène Schueller BP22, 93601, Aulnay Sous Bois, France
| | - Brice M R Appenzeller
- Human Biomonitoring Research Unit, Department of Precision Health, Luxembourg Institute of Health, 1 A-B Rue Thomas Edison, 1445, Strassen, Luxembourg.
| |
Collapse
|
6
|
Schmalbach I, Steudte-Schmiedgen S, Osmers A, Witthöft M, Drees P, Petrowski K. Longitudinal Assessment of Hair Cortisol as a Predictor of Psychological Symptoms During COVID-19. Psychoneuroendocrinology 2024; 163:106991. [PMID: 38412741 DOI: 10.1016/j.psyneuen.2024.106991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND There is a lack of evidence regarding enduring psychoneuroendocrine changes following an initial traumatic event, particular in the presence of an ongoing stressor. The coronavirus pandemic presents an opportunity to explore this matter. Consequently, the purpose of the present study was to investigate the impact of the ongoing pandemic (2021) on individuals, who experienced a first-time motor vehicle crash (MVC) at least 6 years earlier. To this end, we hypothesized that hair cortisol concentrations (HCC) following a first-time traumatic event positively predict symptoms of depression. METHOD We investigated N = 69 individuals (18 - 65 yrs.), who were victims of a MVC during 2010 - 2014. Hair strands were collected 10 days (t1) and 3 months after the MVC (t2), as well during the pandemic in 2021 (t3). To assess symptoms of depression, the participants filled out the Beck Depression Inventory at t1 - t3 and were additionally interviewed (Structured Clinical Interview for DSM-IV Axis I) at t1 and t2. Exclusion criteria conveyed a lifetime or acute mental disorder (incl. past trauma exposure). RESULTS Elevated pre-pandemic HCC following adversity (i.e., MVC) significantly predicted symptoms of depression in adults during the coronavirus pandemic (BDI: ß =.44, p =.010, R2 =.20), even after controlling for confounders. HCC significantly decreased over time, while in average psychological symptoms remained consistent. CONCLUSION Cortisol dysregulation in the past presents an enduring vulnerability to ongoing stress. In this regard, vulnerable groups may benefit from preventive measures. This finding validates the predictive power of HCC and extended past evidence in this regard, at the same time reinforcing the concept of the diathesis-stress model.
Collapse
Affiliation(s)
- I Schmalbach
- Department of Medical Psychology and Medical Sociology, Johannes-Gutenberg University Mainz, Mainz, Germany
| | - S Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - A Osmers
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - M Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P Drees
- University Hospital of the University Johannes-Gutenberg Mainz, Department for Orthopedics and Trauma Surgery, Mainz, Germany
| | - K Petrowski
- Department of Medical Psychology and Medical Sociology, Johannes-Gutenberg University Mainz, Mainz, Germany; Dresden University of Technology, Carl Gustav Carus Medical Faculty, Department of General Medicine/MK3, Dresden, Germany.
| |
Collapse
|
7
|
Reyes Del Paso GA, Garcia-Hernandez A, Contreras-Merino AM, Galvez-Sánchez CM, de la Coba P, Montoro CI, Davydov DM. A two-component model of hair cortisol concentration in fibromyalgia: Independent effects of pain chronicity and severity. Eur J Pain 2024; 28:821-830. [PMID: 38102835 DOI: 10.1002/ejp.2223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/30/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Fibromyalgia (FM) is a chronic pain disorder of unknown aetiopathogenesis, in which the role of activity of the hypothalamic-pituitary-adrenal (HPA) axis is not clearly established. METHODS This study analysed the modulatory effects of disease chronicity and severity on cortisol levels. Hair cortisol concentrations (HCC) and clinical evaluation data (pain severity, impact of FM on daily activities, depression, anxiety, fatigue and insomnia) were collected from 47 female patients with FM and 36 healthy women (HW). RESULTS The results showed that disease chronicity, with a negative effect, and symptom severity, with a positive effect, were independent predictors of HCC. Patients with a shorter disease duration had higher HCC than patients with a longer disease duration and healthy participants. Furthermore, patients with greater symptom severity had higher HCC than those patients with lower clinical severity and healthy participants. While disease chronicity in FM was associated with a decrease in HCC, clinical severity increased HCC. CONCLUSIONS These results support the existence of a dysfunction in the regulation of the HPA axis in FM and its possible contribution to chronic pain development. SIGNIFICANCE This is the first study to assess hair cortisol concentrations in a specific sample of patients with fibromyalgia (FM). This method is especially useful for the assessment of long-term regular cortisol excretion. Results showed a two-component model for explaining cortisol levels: disease chronicity, with a negative effect, and symptom severity, with a positive effect. This suggests that severe pain/stress evokes higher cortisol levels at earlier stages of FM, while in the longer term a decrease in cortisol levels was observed.
Collapse
Affiliation(s)
| | | | | | | | - P de la Coba
- Department of Psychology and Anthropology, University of Extremadura, Cáceres, Spain
| | - C I Montoro
- Department of Psychology, University of Jaén, Jaén, Spain
| | - D M Davydov
- María Zambrano senior scholar, University of Jaén, Jaén, Spain
| |
Collapse
|
8
|
Chan II, Wu AM. Assessing the Role of Cortisol in Anxiety, Major Depression, and Neuroticism: A Mendelian Randomization Study Using SERPINA6/ SERPINA1 Variants. Biol Psychiatry Glob Open Sci 2024; 4:100294. [PMID: 38525495 PMCID: PMC10959652 DOI: 10.1016/j.bpsgos.2024.100294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 03/26/2024] Open
Abstract
Background Previous evidence informed by the toxic stress model suggests that higher cortisol causes anxiety and major depression, but clinical success is lacking. To clarify the role of cortisol, we used Mendelian randomization to estimate its associations with anxiety, major depression, and neuroticism, leveraging the largest available genome-wide association studies including from the Psychiatric Genomics Consortium, the UK Biobank, and FinnGen. Methods After meta-analyzing 2 genome-wide association studies on morning plasma cortisol (n = 32,981), we selected single nucleotide polymorphisms (SNPs) at p < 5 × 10-8 and r2 < 0.3 in the SERPINA6/SERPINA1 gene region encoding proteins that influence cortisol bioavailability. We applied these SNPs to summary genetic associations with the outcomes considered (n = 17,310-449,484), and systolic blood pressure as a positive outcome, using inverse-variance weighted meta-analysis accounting for correlation. Sensitivity analyses addressing SNP correlation and confounding by childhood maltreatment and follow-up analyses using only SNPs that colocalized with SERPINA6 expression were conducted. Results Cortisol was associated with anxiety (pooled odds ratio [OR] 1.16 per cortisol z score; 95% CI, 1.04 to 1.31), but not major depression (pooled OR 1.02, 95% CI, 0.95 to 1.10) or neuroticism (β -0.025; 95% CI, -0.071 to 0.022). Sensitivity analyses yielded similar estimates. Cortisol was positively associated with systolic blood pressure, as expected. Using rs9989237 and rs2736898, selected using colocalization, cortisol was associated with anxiety in the UK Biobank (OR 1.32; 95% CI, 1.01 to 1.74) but not with major depression in FinnGen (OR 1.14; 95% CI, 0.95 to 1.37). Conclusions Cortisol was associated with anxiety and may be a potential target for prevention. Other targets may be more relevant to major depression and neuroticism.
Collapse
Affiliation(s)
- Io Ieong Chan
- Department of Public Health and Medicinal Administration, Faculty of Health Science, University of Macau, Macao, China
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, China
| | - Anise M.S. Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, China
| |
Collapse
|
9
|
Bergunde L, Steudte-Schmiedgen S, Karl M, Jaramillo I, Gao W, von Soest T, Garthus-Niegel S. Stability and inter-family associations of hair endocannabinoid and N-acylethanolamines across the perinatal period in mothers, fathers, and children. Sci Rep 2024; 14:9459. [PMID: 38658668 PMCID: PMC11043453 DOI: 10.1038/s41598-024-59818-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
Analysis of endocannabinoids (ECs) and N-acylethanolamines (NAEs) in hair is assumed to retrospectively assess long-term EC/NAE concentrations. To inform their use, this study investigated stability of EC/NAE hair concentrations in mothers, fathers, and their children across the perinatal period as well as associations between family members. In a prospective cohort study, EC (AEA, 1-AG/2-AG) and NAE (SEA, PEA, OEA) levels were quantified in hair samples taken four times in mothers (n = 336) and their partners (n = 225) from pregnancy to two years postpartum and in offspring (n = 319) from shortly after birth to two years postpartum. Across the perinatal period, maternal and paternal hair ECs/NAEs showed poor multiple-test consistency (16-36%) and variable relative stability, as well as inconsistent absolute stability for mothers. Regarding children, hair ECs/NAEs evidenced poor multiple-test consistency (4-19%), no absolute stability, and either no or variable relative stability. Hair ECs/NAEs showed small to medium significant associations across the perinatal period within couples and parent-child dyads. Findings suggest hair ECs/NAEs during the perinatal period possess variable stability in adults, albeit more stability in fathers than mothers in this time. This highlights the need to further investigate factors associated with changes in hair ECs/NAEs across time. The first two years of life may be a dynamic phase for the endocannabinoid system in children, potentially characterized by complex within-family correspondence that requires further systematic investigation.
Collapse
Affiliation(s)
- L Bergunde
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
| | - S Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - M Karl
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - I Jaramillo
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - W Gao
- School of Psychology, Nanjing Normal University, Nanjing, China
| | - T von Soest
- Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
| | - S Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg MSH, Hamburg, Germany
- Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
10
|
Gallistl M, Linz R, Puhlmann LMC, Singer T, Engert V. Evidence for differential associations of distinct trait mindfulness facets with acute and chronic stress. Psychoneuroendocrinology 2024; 166:107051. [PMID: 38678734 DOI: 10.1016/j.psyneuen.2024.107051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 05/01/2024]
Abstract
Stress and stress-associated disease are considered the health epidemic of the 21st century. Interestingly, despite experiencing similar amounts of stress than those falling ill, some individuals are protected against the "wear and tear of daily life". Based on the notion that mindfulness training strengthens stress resilience, we explored whether facets of trait mindfulness, prior to training intervention, are linked to acute psychosocial stress reactivity and chronic stress load. To assess different mindfulness facets, over 130 participants completed the Five Facet Mindfulness Questionnaire (FFMQ) and the Freiburg Mindfulness Inventory (FMI). For acute stress induction, a standardized psychosocial stress test was conducted. Subjective stress, sympathetic and parasympathetic activity, and levels of the hypothalamic-pituitary-adrenal axis end hormone cortisol were assessed repeatedly. Additionally, levels of hair cortisol and cortisone as indices of the long-term physiological stress load were collected. We found differential associations of different facets of mindfulness with subjective stress, cortisol, and hair cortisone levels. Specifically, the trait mindfulness facets FMI "Acceptance" and the ability to put one's inner experience into words (FFMQ "Describing") were associated with lower acute subjective and cortisol stress reactivity. Contrarily, monitoring-related trait mindfulness facets (FFMQ "Acting with Awareness" and "Observing") were associated with higher acute cortisol and marginally higher long-term cortisone release. Our results suggest granularity of the mindfulness construct. In accordance with the "Monitor and Acceptance Theory", especially acceptance-related traits buffered against stress, while monitoring-related traits seemed to be maladaptive in the context of stress. The current results give valuable guidance for the conceptualization of mindfulness-based interventions geared towards stress reduction.
Collapse
Affiliation(s)
- Mathilde Gallistl
- Independent Research Group "Social Stress and Family Health", Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Roman Linz
- Independent Research Group "Social Stress and Family Health", Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Lara M C Puhlmann
- Independent Research Group "Social Stress and Family Health", Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Tania Singer
- Social Neuroscience Lab, Max Planck Society, Berlin, Germany
| | - Veronika Engert
- Independent Research Group "Social Stress and Family Health", Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Institute for Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller University, Jena, Germany; German Center for Mental Health (DZPG), partner site Halle-Jena-Magdeburg
| |
Collapse
|
11
|
Qi D, Wang W, Chu L, Wu Y, Wang W, Zhu M, Yuan L, Gao W, Deng H. Associations of schizophrenia with the activities of the HPA and HPG axes and their interactions characterized by hair-based biomarkers. Psychoneuroendocrinology 2024; 165:107049. [PMID: 38657340 DOI: 10.1016/j.psyneuen.2024.107049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/11/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Past studies on schizophrenia (SCZ) and the stress-sensitive neuroendocrine systems have mostly focused on a single system and traditionally utilized acute biomarkers (e.g., biomarkers from blood, urine and saliva) that poorly match the chronic course of schizophrenia in time span. Using eight biomarkers in hair, this study aimed to explore the functional characteristics of SCZ patients in the hypothalamic-pituitary-adrenocortical (HPA) and hypothalamic-pituitary-gonadal (HPG) axes and the interaction between the two axes. METHODS Hair samples were taken from 137 SCZ patients and 73 controls. The SCZ patients were diagnosed by their attending physician according to the Diagnostic and Statistical Manual of Mental Disorders IV and were clinically stable after treatment. Gender, age, BMI, frequency of hair washing, marital status, education level, family history of mental illness and clozapine dosage were concurrently collected as covariates. The 10-item perceived stress scale (PSS-10) and the social readjustment rating scale were used to assess chronic stress status in SCZ patients. Eight hair biomarkers, cortisol, cortisone, dehydroepiandrosterone (DHEA), testosterone, progesterone, cortisol/cortisone, cortisol/DHEA and cortisol/testosterone, were measured by high performance liquid chromatography tandem mass spectrometer. Among them, cortisol, cortisone, DHEA and cortisol/DHEA reflected the functional activity of the HPA axis, and testosterone and progesterone reflected the functional activity of the HPG axis, and cortisol/cortisone reflected the activity of 11β-hydroxysteroid dehydrogenase types 2 (11β-HSD 2), and cortisol/testosterone reflected the HPA-HPG interaction. RESULTS SCZ patients showed significantly higher cortisone and cortisol/testosterone than controls (p<0.001, η²p=0.180 and p=0.015, η²p=0.031), lower testosterone (p=0.009, η²p=0.034), progesterone (p<0.001, η²p=0.069) and cortisol/cortisone (p=0.001, η²p=0.054). There were significant intergroup differences in male and female progesterone (p=0.003, η²p=0.088 and p=0.030, η²p=0.049) and female testosterone (p=0.028, η²p=0.051). In SCZ patients, cortisol, cortisol/cortisone, cortisol/DHEA and cortisol/testosterone were positively associated with PSS-10 score (ps<0.05, 0.212 CONCLUSION The function of the HPA and HPG axes, the activity of 11β-HSD 2 and the HPA-HPG interaction were abnormal in SCZ patients. The abnormality of neuroendocrine systems was associated with chronic stress status in SCZ patients. This study provided evidence for abnormalities in the neuroendocrine systems in SCZ patients.
