Michael A, Jenaway A, Paykel E S, Herbert J
Department of Psychiatry, University of Cambridge, Cambridge, UK.
Biol Psychiatry. 2000 Nov 15;48(10):989-95. doi: 10.1016/s0006-3223(00)00955-0.
The authors sought to examine whether levels of dehydroepiandrosterone are abnormal in depression.
Three groups of subjects aged 20-64 were studied: 44 major depressives, 35 subjects with partially or completely remitted depression, matched as far as possible for age and drug treatment, and 41 normal control subjects. Dehydroepiandrosterone and cortisol in saliva were determined from specimens taken at 8:00 AM and 8:00 PM on 4 days.
The mean age of the three groups did not differ. Dehydroepiandrosterone was lowered at 8:00 AM and 8:00 PM compared with control subjects. Values for the remitted group were intermediate. Dehydroepiandrosterone levels at 8:00 AM correlated negatively with severity of depression and were not related to drug treatment or smoking, but decreased with age (as expected). Cortisol was elevated in depression in the evening. The molar cortisol/dehydroepiandrosterone ratio also differentiated those with depression from the control group.
Lowered dehydroepiandrosterone levels are an additional state abnormality in adult depression. Adrenal steroid changes are thus not limited to cortisol. Because dehydroepiandrosterone may antagonize some effects of cortisol and may have mood improving properties, these findings may have significant implications for the pathophysiology of depression.
作者试图研究抑郁症患者体内脱氢表雄酮水平是否异常。
对三组年龄在20 - 64岁的受试者进行了研究：44名重度抑郁症患者、35名部分或完全缓解的抑郁症患者（尽可能在年龄和药物治疗方面进行匹配）以及41名正常对照受试者。在4天内于上午8:00和晚上8:00采集唾液样本，测定其中的脱氢表雄酮和皮质醇水平。
三组的平均年龄无差异。与对照受试者相比，上午8:00和晚上8