Collapse
Affiliation(s)
- Deyi Qi
- Department of Brain and Learning Science, School of Biological Science & Medical Engineering, Southeast University, Nanjing 211189, China; Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing 211189, China; Institute of Child Development and Education, Southeast University, Nanjing 211189, China
| | - Weiliang Wang
- School of Nursing, Harbin Medical University, Harbin 163319, China.
| | - Liuxi Chu
- Department of Brain and Learning Science, School of Biological Science & Medical Engineering, Southeast University, Nanjing 211189, China; Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing 211189, China; Institute of Child Development and Education, Southeast University, Nanjing 211189, China
| | - Yan Wu
- Department of Brain and Learning Science, School of Biological Science & Medical Engineering, Southeast University, Nanjing 211189, China; Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing 211189, China; Institute of Child Development and Education, Southeast University, Nanjing 211189, China
| | - Wei Wang
- Department of Brain and Learning Science, School of Biological Science & Medical Engineering, Southeast University, Nanjing 211189, China; Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing 211189, China; Institute of Child Development and Education, Southeast University, Nanjing 211189, China
| | - Minhui Zhu
- Department of Brain and Learning Science, School of Biological Science & Medical Engineering, Southeast University, Nanjing 211189, China; Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing 211189, China; Institute of Child Development and Education, Southeast University, Nanjing 211189, China
| | - Lin Yuan
- Department of Brain and Learning Science, School of Biological Science & Medical Engineering, Southeast University, Nanjing 211189, China; Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing 211189, China; Institute of Child Development and Education, Southeast University, Nanjing 211189, China
| | - Wei Gao
- Institute of Child Development and Education, Southeast University, Nanjing 211189, China; School of Psychology, Nanjing Normal University, Nanjing 210024, China
| | - Huihua Deng
- Department of Brain and Learning Science, School of Biological Science & Medical Engineering, Southeast University, Nanjing 211189, China; Key Laboratory of Child Development and Learning Science (Southeast University), Ministry of Education, Nanjing 211189, China; Institute of Child Development and Education, Southeast University, Nanjing 211189, China.
| |
Collapse
|
12
|
Johnson-Ferguson L, Shanahan L, Loher M, Bechtiger L, Binz TM, Baumgartner M, Ribeaud D, Eisner M, Quednow BB. Higher paracetamol levels are associated with elevated glucocorticoid concentrations in hair: findings from a large cohort of young adults. Arch Toxicol 2024:10.1007/s00204-024-03747-w. [PMID: 38615315 DOI: 10.1007/s00204-024-03747-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/21/2024] [Indexed: 04/15/2024]
Abstract
Paracetamol is one of the most commonly used over-the-counter medications. Experimental studies suggest a possible stress-suppressing effect of paracetamol in humans facing experimental stress-inducing paradigms. However, no study has investigated whether paracetamol and steroid hormones covary over longer time frames and under real-life conditions. This study addresses this gap by investigating associations between steroid hormones (cortisol, cortisone, and testosterone) and paracetamol concentrations measured in human hair, indexing a timeframe of approximately three months. The data came from a large community sample of young adults (N = 1002). Hair data were assayed using liquid chromatography-tandem mass spectrometry. Multiple regression models tested associations between paracetamol and steroid hormones, while adjusting for a wide range of potential confounders, such as sex, stressful live events, psychoactive substance use, hair colour, and body mass index. Almost one in four young adults from the community had detectable paracetamol in their hair (23%). Higher paracetamol hair concentrations were robustly associated with more cortisol (β = 0.13, ηp = 0.016, p < 0.001) and cortisone (β = 0.16, ηp = 0.025, p < 0.001) in hair. Paracetamol and testosterone hair concentrations were not associated. Paracetamol use intensity positively correlated with corticosteroid functioning across several months. However, a potential corticosteroid-inducing effect of chronic paracetamol use has yet to be tested in future experimental designs.
Collapse
Affiliation(s)
- Lydia Johnson-Ferguson
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050, Zurich, Switzerland.
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050, Zurich, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Michelle Loher
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050, Zurich, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050, Zurich, Switzerland
| | - Tina M Binz
- Center for Forensic Hair Analytics, Zurich Institute of Legal Medicine, University of Zurich, Zurich, Switzerland
| | - Markus Baumgartner
- Center for Forensic Hair Analytics, Zurich Institute of Legal Medicine, University of Zurich, Zurich, Switzerland
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050, Zurich, Switzerland
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Cambridge, UK
| | - Boris B Quednow
- Jacobs Center for Productive Youth Development, University of Zurich, Andreasstrasse 15, 8050, Zurich, Switzerland
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| |
Collapse
|
13
|
Gifford RM, Taylor N, Carroll A, Sweeting J, Parsons IT, Stacey MJ, Homer NZM, Tsanas A, Woods DR, Reynolds RM. Assessment of salivary cortisol dynamics in an infantry training exercise: a pilot study. BMJ Mil Health 2024:e002622. [PMID: 38604756 DOI: 10.1136/military-2023-002622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/26/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Measuring cortisol during military training offers insights into physiological responses to stress. We attempted precisely timed, cortisol awakening response (CAR) and pre-sleep cortisol (PSC), and diurnal slope (peak morning minus evening cortisol), during a British Army exercise. We aimed to understand cortisol dynamics and evaluate the feasibility of CAR and PSC in this environment. METHOD Setting: high-intensity, 10-day infantry exercise. Participants: regular infantry soldiers exercising (EX, n=25) or headquarters-based (HQ, n=6). Participants undertook PSC and WAKE and WAKE+30 min samples after 1-2 days, 5-6 days and 9-10 days. Wrist-worn GENEActiv accelerometers were used to assess sleep duration in EX only. Samples taken ±15 min from prespecified time points were deemed adherent. Validated questionnaires were used to measure resilience and perceived stress. Cortisol and cortisone were measured simultaneously by liquid chromatography tandem mass spectrometry. RESULTS From adherent participants' samples, CAR was positive and tended to decrease as the exercise progressed. From all available data, HQ demonstrated greater diurnal slope than EX (F=7.68, p=0.02), reflecting higher morning cortisol (F=4.72, p=0.038) and lower PSC (p=0.04). No differences were seen in cortisol:cortisone ratio. 26.1% of CAR samples were adherent, with moderately strong associations between adherence and stress (r=0.41, p=0.009) but no association between adherence and day of exercise (χ2=0.27, p=0.8), sleep duration (r=-0.112, p=0.43) or resilience (r=-0.79, p=0.75). Test-retest reliability ratings for CAR were Cronbach's α of 0.48, -11.7 and 0.34 for the beginning, middle and end of the exercise, respectively. CONCLUSIONS We observed a reduction in morning cortisol and decreased diurnal slope during a high-intensity military exercise, compared with the HQ comparator cohort in whom diurnal slope was preserved. A carefully timed CAR was not feasible in this setting.
Collapse
Affiliation(s)
- Robert M Gifford
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - N Taylor
- Academic Department of Military General Practice, Royal Centre for Defence Medicine, Birmingham, UK
| | - A Carroll
- Royal Centre for Defence Medicine, Birmingham, UK
| | - J Sweeting
- Royal Centre for Defence Medicine, Birmingham, UK
| | - I T Parsons
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - M J Stacey
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - N Z M Homer
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - A Tsanas
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
| | - D R Woods
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - R M Reynolds
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
14
|
Rodrigues KL, Scaranni PDODS, Pereira ENGDS, da Silva VVD, Silvares RR, de Araujo BP, Castilho C, Schmidt MI, da Fonseca MDJM, Griep RH, Daliry A. Hair cortisol levels are associated with overweight and obesity in the ELSA-Brasil cohort. Front Endocrinol (Lausanne) 2024; 15:1361715. [PMID: 38654925 PMCID: PMC11035765 DOI: 10.3389/fendo.2024.1361715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/09/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Hair cortisol level has recently been identified as a promising marker for detecting long-term cortisol levels and a marker of hypothalamic-pituitary-adrenal cortex (HPA) axis activity. However, research on the association between obesity and an altered cortisol metabolism remains controversial. Objective This study aimed to investigate the relationship between hair cortisol levels and overweight and obesity in participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This was a cross-sectional study involving 2,499 participants from the second follow-up (visit 3, 2017-2019) attending research centers in Rio de Janeiro and Rio Grande do Sul states. Hair samples were collected, and cortisol levels were analyzed using enzyme-linked immunosorbent assay (ELISA) kits. Cortisol levels were classified as low (< 40 pg/mg), medium (40-128 pg/mg), or high (> 128 pg/mg). The participants were classified as eutrophic, overweight, or obese according to their weight (kg) and height (m2). Odds ratios (ORs) with 95% confidence intervals (95%CI) were estimated. Results Of the 2499 individuals, 30% had eutrophic weight, 40% were overweight, and 30% were obese. Notably, cortisol levels gradually increased with increasing body weight. Among participants with high hair cortisol levels, 41.2% were classified as overweight and 34.2% as obese. Multinomial logistic regression analysis indicated that participants with high cortisol levels were 43% (OR =1.43; 95%CI: 1.02-2.03) more likely to be overweight and 72% (OR =1.72; 95%CI:1.20-2.47) more likely to be obese than participants with low hair cortisol levels. After adjustment for all covariates, high cortisol levels remained associated with obesity (OR = 1.54; 95%CI:1.02-2.31) and overweight (OR =1.33; 95%CI:0.91-1.94). Conclusion In the ELSA-Brazil cohort, hair stress were positively associated with overweight and obesity. These results underscore the importance of considering stress and cortisol as potential factors in obesity prevention and intervention efforts, and highlight a novel aspect of the complex relationship between stress and obesity in the Brazilian population.
Collapse
Affiliation(s)
- Karine Lino Rodrigues
- Laboratory of Clinical and Experimental Physiopathology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | | | - Raquel Rangel Silvares
- Laboratory of Clinical and Experimental Physiopathology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Beatriz Peres de Araujo
- Laboratory of Clinical and Experimental Physiopathology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Cristina Castilho
- Department of Public Health, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Inês Schmidt
- Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rosane Harter Griep
- Laboratory of Environmental and Health Education, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Anissa Daliry
- Laboratory of Clinical and Experimental Physiopathology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| |
Collapse
|
15
|
Li Z, Kong W, Park HY, Koo SJ, Bang M, Park JT, Lee E, An SK. Association of hair cortisol concentration with brain-derived neurotrophic factor gene methylation: The role of sex as a moderator. Stress Health 2024:e3401. [PMID: 38581566 DOI: 10.1002/smi.3401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/20/2024] [Accepted: 03/29/2024] [Indexed: 04/08/2024]
Abstract
Hair cortisol concentration (HCC) reflects the long-term activity of the hypothalamus-pituitary-adrenal (HPA) axis in response to stress. Brain-derived neurotrophic factor DNA methylation (BDNF DNAM) may affect HCC, and sex and Val66Met may contribute to this association. Thus, the aim of this study was to investigate the associations between HCC and Brain-derived neurotrophic factor (BDNF) DNAM, and the moderating effects of Val66Met and sex. We recruited 191 healthy young participants (96 women, mean age 23.0 ± 2.6 years) and collected body samples to evaluate HCC, and to determine BDNF DNAM and Val66Met genotypes. We analyzed the effects of BDNF DNAM, sex, and Val66Met on HCC. We also evaluated the associations between BDNF DNAM and HCC in groups separated by sex and genotypes. We found a marked association of BDNF DNAM with HCC across men and women. After dividing the data by sex, a positive correlation of HCC with BDNF DNAM was found only in women. There was no substantial moderation effect of Val66Met genotypes on the association between BDNF DNAM and HCC. Therefore, BDNF DNAM was found to have positive association with HCC only in healthy young women, indicating that sex moderates the association of BDNF DNAM with long-term HPA axis activity.
Collapse
Affiliation(s)
- Zhenxu Li
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Yonsei University College of Medicine, Seoul, South Korea
| | - Wanji Kong
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Yoon Park
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Se Jun Koo
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Graduate Program in Cognitive Science, Yonsei University, Seoul, South Korea
| | - Minji Bang
- Department of Psychiatry, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, South Korea
| | - Jung Tak Park
- Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Lee
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Suk Kyoon An
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Graduate Program in Cognitive Science, Yonsei University, Seoul, South Korea
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| |
Collapse
|
16
|
Marsland AL, Jones E, Reed RG, Walsh CP, Natale BN, Lindsay EK, Ewing LJ. Childhood trauma and hair cortisol response over the year following onset of a chronic life event stressor. Psychoneuroendocrinology 2024; 165:107039. [PMID: 38581748 DOI: 10.1016/j.psyneuen.2024.107039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/07/2024] [Accepted: 03/29/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE Childhood trauma may contribute to poor lifelong health in part through programming of the HPA-axis response to future life stressors. To date, empirical evidence shows an association of childhood trauma with dysregulation of the HPA-axis and blunted cortisol reactivity to acute stressors. Here, we conduct an initial examination of childhood trauma as a moderator of changes over time in perceived stress levels and HPA-axis response to a major chronic stressor in adulthood. METHODS Participants were 83 maternal caregivers of children newly diagnosed with cancer who completed the Childhood Trauma Questionnaire (CTQ), and who, over the year following their child's cancer diagnosis, had hair samples collected up to 7 times for the assessment of cortisol and completed monthly measures of perceived stress. RESULTS CTQ scores were in the expected range for a community sample and associated with changes in perceived stress and cortisol concentration over time (γ =.003, p =.002; γ = -.0004, p =.008, respectively) independently of age, education, treatment intensity and randomization to stress management intervention. Maternal caregivers who endorsed lower childhood trauma showed a steeper decline in perceived stress and a larger increase in cortisol levels across the year than caregivers who recalled more childhood trauma. CONCLUSIONS Findings extend animal models and studies that examine cortisol reactivity to acute stressors and suggest that childhood trauma may program a phenotype that is more psychologically reactive but shows a blunted HPA-axis response to chronic stress. While adaptive in the short-term, this early life programming may incur long-term costs for health. Further work is warranted to examine this possibility.
Collapse
Affiliation(s)
| | | | | | - Catherine P Walsh
- University of Hawaii Cancer Center, University of Hawaii at Manoa, USA
| | | | | | | |
Collapse
|
17
|
Mustonen P, Kortesluoma S, Scheinin NM, Perasto L, Kataja EL, Tervahartiala K, Tuulari JJ, Coimbra B, Carter AS, Rodrigues AJ, Sousa N, Paavonen EJ, Korja R, Karlsson H, Karlsson L. Negative associations between maternal prenatal hair cortisol and child socioemotional problems. Psychoneuroendocrinology 2024; 162:106955. [PMID: 38232530 DOI: 10.1016/j.psyneuen.2023.106955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/19/2023] [Accepted: 12/30/2023] [Indexed: 01/19/2024]
Abstract
Maternal prenatal distress can participate in the programming of offspring development, in which exposure to altered maternal long-term cortisol levels as measured by hair cortisol concentrations (HCC) may contribute. Yet, studies investigating whether and how maternal prenatal HCC associates with problems in child socioemotional development are scarce. Furthermore, questions remain regarding the timing and potential sex-specificity of fetal exposure to altered cortisol levels and whether there are interactions with maternal prenatal distress, such as depressive symptoms. The subjects were drawn from those FinnBrain Birth Cohort families that had maternal reports of child socioemotional problems (the Brief Infant-Toddler Social and Emotional Assessment [BITSEA] at 2 years and/or the Strengths and Difficulties Questionnaire [SDQ] at 5 years) as follows: HCC1 population: maternal mid-pregnancy HCC measured at gestational week 24 with 5 cm segments to depict cortisol levels from the previous five months (n = 321); and HCC2 population: end-of-pregnancy HCC measured 1-3 days after childbirth (5 cm segment; n = 121). Stepwise regression models were utilized in the main analyses and a sensitivity analysis was performed to detect potential biases. Negative associations were observed between maternal HCC2 and child BITSEA Total Problems at 2 years but not with SDQ Total difficulties at 5 years, and neither problem score was associated with HCC1. In descriptive analyses, HCC2 was negatively associated with Internalizing problems at 2 years and SDQ Emotional problems at 5 years. A negative association was observed among 5-year-old girls between maternal HCC1 and SDQ Total Difficulties and the subscales of Conduct and Hyperactivity/inattentive problems. When interactions were also considered, inverse associations between HCC2 and BITSEA Internalizing and Dysregulation Problems were observed in subjects with elevated prenatal depressive symptoms. It was somewhat surprising that only negative associations were observed between maternal HCC and child socioemotional problems. However, there are previous observations of elevated end-of-pregnancy cortisol levels associating with better developmental outcomes. The magnitudes of the observed associations were, as expected, mainly modest. Future studies with a focus on the individual changes of maternal cortisol levels throughout pregnancy as well as studies assessing both maternal and child HPA axis functioning together with child socioemotional development are indicated.
Collapse
Affiliation(s)
- Paula Mustonen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Child Psychiatry, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
| | - Susanna Kortesluoma
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland
| | - Noora M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychiatry, University of Turku and Satakunta Wellbeing Services County, Sairaalantie 3, 28500 Pori, Finland
| | - Laura Perasto
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychology, University of Turku and Turku University Hospital, Assistentinkatu 7, 20014 Turku, Finland
| | - Katja Tervahartiala
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychology and Speech-Language Pathology, University of Turku, Assistentinkatu 7, 20014 Turku, Finland; Department of Psychology, University of Jyväskylä, Seminaarinkatu 15, 40014 Jyväskylä, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Turku Collegium for Science, Medicine and Technology, University of Turku, 20520 Turku, Finland
| | - Bárbara Coimbra
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, R. da Universidade, 4710-057 Braga, Portugal
| | - Alice S Carter
- Department of Psychology, University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA 02125, USA
| | - Ana João Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, R. da Universidade, 4710-057 Braga, Portugal; Clinical Academic Center-Braga (2CA), Hospital de Braga, Lugar de Sete Fontes, S. Victor, 4710-243 Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, R. da Universidade, 4710-057 Braga, Portugal
| | - E Juulia Paavonen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland; Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, 00029 Helsinki, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychology, University of Turku and Turku University Hospital, Assistentinkatu 7, 20014 Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Psychiatry, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 10, 20520 Turku, Finland; Department of Pediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Savitehtaankatu 5, 20520 Turku, Finland; Department of Clinical Medicine, Unit of Public Health, University of Turku and Turku University Hospital, Savitehtaankatu 5, 20520 Turku, Finland
| |
Collapse
|
18
|
Albdour M, Templin T, Zilioli S, Hong JS, Lumley MA. Current and Cumulative Stress Experiences: A Model for Arab American Young Adults. J Am Psychiatr Nurses Assoc 2024; 30:364-377. [PMID: 36217725 DOI: 10.1177/10783903221110235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The effect of multiple stressors on immigrant young adults' endocrine functioning and health outcomes has not been comprehensively investigated. AIMS This study tested a theoretical model of cumulative and current stressor effects on the hypothalamic-pituitary-adrenocortical (HPA) axis functioning and health-related quality of life (HRQL) among Arab American young adults. METHODS Using a cross-sectional design, we recruited 160 participants, ages 18 to 24 years, from an urban university in the Midwest. Cumulative stress was assessed by self-report measures of childhood adversity, bullying victimization, and perceived ethnic discrimination. Current perceived stress was measured using the Perceived Stress Scale (PSS) while cortisol levels were measured in participants' hair. Structural equation modeling tested the effects of cumulative and current stress on cortisol and HRQL. RESULTS Cumulative stress was negatively associated with HRQL (standardized path coefficient = -.51, p < .05). Interestingly, however, cumulative stress was inversely associated with hair cortisol level (standardized path coefficient = -.51, p < .05). Current stress was positively associated with cortisol level (standardized path coefficient = .43, p < .05) and negatively associated with the mental HRQL (standardized path coefficient < -.37, p < .05). CONCLUSION Cumulative stress exhibited a different effect on HPA functioning from current perceived stress. Mental health was significantly impaired by both cumulative and current perceived stress. Implications for mental health nursing practice and research among Arab Americans are discussed.
Collapse
Affiliation(s)
- Maha Albdour
- Maha Albdour, PhD, APHN-BC, RN, College of Nursing, Wayne State University, Detroit, MI, USA
| | - Thomas Templin
- Thomas Templin, PhD, College of Nursing, Wayne State University, Detroit, MI, USA
| | - Samuele Zilioli
- Samuele Zilioli, PhD, Department of Family Medicine and Public Health Sciences, Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Jun Sung Hong
- Jun Sung Hong, PhD, School of Social Work, Wayne State University, Detroit, MI, USA
| | - Mark A Lumley
- Mark A. Lumley, PhD, Department of Psychology, Wayne State University, Detroit, MI, USA
| |
Collapse
|
19
|
Kampa M, Stark R, Klucken T. The impact of extinction timing on pre-extinction arousal and subsequent return of fear. Learn Mem 2024; 31:a053902. [PMID: 38627067 DOI: 10.1101/lm.053902.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/07/2024] [Indexed: 04/19/2024]
Abstract
Exposure-based therapy is effective in treating anxiety, but a return of fear in the form of relapse is common. Exposure is based on the extinction of Pavlovian fear conditioning. Both animal and human studies point to increased arousal during immediate compared to delayed extinction (>+24 h), which presumably impairs extinction learning and increases the subsequent return of fear. Impaired extinction learning under arousal might interfere with psychotherapeutic interventions. The aim of the present study was to investigate whether arousal before extinction differs between extinction groups and whether arousal before extinction predicts the return of fear in a later (retention) test. As a highlight, both the time between fear acquisition and extinction (immediate vs. delayed) and the time between extinction and test (early vs. late test) were systematically varied. We performed follow-up analyses on data from 103 young, healthy participants to test the above hypotheses. Subjective arousal ratings and physiological arousal measures of sympathetic and hypothalamic pituitary adrenal axis activation (tonic skin conductance and salivary cortisol) were collected. Increased pre-extinction arousal in the immediate extinction group was only confirmed for subjective arousal. In linear regression analyses, none of the arousal measures predicted a significant return of fear in the different experimental groups. Only when we aggregated across the two test groups, tonic skin conductance at the onset of extinction predicted the return of fear in skin conductance responses. The overall results provide little evidence that pre-extinction arousal affects subsequent extinction learning and memory. In terms of clinical relevance, there is no clear evidence that exposure could be improved by reducing subjective or physiological arousal.
Collapse
Affiliation(s)
- Miriam Kampa
- Department of Clinical Psychology and Psychotherapy, University of Siegen, 57072 Siegen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University, 35394 Giessen, Germany
| | - Rudolf Stark
- Bender Institute of Neuroimaging, Justus Liebig University, 35394 Giessen, Germany
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg, 35032 Marburg, Germany and Justus Liebig University, 35394 Giessen, Germany
| | - Tim Klucken
- Department of Clinical Psychology and Psychotherapy, University of Siegen, 57072 Siegen, Germany
| |
Collapse
|
20
|
Downes N, Kallas KA, Moirangthem S, Maguet C, Marr K, Tafflet M, Kirschbaum C, Heude B, Koehl M, Waerden JVD. Longitudinal effects of maternal depressive and anxious symptomatology on child hair cortisol and cortisone from pregnancy to 5-years: The EDEN mother-child cohort. Psychoneuroendocrinology 2024; 162:106957. [PMID: 38232529 DOI: 10.1016/j.psyneuen.2024.106957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/19/2024]
Abstract
Exposure to maternal depressive and anxious symptomatology in utero and after birth can affect child outcomes. One proposed mechanism is through changes in child stress hormone levels, however current studies present inconsistent findings, and further research is needed to better understand the impact of maternal mental health on child stress response. This study aims to add to the limited literature by analysing longitudinal data ranging from 24 weeks amenorrhea to 5 years postpartum among 281 mother-child pairs from the French EDEN mother-child birth cohort. Hair cortisol and cortisone data were collected from children at four time points: birth, 1, 3, and 5 years. Mothers reported depressive symptomatology via the Center for Epidemiologic Studies Depression Scale (CES-D) (at 24-weeks amenorrhea, 3-, and 5-year follow-up), and the Edinburgh Postnatal Depression Scale (EPDS) (at 4, 8 and 12 months postpartum). Prenatal anxiety symptomatology was measured via the State Anxiety Inventory (STAI) at 24 weeks amenorrhea. Group-based trajectory modelling indicated a 1-cluster classification of longitudinal child hair cortisol, cortisone and cortisol-to-cortisone ratio, as analyses did not reveal a classification by subgroups representing different child profiles. After inverse probability weighting, small effects showed prenatal depressive symptomatology was significantly associated to higher levels of child hair cortisone at one year. Prenatal anxiety symptomatology was significantly linked to higher levels of child cortisol measured at birth and cortisone at birth and at 1 year. Postpartum depressive symptomatology at 8 months was related to higher levels of cortisone among 3-year-olds. These effects were not moderated by child sex or maternal socio-economic status. Further research is needed to understand why there are associations at some time points and not others to determine any potential buffering factors.
Collapse
Affiliation(s)
- Naomi Downes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France.
| | - Kadri-Ann Kallas
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France
| | - Simi Moirangthem
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France
| | - Charlotte Maguet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France
| | - Ketevan Marr
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France
| | - Muriel Tafflet
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
| | - Clemens Kirschbaum
- Faculty of Psychology, Institute of Biopsychology, Technische Universität Dresden, 01062 Dresden, Germany
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
| | - Muriel Koehl
- Univ. Bordeaux, INSERM, Neurocentre Magendie, U1215, Neurogenesis and Pathophysiology group, 3300 Bordeaux, France
| | - Judith van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), 75012 Paris, France
| |
Collapse
|
21
|
Holleman J, Kåreholt I, Aspö M, Hagman G, Udeh-Momoh CT, Kivipelto M, Solomon A, Sindi S. Life-course stress, cognition, and diurnal cortisol in memory clinic patients without dementia. Arch Gerontol Geriatr 2024; 119:105316. [PMID: 38134708 DOI: 10.1016/j.archger.2023.105316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/13/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023]
Abstract
AIMS To examine associations of life-course stress with cognition and diurnal cortisol patterns in older adulthood, as well as potential mediation effects of diurnal cortisol patterns and perceived stress on the association between life-course stress and cognition. METHODS 127 participants without dementia were selected from a cohort of Swedish memory clinic patients. Cross-sectional associations between scores on two chronic stress questionnaires (perceived stress, stressful life events (SLEs)), five cognitive domains (overall cognition, memory, working memory, processing speed, perceptual reasoning), and two measures of diurnal cortisol patterns (total daily output, diurnal cortisol slope), as well as potential mediation effects of diurnal cortisol patterns and perceived stress on associations between life-course stress and cognition, were assessed using linear regressions. RESULTS Greater lifetime exposure to SLEs was associated with worse memory, working memory, and processing speed performance, but not with diurnal cortisol patterns. A greater number of SLEs in late childhood was associated with worse working memory and processing speed, while a greater number of SLEs in non-recent adulthood were associated with better overall cognition and perceptual reasoning. Greater perceived stress was associated with a flattened diurnal cortisol slope, but not with cognition. No evidence for interplay between self-reported and physiological stress markers was found in relation to cognition, although there appeared to be a significant positive indirect association between economic/legal SLEs and the diurnal cortisol slope via perceived stress. CONCLUSIONS The associations between SLEs and cognition depend on the period during which SLEs occur, but seem independent of late-life cortisol dysregulation.
Collapse
Affiliation(s)
- Jasper Holleman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden.
| | - Ingemar Kåreholt
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; School of Health and Welfare, Aging Research Network -Jönköping (ARN-J), Institute of Gerontology, Jönköping University, Jönköping, Sweden
| | - Malin Aspö
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Göran Hagman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Chinedu T Udeh-Momoh
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; School of Public Health, Faculty of Medicine, Imperial College London, Ageing Epidemiology Research Unit (AGE), UK; Global Brain Health Institute, University of California San Francisco, USA; Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden; School of Public Health, Faculty of Medicine, Imperial College London, Ageing Epidemiology Research Unit (AGE), UK; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden; School of Public Health, Faculty of Medicine, Imperial College London, Ageing Epidemiology Research Unit (AGE), UK; Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Shireen Sindi
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, Stockholm, Solna 17164, Sweden; School of Public Health, Faculty of Medicine, Imperial College London, Ageing Epidemiology Research Unit (AGE), UK
| |
Collapse
|
22
|
Boswell L, Vega-Beyhart A, Blasco M, Quintana LF, Rodríguez G, Díaz-Catalán D, Vilardell C, Claro M, Mora M, Amor AJ, Casals G, Hanzu FA. Hair cortisol and changes in cortisol dynamics in chronic kidney disease. Front Endocrinol (Lausanne) 2024; 15:1282564. [PMID: 38638132 PMCID: PMC11024788 DOI: 10.3389/fendo.2024.1282564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/06/2024] [Indexed: 04/20/2024] Open
Abstract
Objective We compared hair cortisol (HC) with classic tests of the hypothalamic-pituitary-adrenal (HPA) axis in chronic kidney disease (CKD) and assessed its association with kidney and cardiometabolic status. Design and methods A cross-sectional study of 48 patients with CKD stages I-IV, matched by age, sex, and BMI with 24 healthy controls (CTR) was performed. Metabolic comorbidities, body composition, and HPA axis function were studied. Results A total of 72 subjects (age 52.9 ± 12.2 years, 50% women, BMI 26.2 ± 4.1 kg/m2) were included. Metabolic syndrome features (hypertension, dyslipidaemia, glucose, HOMA-IR, triglycerides, waist circumference) and 24-h urinary proteins increased progressively with worsening kidney function (p < 0.05 for all). Reduced cortisol suppression after 1-mg dexamethasone suppression (DST) (p < 0.001), a higher noon (12:00 h pm) salivary cortisol (p = 0.042), and salivary cortisol AUC (p = 0.008) were seen in CKD. 24-h urinary-free cortisol (24-h UFC) decreased in CKD stages III-IV compared with I-II (p < 0.001); higher midnight salivary cortisol (p = 0.015) and lower suppressibility after 1-mg DST were observed with declining kidney function (p < 0.001). Cortisol-after-DST cortisol was >2 mcg/dL in 23% of CKD patients (12.5% in stage III and 56.3% in stage IV); 45% of them had cortisol >2 mcg/dL after low-dose 2-day DST, all in stage IV (p < 0.001 for all). Cortisol-after-DST was lineally inversely correlated with eGFR (p < 0.001). Cortisol-after-DST (OR 14.9, 95% CI 1.7-103, p = 0.015) and glucose (OR 1.3, 95% CI 1.1-1.5, p = 0.003) were independently associated with eGFR <30 mL/min/m2). HC was independently correlated with visceral adipose tissue (VAT) (p = 0.016). Cortisol-after-DST (p = 0.032) and VAT (p < 0.001) were independently correlated with BMI. Conclusion Cortisol-after-DST and salivary cortisol rhythm present progressive alterations in CKD patients. Changes in cortisol excretion and HPA dynamics in CKD are not accompanied by significant changes in long-term exposure to cortisol evaluated by HC. The clinical significance and pathophysiological mechanisms explaining the associations between HPA parameters, body composition, and kidney damage warrant further study.
Collapse
Affiliation(s)
- Laura Boswell
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Endocrinology and Nutrition Department, Althaia University Health Network, Manresa, Spain
| | - Arturo Vega-Beyhart
- Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Miquel Blasco
- Group of Nephrology and Transplantation, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Nephrology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Luis F. Quintana
- Group of Nephrology and Transplantation, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Nephrology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Gabriela Rodríguez
- Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Daniela Díaz-Catalán
- Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Carme Vilardell
- Endocrinology and Nutrition Department, Althaia University Health Network, Manresa, Spain
| | - María Claro
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mireia Mora
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabo´ licas Asociadas (CIBERDEM), Carlos III Health Institute, Madrid, Spain
| | - Antonio J. Amor
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Gregori Casals
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Felicia A. Hanzu
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabo´ licas Asociadas (CIBERDEM), Carlos III Health Institute, Madrid, Spain
| |
Collapse
|
23
|
van der Valk ES, Mohseni M, Iyer AM, van den Hurk M, Lengton R, Kuckuck S, Wester VL, Leenen PJM, Dik WA, Visser JA, Kavousi M, Mirzaian M, van den Berg SAA, van Rossum EFC. Long-term glucocorticoid exposure and incident cardiovascular diseases - the Lifelines cohort. J Clin Endocrinol Metab 2024:dgae081. [PMID: 38500477 DOI: 10.1210/clinem/dgae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/10/2024] [Accepted: 02/06/2024] [Indexed: 03/20/2024]
Abstract
CONTEXT Long-term glucocorticoid levels in scalp hair (HairGCs), including cortisol and the inactive form cortisone, represent the cumulative systemic exposure to glucocorticoids over months. HairGCs have repeatedly shown associations with cardiometabolic and immune parameters, but longitudinal data are lacking. DESIGN We investigated 6341 hair samples of participants from the Lifelines cohort study for cortisol and cortisone levels, and associated these to incident cardiovascular diseases (CVD) during 5-7 years of follow-up. We computed the odds ratio (OR) of HairGC levels for incident CVD via logistic regression, adjusting for classical cardiovascular risk factors, and performed a sensitivity analysis in subcohorts of participants <60 years and >= 60 years. Also, we associated HairGC levels to immune parameters (total leukocytes and subtypes). RESULTS Hair cortisone levels (available in n = 4701) were independently associated with incident CVD (p < 0.001), particularly in younger individuals (multivariate-adjusted OR 4.21, 95% confidence interval (CI) 1.91-9.07 per point increase in 10-log cortisone concentration (pg/mg), p < 0.001). All immune parameters except eosinophils were associated with hair cortisone (all multivariate-adjusted p < 0.05). CONCLUSIONS In this large, prospective cohort study, we found that long-term cortisone levels, measured in scalp hair, represent a relevant and significant predictor for future cardiovascular diseases in younger individuals. These results highlight glucocorticoid action as possible treatment target for CVD prevention, where hair glucocorticoid measurements could help identify individuals that may benefit from such treatments.
Collapse
Affiliation(s)
- Eline S van der Valk
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mostafa Mohseni
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Anand M Iyer
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maartje van den Hurk
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Robin Lengton
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Susanne Kuckuck
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Vincent L Wester
- Department of Internal Medicine, division of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Pieter J M Leenen
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Willem A Dik
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Laboratory of Medical Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jenny A Visser
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mina Mirzaian
- Department of Clinical Chemistry, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sjoerd A A van den Berg
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Clinical Chemistry, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Elisabeth F C van Rossum
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
24
|
Grafinger KE, Kassis W, Favre CA, Aksoy D, Gaugler S. Analysing and quantifying chronic stress-associated endogenous steroids in hair samples. Drug Test Anal 2024. [PMID: 38477213 DOI: 10.1002/dta.3678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
In previous studies, various steroids have been associated with stress and have therefore been quantified to investigate stress-related questions. Since the main stress-related steroid cortisol follows a circadian rhythm, often hair is analysed to quantify this steroid. Further, hair analysis gives the unique possibility of long-time monitoring by analysing a certain segment of hair, since hair grows on average 1 cm per month. Hair is a difficult matrix due to the complex sample preparation with many steps including washing and grinding, followed by various extraction steps. Additionally, steroids are endogenous and are therefore present in the hair matrix. Hence, no analyte free matrix is available, which is needed for the quantification via external calibrators. To overcome this problem, the so-called surrogate methods can be used, for which a 13 C3 labelled or deuterated reference compound of the steroid of interest is used for quantification. In the present study, a surrogate method was developed and fully validated for the quantitative analysis of seven steroids in human hair. Validation experiments showed that the method is further suitable for semi-quantitative analysis of estradiol. However, it is not suitable for the analysis of androsterone and DHEAS. The method was successfully used to analyse steroids in a comprehensive study of 360 adolescent hair samples, enabling research into stress markers.
Collapse
Affiliation(s)
- Katharina Elisabeth Grafinger
- Institute of Chemistry and Bioanalytics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
| | - Wassilis Kassis
- Institute of Research and Development, School of Education, University of Applied Sciences and Arts Northwestern Switzerland, Windisch, Switzerland
| | - Céline A Favre
- Institute of Research and Development, School of Education, University of Applied Sciences and Arts Northwestern Switzerland, Windisch, Switzerland
| | - Dilan Aksoy
- Institute of Research and Development, School of Education, University of Applied Sciences and Arts Northwestern Switzerland, Windisch, Switzerland
| | - Stefan Gaugler
- Institute of Chemistry and Bioanalytics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
| |
Collapse
|
25
|
Gettler LT, Jankovic-Rankovic J, Gengo RG, Eick GN, Nash MP, Arumah EN, Boru AM, Ali SA, Urlacher SS, Meyer JS, Snodgrass JJ, Oka RC. Refugee health and physiological profiles in transitional settlements in Serbia and Kenya: Comparative evidence for effects of gender and social support. Psychoneuroendocrinology 2024; 165:107024. [PMID: 38569397 DOI: 10.1016/j.psyneuen.2024.107024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/30/2024] [Accepted: 03/11/2024] [Indexed: 04/05/2024]
Abstract
When armed conflict compels people to flee from their homelands, they embark on protracted journeys during which they experience wide ranging physical, social, and psychological challenges. Few studies have focused on refugee psychosocial and physiological profiles during the transitional phase of forced migration that often involves temporary sheltering. Transient refugees' experiences can vary substantially based on local socio-ecological conditions in temporary settlements, including the length of stay, living conditions, as well as the availability and accessibility of physical and social resources. In this study, we compared physiological and psychosocial data from refugees (N=365; 406 observations) in Serbia and Kenya, respectively, with divergent temporal (length of stay) and socio-ecological conditions. In Serbia, refugees resided in asylum centers (mean stay: 0.9 y); in Kenya they were living in Kakuma Refugee Camp (mean stay: 8.8 y), one of the world's largest camps at the time. We had limited ability to directly compare psychosocial measures and used meta-analytic techniques to evaluate predictors of refugee mental and physical health at the two sites, including based on perceived social support. Refugees in Serbia had higher fingernail cortisol (p < 0.001) and were less likely to have elevated C-reactive protein (CRP) levels (p < 0.01) than refugees in Kakuma. We found common gender differences in both settings; women had lower cortisol but higher EBV antibody titers and higher likelihood of having elevated CRP compared to men (all p < 0.01). Woman also reported poorer mental and physical health (p < 0.001). These physiological and health differences may reflect variation between men and women in their psychosocial and physical experiences of factors such as stress, violence, and trauma during their journeys and as transitional refugees. Finally, we also found that refugees with lower levels of perceived social support reported poorer physical and mental health (p < 0.001). Although our results are cross-sectional, they suggest that this intermittent phase of the refugee experience is a key window for helping enhance refugee well-being through an emphasis on interpersonal and community support systems.
Collapse
Affiliation(s)
- Lee T Gettler
- Department of Anthropology, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA.
| | | | - Rieti G Gengo
- Department of Anthropology, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA
| | - Geeta N Eick
- Department of Anthropology, University of Oregon, OR, USA
| | | | | | | | | | | | - Jerrold S Meyer
- Psychological and Brain Sciences, University of Massachusetts- Amherst, MA, USA
| | | | - Rahul C Oka
- Keough School of Global Affairs, Department of Anthropology, University of Notre Dame, Notre Dame, IN, USA
| |
Collapse
|
26
|
Zapater-Fajarí M, Crespo-Sanmiguel I, Montoliu T, Hidalgo V, Salvador A. Hair cortisol and dehydroepiandrosterone and their associations with optimism and pessimism in older people. Horm Behav 2024; 159:105474. [PMID: 38194858 DOI: 10.1016/j.yhbeh.2023.105474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024]
Abstract
The cumulative negative effects of prolonged Hypothalamic-Pituitary-Adrenal axis (HPA axis) activation are associated with several age-related diseases. Some psychological traits such as optimism and pessimism have been shown to be related to both health and the stress response, although their relationship with the HPA axis is inconclusive. More stable HPA axis biomarkers, such as hair samples of cortisol (HC) and dehydroepiandrosterone (HDHEA), would help to clarify the association between these psychological traits and HPA axis functioning. The main aim of this study was to test the relationships between optimism and pessimism and chronic stress biomarkers measured in hair (HC and HDHEA). Additionally, a secondary objective was to explore sex differences in HC and HDHEA levels and their relationship with these psychological traits. We measured optimism, pessimism, and their combination (dispositional optimism) using the Life Orientation Test Revised (LOT-R) and chronic stress biomarkers (HC and HDHEA) in 119 healthy participants (46 men and 73 women) between 56 and 81 years old who belonged to a university program. Regression analyses controlling for perceived stress and BMI indicated that higher dispositional optimism was related to lower HC and HC:HDHEAratio (β = -0.256, p = .008 and β = -0.300, p = .002, respectively). More specifically, higher pessimism was related to higher HC (β = 0.235; p = .012) and HC:HDHEAratio (β = 0.240; p = .011), whereas higher optimism was associated with a lower HC:HDHEAratio(β = -0.205; p = .031). Moderation analyses showed no sex differences. To date, this is the first study to investigate the link between these traits and HC and HDHEA in older people. Our results confirm that positive and negative expectations about the future (i.e. optimism and pessimism) may play an important role in health due to their relationship with the HPA axis. They also strengthen the idea that the negative effects of pessimism have a greater weight than the protective effects of optimism in their relationship with HPA axis regulation.
Collapse
Affiliation(s)
- Mariola Zapater-Fajarí
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Isabel Crespo-Sanmiguel
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Teresa Montoliu
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Vanesa Hidalgo
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain; Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, Teruel, Spain.
| | - Alicia Salvador
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain; Spanish National Network for Research in Mental Health CIBERSAM, 28029, Spain
| |
Collapse
|
27
|
Cantave CY, Brendgen M, Lupien S, Dionne G, Vitaro F, Boivin M, Ouellet-Morin I. Concurrent and prospective associations between family socioeconomic status, social support and salivary diurnal and hair cortisol in adolescence. J Child Psychol Psychiatry 2024; 65:298-307. [PMID: 37795803 DOI: 10.1111/jcpp.13893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Exposure to socioeconomic adversity is hypothesized to impact hypothalamic-pituitary-adrenal (HPA) axis activity and cortisol secretion, but existing evidence is inconsistent. Yet, few studies have investigated this association using a developmental approach that considers potential protective contextual factors. This study examined the role of stability and changes in family socioeconomic status (SES) in the prediction of multiple cortisol indicators and tested whether social support moderated these associations. METHODS Participants were part of a population-based sample of twin pairs recruited at birth. Family SES was assessed in early childhood (ages 0-5) and mid-adolescence (age 14). Social support was assessed at ages 14 and 19. Diurnal cortisol (n = 569) was measured at age 14 at awakening, 30 min later, in the afternoon and evening over four non-consecutive days. Hair cortisol concentration (HCC, n = 704) was measured at age 19. All data were collected before the pandemic and multilevel regression models were conducted to account for the nested data structure. RESULTS Youth exposed to lower family SES levels in childhood and mid-adolescence had a flatter diurnal slope and higher HCC compared with those who experienced upward socioeconomic mobility in mid-adolescence. Contrastingly, mid-adolescence SES showed no association with the diurnal slope or HCC for youth from higher-SES households in early childhood. Moreover, youth raised in higher-SES families in early childhood had a higher CAR in mid-adolescence if they reported greater social support in mid-adolescence. Social support also moderated the SES-cortisol association in mid-adolescence, with higher-SES youth showing higher awakening cortisol secretion when reporting more social support. CONCLUSIONS Our findings support the hypothesis that early socioeconomic adversity sensitizes HPA axis activity to later socioeconomic disadvantage, which may bear consequences for socioemotional and behavioral functioning.
Collapse
Affiliation(s)
| | - Mara Brendgen
- Department of Psychology, University of Quebec at Montreal, Montréal, QC, Canada
- Sainte-Justine Hospital Research Center, Montréal, QC, Canada
| | - Sonia Lupien
- Research Center of the Montreal Mental Health University Institute, Montréal, QC, Canada
- Centre for Studies on Human Stress, Department Psychiatry, University of Montreal, Montréal, QC, Canada
| | - Ginette Dionne
- School of Psychology, Laval University, Quebec City, QC, Canada
| | - Frank Vitaro
- Sainte-Justine Hospital Research Center, Montréal, QC, Canada
- School of Psychoeducation, University of Montreal, Montréal, QC, Canada
| | - Michel Boivin
- School of Psychology, Laval University, Quebec City, QC, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal, Montréal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Montréal, QC, Canada
| |
Collapse
|
28
|
Kaltenegger HC, Marques MD, Becker L, Rohleder N, Nowak D, Wright BJ, Weigl M. Prospective associations of technostress at work, burnout symptoms, hair cortisol, and chronic low-grade inflammation. Brain Behav Immun 2024; 117:320-329. [PMID: 38307447 DOI: 10.1016/j.bbi.2024.01.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Working conditions in the age of digitalization harbor risks for chronic stress and burnout. However, real-world investigations into biological effects of technostress, that is stress in the context of digital technology use, are sparse. This study prospectively assessed associations between technostress, general work stress, burnout symptoms, hair cortisol, and chronic low-grade inflammation. METHODS Hospital employees (N = 238, 182 females, Mage = 28.5 years) participated in a prospective cohort study with two follow-ups six months apart (T2, T3). Participants answered standardized questionnaires on general job strain (job demand-control ratio), technostressors (work interruptions, multitasking, information overload), burnout symptoms (exhaustion, mental distance), and relevant confounders. Moreover, they provided capillary blood samples for C-reactive protein (CRP) and hair strands for hair cortisol concentration (HCC) analysis. Structural equation modelling was performed. RESULTS The factorial structure of survey measures was confirmed. Burnout symptoms (MT2 = 2.17, MT3 = 2.33) and HCC (MT2 = 4.79, MT3 = 9.56; pg/mg) increased over time, CRP did not (MT2 = 1.15, MT3 = 1.21; mg/L). Adjusted path models showed that technostress was negatively associated with HCC (β = -0.16, p =.003), but not with burnout and CRP. General work stress in contrast, was not significantly associated with burnout, HCC or CRP. Furthermore, there were reciprocal effects of CRP on HCC (β = 0.28, p =.001) and of HCC on CRP (β = -0.10, p ≤.001). Associations were robust in additional analyses including further confounders. CONCLUSION This is the first study on prospective effects of technostress on employees' endocrine and inflammatory systems. Results suggest differential effects of technostress on the hypothalamic-pituitary-adrenocortical axis activity. Given its key role for long-term health, the findings have important implications for occupational health and safety in digitalized work environments.
Collapse
Affiliation(s)
- Helena C Kaltenegger
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany.
| | - Mathew D Marques
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Linda Becker
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Humanwissenschaftliche Fakultät, Vinzenz Pallotti University gGmbH, Vallendar, Germany
| | - Nicolas Rohleder
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Bradley J Wright
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Matthias Weigl
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute for Patient Safety, University Hospital Bonn, Bonn, Germany
| |
Collapse
|
29
|
Castro-Quintas Á, Eixarch E, Martin-Gonzalez NS, Daura-Corral M, Marques-Feixa L, Palma-Gudiel H, Rocavert-Barranco M, Miguel-Valero A, Monteserín-García JL, de la Fuente-Tomás L, Crispi F, Arias B, García-Portilla MP, Fañanás L. Diurnal cortisol throughout pregnancy and its association with maternal depressive symptoms and birth outcomes. Psychoneuroendocrinology 2024; 161:106930. [PMID: 38142606 DOI: 10.1016/j.psyneuen.2023.106930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 11/29/2023] [Accepted: 12/13/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Depression during pregnancy is a common complication that can negatively affect fetal health and birth outcomes. Cortisol is believed to be a key mediator of this association. Although pregnancy entails a natural increase in cortisol levels, preclinical depression could alter its circadian rhythm, producing excessively high overall diurnal cortisol levels that might be harmful for the fetus and future offspring development. OBJECTIVES Using a prospective longitudinal design, we aimed to study (i) trimestral cortisol circadian rhythm and its overall levels throughout pregnancy in healthy women, (ii) the extent to which maternal depressive symptoms influence both cortisol rhythmicity and overall levels, and (iii) the possible adverse consequences of elevated maternal cortisol on the offspring's weight and gestational age at birth. STUDY DESIGN 112 healthy pregnant women from the general Spanish population were recruited before their first pregnancy. To assess cortisol circadian rhythm, participants provided four saliva samples at each trimester of pregnancy (at awakening, 30 min after awakening, before lunch and before going to bed). Overall cortisol levels were calculated with AUCg approximation. Depressive symptoms were evaluated in each trimester and defined according to EPDS cut-off values (1st trimester, EPDS ≥ 11; 2nd and 3rd trimesters, EPDS ≥ 10). At birth, the risk for low weight, prematurity and weight birth percentile was retrieved for 100 infants. Mixed models and simple effects were employed to study changes of maternal cortisol circadian rhythm and overall levels throughout pregnancy and the possible influence of maternal depressive symptoms. Finally, logistic regressions were performed to assess the associations between maternal overall cortisol levels in each trimester of pregnancy and birth anthropometrics. RESULTS Although overall diurnal cortisol levels increase throughout pregnancy, cortisol circadian rhythm is preserved in all trimesters [1st (F(3110)= 92.565, p < .001), 2nd (F(3,85)= 46.828, p < .001) and 3rd (F(3,90)= 65.555, p < .001)]. However, women with depressive symptoms showed a flattened cortisol circadian pattern only during the second trimester, characterized by a blunted awakening peak and reduced evening decline (F(3,85)= 4.136, p = .009), but not during the first (F(3,11)= 1.676, p = .176) or the third (F(3,90)= 1.089, p = .358) trimesters. Additionally, they did not show a cortisol increase from second to third trimester (p = .636). Finally, higher maternal cortisol levels in second and third trimesters seemed to be associated with increased risk of prematurity (adjusted OR -0.371, 95% CI 0.490-0.972, p = .034) and low birth weight percentile (adjusted OR -0.612, 95% CI 0.348-0.846, p = .007) respectively. CONCLUSION Maternal cortisol levels increased throughout pregnancy, although cortisol circadian rhythm was preserved in all trimesters of pregnancy. However, prenatal depressive symptoms were associated with flattened maternal cortisol circadian rhythm in mid-pregnancy. Therefore, it seems that women with depressive symptoms tended to increase less gradually their cortisol levels from mid to late pregnancy. Finally, higher maternal cortisol levels in mid and late-pregnancy seem to be associated with poorer birth anthropometrics Early detection of depressive symptoms in general population could help to prevent putative obstetrical and birth adverse outcomes.
Collapse
Affiliation(s)
- Águeda Castro-Quintas
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Elisenda Eixarch
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Network Centre for Biomedical Research on Rare Diseases (CIBER of Rare Diseases, CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Nerea San Martin-Gonzalez
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Maria Daura-Corral
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Laia Marques-Feixa
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Helena Palma-Gudiel
- Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain; College of Public Health and Health Professions, Department of Epidemiology, University of Florida, United States
| | | | - Alba Miguel-Valero
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Jose Luis Monteserín-García
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - Lorena de la Fuente-Tomás
- Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain; Department of Psychiatry, University of Oviedo, Asturias, Spain
| | - Fátima Crispi
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu); Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Network Centre for Biomedical Research on Rare Diseases (CIBER of Rare Diseases, CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Barbara Arias
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain
| | - María Paz García-Portilla
- Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain; Department of Psychiatry, University of Oviedo, Asturias, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Lourdes Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain; Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Institute of Health Carlos III, Madrid, Spain.
| |
Collapse
|
30
|
Lee WH, Larsson SC, Wood A, Di Angelantonio E, Butterworth AS, Burgess S, Allara E. Genetically predicted plasma cortisol and common chronic diseases: A Mendelian randomization study. Clin Endocrinol (Oxf) 2024; 100:238-244. [PMID: 37667866 PMCID: PMC7615603 DOI: 10.1111/cen.14966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 05/29/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Cushing's syndrome is characterized by hypercortisolaemia and is frequently accompanied by comorbidities such as type 2 diabetes, hypertension, osteoporosis, depression and schizophrenia. It is unclear whether moderate but lifelong hypercortisolaemia is causally associated with these diseases in the general population. We aimed to address this research gap using a Mendelian randomization approach. METHODS We used three cortisol-associated genetic variants in the SERPINA6/SERPINA1 region as genetic instruments in a two-sample, inverse-variance-weighted Mendelian randomization analysis. We obtained summary-level statistics for cortisol and disease outcomes from publicly available genetic consortia, and meta-analysed them as appropriate. We conducted a multivariable Mendelian randomization analysis to assess potential mediating effects. RESULTS A 1 standard deviation higher genetically predicted plasma cortisol was associated with greater odds of hypertension (odds ratio: 1.12; 95% confidence interval [CI]: 1.05-1.18) as well as higher systolic blood pressure (mean difference [MD]: 0.03 SD change; 95% CI: 0.01-0.05) and diastolic blood pressure (MD: 0.03 SD change; 95% CI: 0.01-0.04). There was no evidence of association with type 2 diabetes, osteoporosis, depression and schizophrenia. The association with hypertension was attenuated upon adjustment for waist circumference, suggesting potential mediation through central obesity. CONCLUSION There is strong evidence for a causal association between plasma cortisol and greater risk for hypertension, potentially mediated by obesity.
Collapse
Affiliation(s)
- Wei-Hsuan Lee
- British Heart Foundation Cardiovascular Epidemiology Uni, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Susanna C. Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Angela Wood
- British Heart Foundation Cardiovascular Epidemiology Uni, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Philip Dahdaleh National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, Cambridge, UK
- Cambridge Centre of Artificial Intelligence in Medicine, Cambridge, UK
| | - Emanuele Di Angelantonio
- British Heart Foundation Cardiovascular Epidemiology Uni, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Philip Dahdaleh National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, Cambridge, UK
- Health Data Science Research Centre, Human Technopole, Milan, Italy
| | - Adam S. Butterworth
- British Heart Foundation Cardiovascular Epidemiology Uni, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Philip Dahdaleh National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, Cambridge, UK
| | - Stephen Burgess
- British Heart Foundation Cardiovascular Epidemiology Uni, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Elias Allara
- British Heart Foundation Cardiovascular Epidemiology Uni, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Philip Dahdaleh National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
| |
Collapse
|
31
|
Xiang L, Zeng X, Luo Y, Tan S, Wang F, Mao X. The association between psychological resilience and hair cortisol concentration in adults: A systematic review and meta-analysis. Int J Psychiatry Med 2024; 59:182-198. [PMID: 37222570 DOI: 10.1177/00912174231178108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Resilience measures are typically based on subjective self-assessment, which is prone to bias. Objective biological/physiological measures of resilience are therefore needed. Hair cortisol concentration is a particularly promising candidate as a biomarker for resilience. METHODS We conducted a meta-analytic review from inception to April 2023 in PubMed, EMBASE, Cochrane Library, and Psych Info databases. All data were analyzed using a random-effects model. RESULTS Eight studies were identified that included a total of 1,064 adults. The random effects model demonstrated that resilience and hair cortisol concentration were inversely correlated (r = -0.18, 95% confidence interval [CI] = -0.27 to -0.09) with substantial heterogeneity (I2 = 54.2%, p = 0.03). The inverse association was stronger in those who were age 40 years or younger compared to those who were over 40 years. The correlation coefficients between psychological resilience and hair cortisol concentration among adults assessed by different resilience measures were r = -0.29 (95% CI = -0.49 to -0.08) for the CD-RISC-10; r = -0.21 (95% CI = -0.31 to -0.11) for the CDRISC- 25, and r = -0.08 (95% CI = -0.22 to 0.06) for the BRS. Six of eight studies examined the connection between resilience and perceived stress, where the weighted mean correlation coefficient was r = -0.45 (95% CI = -0.56 to -0.33), with considerable heterogeneity (I2 = 76.2%, p = 0.001). CONCLUSIONS There is a negative association between psychological resilience and hair cortisol concentration based on these eight studies. Additional research, particularly prospective studies, is needed to determine whether hair cortisol concentration can be used as a biomarker for psychological resilience.
Collapse
Affiliation(s)
- LiWen Xiang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xia Zeng
- Emergence Intensive Care Unit, University of Electronic Science and Technology of China Sichuan Provincial People's Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - YinXia Luo
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- School of Medicine, Guang'an Vocational and Technical College
| | - SuFang Tan
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fang Wang
- Emergence Intensive Care Unit, University of Electronic Science and Technology of China Sichuan Provincial People's Hospital, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - XiaoRong Mao
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- General Surgery Area, Department of Nursing, University of Electronic Science and Technology of China, Sichuan Provincial People's Hospital, Chengdu, China
| |
Collapse
|
32
|
Chan SY, Low XZ, Ngoh ZM, Ong ZY, Kee MZL, Huang P, Kumar S, Rifkin-Graboi A, Chong YS, Chen H, Tan KH, Chan JKY, Fortier MV, Gluckman PD, Zhou JH, Meaney MJ, Tan AP. Neonatal Nucleus Accumbens Microstructure Modulates Individual Susceptibility to Preconception Maternal Stress in Relation to Externalizing Behaviors. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00071-6. [PMID: 38423282 DOI: 10.1016/j.jaac.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 11/20/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Maternal stress influences in utero brain development and is a modifiable risk factor for offspring psychopathologies. Reward circuitry dysfunction underlies various internalizing and externalizing psychopathologies. This study examined (1) the association between maternal stress and microstructural characteristics of the neonatal nucleus accumbens (NAcc), a major node of the reward circuitry, and (2) whether neonatal NAcc microstructure modulates individual susceptibility to maternal stress in relation to childhood behavioral problems. METHOD K-means longitudinal cluster analysis was performed to determine trajectories of maternal stress measures (Perceived Stress Scale [PSS], hair cortisol) from preconception to the third trimester. Neonatal NAcc microstructural measures (orientation density index [ODI] and intracellular volume fraction [ICVF]) were compared across trajectories. We then examined the interaction between maternal stress and neonatal NAcc microstructure on child internalizing and externalizing behaviors, assessed between ages 3 and 4 years. RESULTS Two trajectories of maternal stress magnitude ("low"/"high") were identified for both PSS (n = 287) and hair cortisol (n = 336). Right neonatal NAcc ODI (rNAcc-ODI) was significantly lower in "low" relative to "high" PSS trajectories (n = 77, p = .04). PSS at preconception had the strongest association with rNAcc-ODI (r = 0.293, p = .029). No differences in NAcc microstructure were found between hair cortisol trajectories. A significant interaction between preconception PSS and rNAcc-ODI on externalizing behavior was observed (n = 47, p = .047). CONCLUSION Our study showed that the preconception period contributes to in utero NAcc development, and that NAcc microstructure modulates individual susceptibility to preconception maternal stress in relation to externalizing problems.
Collapse
Affiliation(s)
- Shi Yu Chan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Xi Zhen Low
- National University Health System, Singapore, Singapore
| | - Zhen Ming Ngoh
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Zi Yan Ong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Michelle Z L Kee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | - Pei Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | | | - Anne Rifkin-Graboi
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore; National University Health System, Singapore, Singapore; National University of Singapore, Singapore, Singapore
| | - Helen Chen
- KK Women's and Children's Hospital, Duke-National University of Singapore, Singapore, Singapore
| | - Kok Hian Tan
- KK Women's and Children's Hospital, Duke-National University of Singapore, Singapore, Singapore
| | - Jerry K Y Chan
- KK Women's and Children's Hospital, Duke-National University of Singapore, Singapore, Singapore
| | - Marielle V Fortier
- KK Women's and Children's Hospital, Duke-National University of Singapore, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
| | | | - Michael J Meaney
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore; National University of Singapore, Singapore, Singapore; Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Ai Peng Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore; National University Health System, Singapore, Singapore; National University of Singapore, Singapore, Singapore.
| |
Collapse
|
33
|
Tang X, Hu W, Zhao X, Liu Y, Ren Y, Tang Z, Yang J. The role of personal, relational, and collective self-esteem in predicting acute salivary cortisol response and perceived stress. Appl Psychol Health Well Being 2024. [PMID: 38362823 DOI: 10.1111/aphw.12534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
Personal self-esteem (PSE) has been well recognized as a buffer against stress; however, the effects of other types of self-esteem, such as relational self-esteem (RSE) and collective self-esteem (CSE), on stress have not been adequately explored. This study investigated the roles of PSE, RSE, and CSE in reducing stress response. The Rosenberg, Relational, and Collective Self-Esteem Scales were adopted to assess PSE, RSE, and CSE, respectively. Participants underwent an acute social stress paradigm, and their acute stress response was assessed using subjective stress reports and salivary cortisol levels. Chronic stress level was estimated using the Perceived Stress Scale and hair cortisol concentration. The results showed that PSE was negatively correlated with salivary cortisol response during acute social stress; however, no significant associations were found between any type of self-esteem and subjective stress reports. For chronic stress, all types of self-esteem were negatively associated with perceived stress level, but not with hair cortisol concentration. Further hierarchical regression analyses suggested that only PSE negatively predicted acute salivary cortisol response and perceived stress level. Overall, the findings suggest the essential role of PSE in predicting acute salivary cortisol responses and perceived stress.
Collapse
Affiliation(s)
- Xinli Tang
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Weiyu Hu
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Xiaolin Zhao
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Yadong Liu
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Yipeng Ren
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Zihan Tang
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Juan Yang
- Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| |
Collapse
|
34
|
Morris MC, Bruehl S, Rao U, Goodin BR, Karlson C, Carter C, Nag S, Huber FA, Bendinskas KG, Hidoyatov M, Kinney K, Rochelle A, Funches G. Biobehavioral Predictors of Pain Intensity, Pain Interference, and Chronic Pain Episodes: A Prospective Cohort Study of African-American Adults. J Pain 2024:S1526-5900(24)00382-1. [PMID: 38369220 DOI: 10.1016/j.jpain.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/19/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024]
Abstract
Racial disparities in pain experiences are well-established, with African-American (AA) adults reporting higher rates of daily pain, increased pain severity, and greater pain-related interference compared to non-Hispanic Whites. However, the biobehavioral factors that predict the transition to chronic pain among AA adults are not well understood. This prospective cohort study provided a unique opportunity to evaluate predictors of chronic pain onset among 130 AA adults (81 women), ages 18 to 44, who did not report chronic pain at their baseline assessment and subsequently completed follow-up assessments at 6- and 12-months. Outcome measures included pain intensity, pain-related interference, and chronic pain status. Comprehensive assessments of sociodemographic and biobehavioral factors were used to evaluate demographics, socioeconomic status, stress exposure, psychosocial factors, prolonged hypothalamic-pituitary-adrenal secretion, and quantitative sensory testing responses. At baseline, 30 adults (23.1%) reported a history of prior chronic pain. Over the 12-month follow-up period, 13 adults (10.0%) developed a new chronic pain episode, and 18 adults (13.8%) developed a recurrent chronic pain episode. Whereas socioeconomic status measures (ie, annual income, education) predicted changes in pain intensity over the follow-up period, quantitative sensory testing measures (ie, pain threshold, temporal summation of pain) predicted changes in pain interference. A history of chronic pain and higher depressive symptoms at baseline independently predicted the onset of a new chronic pain episode. The present findings highlight distinct subsets of biobehavioral factors that are differentially associated with trajectories of pain intensity, pain-related interference, and onset of chronic pain episodes in AA adults. PERSPECTIVE: This prospective study sought to advance understanding of biobehavioral factors that predicted pain outcomes over a 12-month follow-up period among AA adults without chronic pain at their initial assessment. Findings revealed distinct subsets of factors that were differentially associated with pain intensity, pain-related interference, and onset of chronic pain episodes.
Collapse
Affiliation(s)
- Matthew C Morris
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Uma Rao
- Department of Psychiatry & Human Behavior and Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, California; Psychiatry Division, Children's Hospital of Orange County, Orange, California
| | - Burel R Goodin
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri
| | - Cynthia Karlson
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi; Department of Hematology and Oncology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Chelsea Carter
- School of Medicine, Meharry Medical College, Nashville, Tennessee
| | - Subodh Nag
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Felicitas A Huber
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri
| | | | - Muhammad Hidoyatov
- Chemistry Department, State University of New York at Oswego, Oswego, New York
| | - Kerry Kinney
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Aubrey Rochelle
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Gaarmel Funches
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| |
Collapse
|
35
|
von Werdt L, Binz TM, O’Gorman RT, Schmid A, Naef N, Rousson V, Kretschmar O, Liamlahi R, Latal B, Ehrler M. Stress Markers, Executive Functioning, and Resilience Among Early Adolescents With Complex Congenital Heart Disease. JAMA Netw Open 2024; 7:e2355373. [PMID: 38334997 PMCID: PMC10858402 DOI: 10.1001/jamanetworkopen.2023.55373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/18/2023] [Indexed: 02/10/2024] Open
Abstract
Importance Infants with complex congenital heart disease (cCHD) may experience prolonged and severe stress when undergoing open heart surgery. However, little is known about long-term stress and its role in neurodevelopmental impairments in this population. Objective To investigate potential differences between early adolescents aged 10 to 15 years with cCHD and healthy controls in physiological stress markers by hair analysis, executive function (EF) performance, and resilience. Design, Setting, and Participants This single-center, population-based case-control study was conducted at the University Children's Hospital Zurich, Switzerland. Patients with different types of cCHD who underwent cardiopulmonary bypass surgery during the first year of life and who did not have a genetic disorder were included in a prospective cohort study between 2004 and 2012. A total of 178 patients were eligible for assessment at ages 10 to 15 years. A control group of healthy term-born individuals was cross-sectionally recruited. Data assessment was between 2019 and 2021. Statistical analysis was performed from January to April 2023. Exposure Patients with cCHD who underwent infant open heart surgery. Main Outcomes and Measures Physiological stress markers were quantified by summing cortisol and cortisone concentrations measured with liquid chromatography with tandem mass spectrometry in a 3-centimeter hair strand. EFs were assessed with a neuropsychological test battery to produce an age-adjusted EF summary score. Resilience was assessed with a standardized self-report questionnaire. Results The study included 100 patients with cCHD and 104 controls between 10 and 15 years of age (mean [SD] age, 13.3 [1.3] years); 110 (53.9%) were male and 94 (46.1%) were female. When adjusting for age, sex, and parental education, patients had significantly higher sums of hair cortisol and cortisone concentrations (β, 0.28 [95% CI, 0.12 to 0.43]; P < .001) and lower EF scores (β, -0.36 [95% CI, -0.49 to -0.23]; P < .001) than controls. There was no group difference in self-reported resilience (β, -0.04 [95% CI, -0.23 to 0.12]; P = .63). A significant interaction effect between stress markers and EFs was found, indicating a stronger negative association in patients than controls (β, -0.65 [95% CI, -1.15 to -0.15]; P = .01). The contrast effects were not significant in patients (β, -0.21 [95% CI, -0.43 to -0.00]; P = .06) and controls (β, 0.09 [95% CI, -0.11 to 0.30]; P = .38). Conclusions and Relevance This case-control study provides evidence for altered physiological stress levels in adolescents with cCHD and an association with poorer EF. These results suggest that future studies are needed to better understand the neurobiological mechanisms and timing of alterations in the stress system and its role in neurodevelopment.
Collapse
Affiliation(s)
- Lilian von Werdt
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
| | - Tina M. Binz
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland
| | - Ruth Tuura O’Gorman
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
- Center for MR Research, University Children’s Hospital Zurich, Switzerland
| | - Alenka Schmid
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
| | - Nadja Naef
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
| | - Valentin Rousson
- Division of Biostatistics, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Oliver Kretschmar
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
- Pediatric Cardiology, Pediatric Heart Center, Department of Surgery, University Children’s Hospital Zurich, Switzerland
| | - Rabia Liamlahi
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
| | - Bea Latal
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
- University Research Priority Program (URPP), Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich, Switzerland
| | - Melanie Ehrler
- Child Development Center, University Children’s Hospital Zurich, Switzerland
- Children’s Research Centre, University Children’s Hospital Zurich, Switzerland
- University Research Priority Program (URPP), Adaptive Brain Circuits in Development and Learning (AdaBD), University of Zurich, Switzerland
| |
Collapse
|
36
|
Sears CG, Liu Y, Lanphear BP, Buckley JP, Meyer J, Xu Y, Chen A, Yolton K, Braun JM. Evaluating Mixtures of Urinary Phthalate Metabolites and Serum Per-/Polyfluoroalkyl Substances in Relation to Adolescent Hair Cortisol: The HOME Study. Am J Epidemiol 2024; 193:454-468. [PMID: 37846096 DOI: 10.1093/aje/kwad198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 08/08/2023] [Accepted: 10/05/2023] [Indexed: 10/18/2023] Open
Abstract
Results of toxicological studies indicate that phthalates and per-/polyfluoroalkyl substances (PFAS), 2 classes of endocrine-disrupting chemicals, may alter the functioning of the hypothalamic-pituitary-adrenocortical (HPA) axis. We evaluated the associations of urinary phthalate metabolites and serum PFAS during gestation and childhood with adolescent hair cortisol concentrations (pg/mg hair) at age 12 years, an integrative marker of HPA axis activity (n = 205 mother-child pairs; Cincinnati, Ohio; enrolled 2003-2006). We used quantile-based g-computation to estimate associations between mixtures of urinary phthalate metabolites or serum PFAS and hair cortisol. We also examined whether associations of individual phthalate metabolites or PFAS with cortisol varied by the timing of exposure. We found that a 1-quartile increase in all childhood phthalate metabolites was associated with 35% higher adolescent hair cortisol (phthalate mixture ψ = 0.13; 95% confidence interval: 0.03, 0.22); these associations were driven by monoethyl phthalate, monoisobutyl phthalate, and monobenzyl phthalate. We did not find evidence that phthalate metabolites during gestation or serum PFAS mixtures were related to adolescent hair cortisol concentrations. We found suggestive evidence that higher childhood concentrations of individual PFAS were related to higher and lower adolescent hair cortisol concentrations. Our results suggest that phthalate exposure during childhood may contribute to higher levels of chronic HPA axis activity.
Collapse
|
37
|
Nyengaard R, Kallesøe KH, Rimvall MK, Ørnbøl E, Wellnitz KB, Olsen EM, Wyller VBB, Rask CU. Hair cortisol and self-perceived stress in adolescents with multi-system functional somatic disorders. BMC Psychiatry 2024; 24:101. [PMID: 38317120 PMCID: PMC10840144 DOI: 10.1186/s12888-024-05518-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Long-term stress causing altered hypothalamic-pituitary-adrenal (HPA) axis dynamics with cortisol dysfunction may be involved in the pathophysiology of functional somatic disorders (FSD), but studies on adolescents with multi-system FSD are lacking. Therefore, we investigated: 1) whether hair cortisol concentration (HCC) differentiates adolescents with multi-system FSD from a) a population-based sample and b) a subgroup derived from the sample reporting a high physical symptom load, and 2) whether FSD population HCC is associated with primary symptom presentations and self-perceived stress. METHODS We used data from a clinical sample with multi-system FSD (N = 91, age 15-19 years) and a population-based sample (N = 1,450, age 16-17 years) including a subgroup with top 10% total scores on physical symptoms (N = 147). Density plots and multiple linear regression were applied to compare HCC between groups. In the clinical sample, multiple linear regression was employed to assess the association between HCC and primary symptom clusters and self-perceived stress. RESULTS Median HCC was lower in the clinical sample than in the population-based sample (β = 0.80 (95%CI: 0.66, 0.97)), but not significantly different from median HCC in the derived subgroup (β = 0.84 (95%CI: 0.66, 1.07)). In the clinical sample, HCC was not significantly associated with primary symptom clusters (F(2, 82) = 0.13, p = 0.88) or self-perceived stress (F(4, 83) = 1.18, p = 0.33). CONCLUSION Our findings indicate that HCC is lowered in adolescents with multi-system FSD but not significantly associated with primary symptom presentations or self-perceived stress. Future studies including multiple measures of HPA axis dynamics alongside psychological measures may further elucidate the role of long-term stress in FSD. TRIAL REGISTRATION The AHEAD study was pre-registered at ClinicalTrials.gov (NCT02346071), 26/01/2015.
Collapse
Affiliation(s)
- Rebecca Nyengaard
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
| | - Karen Hansen Kallesøe
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark.
| | - Martin Køster Rimvall
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Kildegaardsvej 28, Entrance 3A, 1st Floor, 2900, Hellerup, Denmark
- Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, Ny Østergade 12, 4000, Roskilde, Denmark
| | - Eva Ørnbøl
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus N, 8200, Denmark
| | - Kaare Bro Wellnitz
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus N, 8200, Denmark
| | - Else Marie Olsen
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Ndr. Fasanvej 57, 1st Floor, Building 14, 2000, Frederiksberg, Denmark
- Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Maglevænget 2, 2750, Ballerup, Denmark
| | - Vegard Bruun Bratholm Wyller
- Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Postboks 1000, 1478, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Blindern, P.O box 1171, 0318, Oslo, Norway
| | - Charlotte Ulrikka Rask
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
| |
Collapse
|
38
|
Nyström-Hansen M, Andersen MS, Davidsen KA, Roehder K, Trier C, Nayberg E, Lyons-Ruth K, Harder S. Hair cortisol concentrations in pregnant women with bipolar, depressive, or schizophrenic spectrum disorders. Arch Womens Ment Health 2024:10.1007/s00737-024-01434-4. [PMID: 38308143 DOI: 10.1007/s00737-024-01434-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Abstract
PURPOSE Maternal cortisol levels in pregnancy may support the growth of or adversely affect fetal organs, including the brain. While moderate cortisol levels are essential for fetal development, excessive or prolonged elevations may have negative health consequences for both the mother and the offspring. Little is known about predictors of altered hypothalamic-pituitary-adrenal (HPA) axis activity during pregnancy. This study examined maternal hair cortisol concentration (HCC) in the 3rd trimester of pregnancy in relation to severe psychopathology. METHODS Hair samples were collected from 69 women, 32 with a lifetime diagnosis of severe mental disorders (bipolar I or II disorder, moderate or severe depressive disorder, schizophrenic spectrum disorder), and 37 non-clinical controls. Hair samples were collected during the 3rd trimester, and liquid chromatography tandem mass spectrometry was used for cortisol assessment. Psychiatric diagnosis and current level of symptomatic functioning were assessed using the structured clinical interview from the DSM-5 and the global assessment of functioning scale. RESULTS Women with a lifetime diagnosis of severe mental illness had significantly elevated HCC compared to controls. Poorer current symptomatic functioning was also significantly associated with elevated HCC in pregnancy. CONCLUSIONS The implications of alterations in HCC on both maternal and infant health need further study.
Collapse
Affiliation(s)
- Maja Nyström-Hansen
- Department of Psychology, University of Copenhagen, Oester Farimagsgade 2A, 1353, Copenhagen, Denmark.
| | | | - Kirstine Agnete Davidsen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Research Unit, Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Katrine Roehder
- Department of Psychology, University of Copenhagen, Oester Farimagsgade 2A, 1353, Copenhagen, Denmark
| | - Christopher Trier
- Department of Psychology, University of Copenhagen, Oester Farimagsgade 2A, 1353, Copenhagen, Denmark
| | - Emilie Nayberg
- Department of Psychology, University of Copenhagen, Oester Farimagsgade 2A, 1353, Copenhagen, Denmark
| | - Karlen Lyons-Ruth
- Department of Psychiatry, Harvard Medical School, Cambridge Hospital, Cambridge, USA
| | - Susanne Harder
- Department of Psychology, University of Copenhagen, Oester Farimagsgade 2A, 1353, Copenhagen, Denmark
| |
Collapse
|
39
|
de Graaff AM, Cuijpers P, Boschloo L, Elsawy M, Hunaidy S, Seedat S, Witteveen AB, Huizink AC, Sijbrandij M. The associations of hair cortisol and DHEA with posttraumatic stress disorder symptoms in refugees. Compr Psychiatry 2024; 129:152438. [PMID: 38104462 DOI: 10.1016/j.comppsych.2023.152438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/09/2023] [Accepted: 11/16/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Exposure to traumatic events, ongoing adversity, and posttraumatic stress disorder (PTSD) are associated with altered activity of the hypothalamic-pituitary-adrenal (HPA) axis, but findings are mixed. This may be explained in part by heterogeneity in PTSD symptom profiles. AIM The aim of this study was to investigate the complex relationships between the number of traumatic events and post-displacement stressors, individual symptoms of PTSD, and HPA-axis hormones cortisol and dehydroepiandrosterone (DHEA) in refugees. METHODS Adult (18+ years) Syrian refugees with increased levels of distress participating in a randomized controlled trial completed baseline measures to assess traumatic events (trauma checklist), post-displacement stressors (Post-Migration Living Difficulties checklist), symptoms of PTSD (PTSD Checklist for DSM-5; PCL-5), and provided a hair sample for additional stress hormone analyses. We used R-packages qgraph and bootnet to perform network analysis on the number of traumatic events and post-displacement stressors, individual symptoms of PTSD, and HPA-axis hormones cortisol and DHEA. The final network model was corrected for depression severity. RESULTS 115 (53% male, M age = 36.9, SD = 12.7) of 206 participants provided a hair sample. A higher number of traumatic events was directly associated with three symptoms of the PTSD cluster arousal and reactivity, i.e., sleep disturbance, hypervigilance and physiological reactivity, and with three other PTSD symptoms, namely flashbacks, avoidance of reminders, and self-destructive behavior. A higher number of post-displacement stressors was associated with four symptoms of the PTSD cluster cognition and mood, i.e., trauma-related amnesia, negative beliefs, blaming of self/others, and detachment, as well as with intrusive thoughts, sleep disturbance, hypervigilance, and exaggerated startle response. The number of traumatic events and post-displacement stressors were not associated with cortisol or DHEA. Cortisol was positively associated with two symptoms of the PTSD cluster cognition and mood, i.e., negative beliefs and negative trauma-related emotions, and negatively associated with avoidance of reminders. DHEA was positively associated with restricted affect and with three symptoms of the PTSD symptom cluster arousal and reactivity, i.e., irritability/anger, sleep disturbance, and self-destructive behavior, and negatively associated with avoidance of thoughts. CONCLUSIONS This study demonstrated that exposure to traumatic events and post-displacement stressors is not related to cortisol and DHEA, but that cortisol and DHEA are differentially related to individual symptoms of PTSD. While lower levels of both cortisol and DHEA were associated with increased avoidance, higher levels of cortisol were mostly associated with symptoms of the PTSD cluster cognition and mood and higher levels of DHEA were mostly associated with symptoms of the PTSD cluster arousal and reactivity. These findings contribute to explaining the variability of findings in the literature on HPA-axis activity in PTSD. ETHICS The study was approved by the Research Ethics Review Committee at VU Medical Center, the Netherlands (Protocol ID: NL61361.029.17, 7 September 2017) and prospectively registered online (https://www.trialregister.nl/trial/6665).
Collapse
Affiliation(s)
- Anne M de Graaff
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands.
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands; Babeș-Bolyai University, International Institute for Psychotherapy, Strada Mihail Kogălniceanu 1, Cluj-Napoca 400347, Romania
| | - Lynn Boschloo
- Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, Utrecht 3584 CS, the Netherlands
| | - Mariam Elsawy
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands
| | - Sam Hunaidy
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands
| | - Soraya Seedat
- SAMRC Genomics of Brain Disorders Unit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Clinical Building, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Anke B Witteveen
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands
| | - Anja C Huizink
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, Amsterdam 1081 BT, the Netherlands
| |
Collapse
|
40
|
Pauli-Pott U, Skoluda N, Nater UM, Becker K, Derz F, Kaspar E, Kasperzack D, Kehm K, Kött M, Mann C, Schurek P, Pott W, Schloß S. Long-term cortisol secretion in attention deficit hyperactivity disorder: roles of sex, comorbidity, and symptom presentation. Eur Child Adolesc Psychiatry 2024; 33:569-579. [PMID: 36917355 PMCID: PMC10869441 DOI: 10.1007/s00787-023-02180-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023]
Abstract
Low activity of the hypothalamic-pituitary-adrenal axis (HPAA) has been found in children with attention deficit hyperactivity disorder (ADHD). The condition may be related to the reduced attention regulation capacity and/or to comorbid oppositional defiant or conduct disorder (ODD/CD). Sex differences are probable but not sufficiently studied. We analyzed the HPAA activity and sympathetic nervous system reactivity (SR) in children with ADHD while accounting for ADHD symptom presentation, comorbidity, and sex differences. The sample comprised 205 children, 98 (61 boys, 37 girls) with ADHD and 107 (48 boys, 59 girls) healthy controls. DSM-5 phenotypic symptom presentation and comorbid ODD/CD were assessed using clinical interviews. Hair cortisol concentration (HCC) was used to assess the long-term, cumulative activity of the HPAA. SR was assessed via skin conductance response (SCR). For control purposes, comorbid internalizing symptoms and indicators of adverse childhood experiences (ACE) were assessed. Children were medication naive. Boys presenting with predominantly inattentive symptoms (ADHD-I) showed lower HCC than healthy boys. Girls presenting with combined symptoms (ADHD-C) showed higher HCC than did healthy girls (p's < 0.05, sex-by-group interaction, F (2,194) = 4.09, p = 0.018). Boys with ADHD plus ODD/CD showed a blunted SR (p < 0.001, sex-by-group interaction, F (2,172) = 3.08, p = 0.048). Adjustment for ACE indicators led to non-significant differences in HCC but did not affect differences in SR. HCC constitutes an easily assessable, reliable, and valid marker of phenotypic ADHD-related features (i.e. symptom presentation and comorbidity). It indicates more homogenous subgroups of ADHD and might point to specifically involved pathophysiological processes.
Collapse
Affiliation(s)
- Ursula Pauli-Pott
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany.
| | - Nadine Skoluda
- Clinical Psychology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria
- Research Platform The Stress of Life (SOLE)-Processes and Mechanisms underlying Everyday Life Stress, Vienna, Austria
| | - Urs M Nater
- Clinical Psychology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria
- Research Platform The Stress of Life (SOLE)-Processes and Mechanisms underlying Everyday Life Stress, Vienna, Austria
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg Justus Liebig University Giessen, Hans-Meerwein-Straße 6, 35032, Marburg, Germany
| | - Friederike Derz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Elena Kaspar
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Daria Kasperzack
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Kira Kehm
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Marie Kött
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Christopher Mann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Pia Schurek
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Wilfried Pott
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Susan Schloß
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| |
Collapse
|
41
|
Bayot M, Brianda ME, van der Straten N, Mikolajczak M, Shankland R, Roskam I. Treating Parental Burnout: Impact and Particularities of a Mindfulness- and Compassion-Based Approach. Children (Basel) 2024; 11:168. [PMID: 38397280 PMCID: PMC10887731 DOI: 10.3390/children11020168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/13/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
Mindfulness- and self-compassion-based programs have been shown to reduce parental stress, and levels of mindfulness and self-compassion have been shown to be negatively related to parental burnout (PB) factors. Based on these results, the present study aimed to test the efficacy of an 8-week mindfulness and compassion-based group approach (MCA) (n = 29) compared with the existing Parenting in Balance Program (PBP) (n = 25). Parents were blindly enrolled in one of the two conditions. Parental burnout, parental neglect and violence, irritability, parental balance between stress-enhancing and stress-alleviating factors, hair cortisol, and mindful parenting and self-compassion were measured before, after, and three months after the end of the program. All the measured outcomes positively changed over time in both conditions, except for irritability. Large effect sizes were found for parental burnout, parental neglect and violence, and mindful parenting and self-compassion. However, contrary to our hypothesis, the decrease in parental burnout in the MCA was not significantly related to an increase in mindful parenting nor self-compassion. Furthermore, certain participants from the MCA group reported higher levels of parental burnout after the intervention. The absence of specific effects between MCA and PBP programs suggests the presence of common effectiveness factors. Therefore, future studies need to analyze specific variables that may explain differential effects of programs on parental burnout levels.
Collapse
Affiliation(s)
- Marie Bayot
- Department of Clinical Sciences, University of Liège, CHU du Sart Tilman–Quartier Hôpital–B23, Avenue Hippocrate 13, 4000 Liège, Belgium;
- Psychological Research Institute, Catholic University of Louvain, Place Cardinal Mercier 10, 1348 Louvain-la-Neuve, Belgium (M.M.)
| | - Maria Elena Brianda
- Psychological Research Institute, University of Liège, Quartier Agora–B33, Place des Orateurs 1, 4000 Liège, Belgium;
| | - Nastasya van der Straten
- Psychological Research Institute, Catholic University of Louvain, Place Cardinal Mercier 10, 1348 Louvain-la-Neuve, Belgium (M.M.)
| | - Moïra Mikolajczak
- Psychological Research Institute, Catholic University of Louvain, Place Cardinal Mercier 10, 1348 Louvain-la-Neuve, Belgium (M.M.)
| | - Rebecca Shankland
- Département de Psychologie du Développement, de l’Éducation et des Vulnérabilités, Université Lumière Lyon 2, Avenue Pierre Mendès-France 5, 69676 Bron, France;
| | - Isabelle Roskam
- Psychological Research Institute, Catholic University of Louvain, Place Cardinal Mercier 10, 1348 Louvain-la-Neuve, Belgium (M.M.)
| |
Collapse
|
42
|
Davydov DM, de la Coba P, Contreras-Merino AM, Reyes Del Paso GA. Impact of homeostatic body hydration status, evaluated by hemodynamic measures, on different pain sensitization paths to a chronic pain syndrome. Sci Rep 2024; 14:1908. [PMID: 38253727 PMCID: PMC10803325 DOI: 10.1038/s41598-024-52419-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 01/18/2024] [Indexed: 01/24/2024] Open
Abstract
Contrasting findings on the mechanisms of chronic pain and hypertension development render the current conventional evidence of a negative relationship between blood pressure (BP) and pain severity insufficient for developing personalized treatments. In this interdisciplinary study, patients with fibromyalgia (FM) exhibiting clinically normal or elevated BP, alongside healthy participants were assessed. Different pain sensitization responses were evaluated using a dynamic 'slowly repeated evoked pain' (SREP) measure, as well as static pain pressure threshold and tolerance measures. Cardiovascular responses to clino-orthostatic (lying-standing) challenges were also examined as acute re- and de-hydration events, challenging cardiovascular and cerebrovascular homeostasis. These challenges involve compensating effects from various cardiac preload or afterload mechanisms associated with different homeostatic body hydration statuses. Additionally, hair cortisol concentration was considered as a factor with an impact on chronic hydration statuses. Pain windup (SREP) and lower pain threshold in FM patients were found to be related to BP rise during clinostatic (lying) rehydration or orthostatic (standing) dehydration events, respectively. These events were determined by acute systemic vasoconstriction (i.e., cardiac afterload response) overcompensating for clinostatic or orthostatic cardiac preload under-responses (low cardiac output or stroke volume). Lower pain tolerance was associated with tonic blood pressure reduction, determined by permanent hypovolemia (low stroke volume) decompensated by permanent systemic vasodilation. In conclusion, the body hydration status profiles assessed by (re)activity of systemic vascular resistance and effective blood volume-related measures can help predict the risk and intensity of different pain sensitization components in chronic pain syndrome, facilitating a more personalized management approach.
Collapse
Affiliation(s)
- Dmitry M Davydov
- María Zambrano Senior Scholar, University of Jaén, Campus Las Lagunillas s/n, 23071, Jaén, Spain.
- Laboratory of Neuroimmunopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Sciences, Moscow, Russia.
| | - Pablo de la Coba
- Department of Psychology, University of Extremadura, Badajoz, Spain
| | | | | |
Collapse
|
43
|
De Looze C, McCrory C, O'Halloran A, Polidoro S, Anne Kenny R, Feeney J. Mind versus body: Perceived stress and biological stress are independently related to cognitive decline. Brain Behav Immun 2024; 115:696-704. [PMID: 37977246 DOI: 10.1016/j.bbi.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 11/19/2023] Open
Abstract
Chronic stress may increase risk of age-related cognitive decline. 'Stress', however, is a multidimensional construct and few studies have investigated the inter-relationship of subjective stress and biological stress with cognitive decline. In this study, we examine the relationship between perceived stress and two measures of biological stress - allostatic load, indexing stress at the physiological level and leukocyte telomere length, indexing stress at the cellular level - with cognitive decline over a 12-year period in adults aged 50 and older. 3,458 participants (aged ≥ 50) from The Irish Longitudinal study on Ageing with measurements of allostatic load, telomere length and perceived stress at baseline and repeated measures of cognitive function were included. Hierarchical linear regression models with adjustment for multiple potential confounders were applied, and repeated stratified by sex in sensitivity analyses. Higher perceived stress at baseline was associated with lower cognitive function (β = -0.10, 95 % CI -0.12, -0.07, p <.001), with similar strength of associations across waves. There were significant interactions between measures of biological stress and wave; higher allostatic load was associated (X2(18) = 64.4; p <.001), and telomere length was borderline (X2(18) = 9.4; p =.09) associated with cognitive decline from 4-year follow-up onward. Sex stratified analyses revealed that the association between telomere length and cognitive decline was present in women only. Mutual adjustment did not attenuate associations in either case. The interactions between allostatic load and telomere length with perceived stress were not significant. Our findings suggest that subjective measures of stress and biological metrics may be independently related to cognitive function over time in older adults, hinting at the potential for different underlying mechanisms.
Collapse
Affiliation(s)
- Céline De Looze
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Cathal McCrory
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Aisling O'Halloran
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, Dublin, Ireland; Mercer's Institute for Successful Ageing (MISA), St James's Hospital, Dublin, Ireland
| | - Joanne Feeney
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
44
|
Igboanugo S, O'Connor C, Zitoun OA, Ramezan R, Mielke JG. A systematic review of hair cortisol in healthy adults measured using immunoassays: Methodological considerations and proposed reference values for research. Psychophysiology 2024; 61:e14474. [PMID: 37950380 DOI: 10.1111/psyp.14474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 11/12/2023]
Abstract
Hair cortisol concentration (HCC) has shown remarkable promise as a stable, non-invasive measure of systemic cortisol; however, despite methodological advances, the value that would typically be seen in healthy adults has not been established. Therefore, we sought to review the relevant literature to determine a reference value for HCC in healthy (i.e., non-clinical) adults. To this end, we conducted a systematic review of the PubMed, Scopus, and CINAHL databases for studies that measured healthy adult HCC using immunoassay methods, given that these are the most widely accessible analytical tools. To be eligible, studies were required to have been published in English, to have provided relevant descriptive statistics (i.e., means and standard deviations), and to have used a healthy adult human sample. We found 17 studies that met our inclusion criteria; the reports involved 1348 participants with a mean age of about 38 years. Since we identified a large amount of between-study heterogeneity, we completed a random-effect meta-regression analysis and found that test kit vendor was the only significant variable of the model. As a result, when using methodologies from traditional finite mixture distributions to determine reference values for mean and elevated HCC in individual healthy adults, we calculated these estimates for each of the major test kit vendors. Future work will need to determine whether our estimated reference values need to be modified, and these efforts will be greatly assisted by studies that account for potential moderating factors, such as age, sex, and ethnicity.
Collapse
Affiliation(s)
- Somkene Igboanugo
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Claire O'Connor
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Osama A Zitoun
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Reza Ramezan
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - John G Mielke
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| |
Collapse
|
45
|
Emal LM, Tamminga SJ, Schaafsma FG, Jakasa I, Peremin I, Kirschbaum C, van der Molen HF, Kezic S. Exploring the potential of stratum corneum biomarkers for assessing psychological distress in health care workers: An observational pilot study. Health Sci Rep 2024; 7:e1710. [PMID: 38186941 PMCID: PMC10764658 DOI: 10.1002/hsr2.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 01/09/2024] Open
Abstract
Backgrounds The detection of biomarkers of a stress response in the stratum corneum (SC) could be used as objective assessment of early stress symptoms and monitoring of stress reduction interventions in health care workers (HCWs). Aim The aim of this study is to explore SC biomarkers of immune and hormonal response and skin barrier for assessment of psychological distress (PD) in HCWs. Methods Twenty-five female HCWs and 25 non-HCWs participated. SC samples were collected using adhesive tapes at baseline and 3-5 days later (T1). We analyzed 24 biomarkers (immunological, vascular, hormones, and natural moisturizing factors). Stress symptoms were assessed using three scales of Copenhagen Psychosocial Questionnaire. The study involved: identifying SC biomarkers, correlating stress symptoms and biomarkers at baseline and T1, examining stress symptoms between the groups with a Mann-Whitney test, comparing stress symptoms and biomarkers between groups using Ordinary Least Regression and investigating temporal variability of SC biomarkers at baseline and T1 using a Wilcoxon-signed rank. Results Fourteen SC biomarkers were identified. We found correlations between general stress and "IL18" (r = 0.55) physical stress and "IL1b" (r = 0.36) and cognitive stress and "MIP3a" (r = 0.38) at baseline and general stress and cortisol (r = -0.49), physical stress and cortisol (r = -0.60) and cortisone (r = -0.67) at T1. We found no differences in stress symptoms and biomarkers between the groups, except for "MIP3a" at baseline. Differences in the biomarker levels between two time points were found for "TARC," "VEGFA," "ILRA," "IL1RA/IL1a," "NMF," and "DHEA." Conclusion The SC can be suitable biological material to assess biomarkers related to immune response, hormonal response, and skin barrier function. The SC biomarkers, showed strong, moderate and weak correlations with stress symptoms. Notably, these associations include cytokines of innate immunity and well-known stress hormones, cortisol and cortisone.
Collapse
Affiliation(s)
- Lima M. Emal
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Sietske J. Tamminga
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Frederieke G. Schaafsma
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Ivone Jakasa
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and BiotechnologyUniversity of ZagrebZagrebCroatia
| | - Ines Peremin
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and BiotechnologyUniversity of ZagrebZagrebCroatia
| | | | - Henk F. van der Molen
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Sanja Kezic
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| |
Collapse
|
46
|
Hounkpatin H, Simpson G, Santer M, Farmer A, Dambha-Miller H. The association between stress and multiple long-term conditions: A cohort study. J Psychosom Res 2024; 176:111566. [PMID: 38100896 DOI: 10.1016/j.jpsychores.2023.111566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/13/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Stress is an important predictor of long-term conditions. We examine whether hair cortisol (a biomarker of stress) is associated with incidence and accumulation of multiple long-term conditions (MLTC). METHODS We included data from 4295 individuals aged ≥50 years within the English Longitudinal Study of Ageing dataset with data on hair cortisol, sociodemographic and health behaviour variables. Cox proportional hazards models were used to quantify the association between hair cortisol at baseline and accumulation of MLTC between 2012/2013 and 2018/2019, both for individuals with and without MLTC at baseline. RESULTS Our cohort included 1458 (34.0%) individuals who accumulated MLTC between 2012/2013 and 2018/2019. The proportion of individuals with zero, 1, and ≥ 2 conditions at baseline who accumulated MLTC were 12.0% (n = 127), 40.4% (n = 520), and 41.7% (n = 811), respectively. Higher cortisol levels were associated with higher risk of accumulation of MLTC in both unadjusted [HR:1.15(1.05-1.25)] and models adjusted for sociodemographic and health behaviours [HR:1.12(1.02-1.22)]. For individuals without MLTC at baseline, higher cortisol levels were significantly associated with higher risk of developing MLTC in unadjusted [HR: 1.20(1.05-1.36)] and adjusted models [HR: 1.16(1.02-1.32)]. CONCLUSION The study provides the first evidence of the role of stress in the development and accumulation of MLTC. This modifiable risk factor could be targeted to reduce the risk of MLTC. However, further work is needed to better understand the mechanisms and pathways that link stress and accumulation of MLTC.
Collapse
Affiliation(s)
- Hilda Hounkpatin
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, United Kingdom.
| | - Glenn Simpson
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, United Kingdom
| | - Miriam Santer
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, United Kingdom
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - Hajira Dambha-Miller
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, United Kingdom
| |
Collapse
|
47
|
Wang R, Kogler L, Derntl B. Sex differences in cortisol levels in depression: A systematic review and meta-analysis. Front Neuroendocrinol 2024; 72:101118. [PMID: 38176541 DOI: 10.1016/j.yfrne.2023.101118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 12/11/2023] [Accepted: 12/31/2023] [Indexed: 01/06/2024]
Abstract
Higher prevalence of depression in females might be associated with sex-specific cortisol levels. Evidence exists that cortisol levels differ between healthy females and males, however a sex-specific association in depression has not been systematically assessed. Thus, the current study quantifies the existing literature on different cortisol parameters, i.e., basal cortisol, hair cortisol, cortisol awakening response (CAR), and cortisol stress reactivity comparing depressed females and males as well as sex-specific comparisons with healthy controls. Following an extensive literature research, fifty original articles were included. Depressed females had significantly higher hair cortisol, higher CAR, and lower cortisol stress reactivity compared to depressed males. In comparison with sex-matched controls, female patients had significantly higher evening basal cortisol, higher CAR and lower cortisol stress reactivity, and male patients had significantly higher general, morning and evening basal cortisol. Overall, sex as a fundamental driver of cortisol levels in depression needs to be taken into account.
Collapse
Affiliation(s)
- Rui Wang
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany.
| | - Lydia Kogler
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany; German Center for Mental Health (DZPG), partner site Tübingen, 72076 Tübingen, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany; German Center for Mental Health (DZPG), partner site Tübingen, 72076 Tübingen, Germany; LEAD Graduate School and Research Network, University of Tübingen, Germany
| |
Collapse
|
48
|
Kuckuck S, Lengton R, Boon MR, Boersma E, Penninx BWJH, Kavousi M, van Rossum EFC. Long-term glucocorticoids in relation to the metabolic syndrome and cardiovascular disease: A systematic review and meta-analysis. J Intern Med 2024; 295:2-19. [PMID: 37926862 DOI: 10.1111/joim.13739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The striking link of Cushing's syndrome with the metabolic syndrome (MetS) and cardiovascular disease (CVD) suggests that long-term exposure to extremely high cortisol levels catalyzes cardiometabolic deterioration. However, it remained unclear whether the findings from the extreme glucocorticoid overabundance observed in Cushing's syndrome could be translated into more subtle variations in long-term glucocorticoid levels among the general population, for example, due to chronic stress. Here, we performed a systematic review (PROSPERO: CRD42023425541) of evidence regarding the role of subtle variations in long-term biological stress, measured as levels of scalp hair cortisol (HairF) and cortisone (HairE), in the context of MetS and CVD in adults. We also performed a meta-analysis on the cross-sectional difference in HairF levels between individuals with versus without CVD. Seven studies were included regarding MetS, sixteen regarding CVD, and one regarding both. Most articles indicated a strong, consistent cross-sectional association of higher HairF and HairE levels with CVD, which was confirmed by our meta-analysis for HairF (eight studies, SMD = 0.48, 95% confidence intervals [CIs]: 0.16-0.79, p = 0.0095). Moreover, these relationships appear largely independent of standard risk factors. Age seems relevant as the effect seems stronger in younger individuals. Results regarding the associations of HairF and HairE with MetS were inconsistent. Altogether, long-term biological stress, measured as HairF and HairE, is associated with the presence of CVD, and less consistently with MetS. Prospective studies need to evaluate the directionality of this relationship and determine whether HairF and HairE can be used in addition to standard risk factors in predicting future cardiometabolic deterioration.
Collapse
Affiliation(s)
- Susanne Kuckuck
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robin Lengton
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mariëtte R Boon
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eric Boersma
- Department of Cardiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
49
|
Abstract
In concert with neuropeptides and transmitters, the end products of the hypothalamus-pituitary-adrenal (HPA) axis, the glucocorticoid hormones cortisol and corticosterone (CORT), promote resilience: i.e., the ability to cope with threats, adversity, and trauma. To exert this protective action, CORT activates mineralocorticoid receptors (MR) and glucocorticoid receptors (GR) that operate in a complementary manner -as an on/off switch- to coordinate circadian events, stress-coping, and adaptation. The evolutionary older limbic MR facilitates contextual memory retrieval and supports an on-switch in the selection of stress-coping styles at a low cost. The rise in circulating CORT concentration after stress subsequently activates a GR-mediated off-switch underlying recovery of homeostasis by providing the energy for restraining the primary stress reactions and promoting cognitive control over emotional reactivity. GR activation facilitates contextual memory storage of the experience to enable future stress-coping. Such complementary MR-GR-mediated actions involve rapid non-genomic and slower gene-mediated mechanisms; they are time-dependent, conditional, and sexually dimorphic, and depend on genetic background and prior experience. If coping fails, GR activation impairs cognitive control and promotes emotional arousal which eventually may compromise resilience. Such breakdown of resilience involves a transition to a chronic stress construct, where information processing is crashed; it leads to an imbalanced MR-GR switch and hence increased vulnerability. Novel MR-GR modulators are becoming available that may reset a dysregulated stress response system to reinstate the cognitive flexibility required for resilience.
Collapse
Affiliation(s)
- E Ronald de Kloet
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden University, Leiden, The Netherlands.
- Leiden/Amsterdam Center of Drug Research, Leiden University, Leiden, The Netherlands.
| | - Marian Joëls
- Dept. Translational Neuroscience, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
50
|
Faresjö Å, LeTran A, Olsen OJ, Faresjö T, Theodorsson E, Jones M. Measuring cortisol concentration in hair month-by-month two years retrospectively. All Life 2023. [DOI: 10.1080/26895293.2023.2172461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Åshild Faresjö
- Department of Health, Medicine and Caring Sciences; Public Health, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Anh LeTran
- Department of Health, Medicine and Caring Sciences; Public Health, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Ole J. Olsen
- Department of Health and Care Sciences, University of Tromsö, Tromsö, Norway
| | - Tomas Faresjö
- Department of Health, Medicine and Caring Sciences; General Practice, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Elvar Theodorsson
- Department of Biomedical and Clinical Sciences; Clinical Chemistry, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Michael Jones
- Department of Psychology, Macquarie University, North Ryde, Australia
| |
Collapse
|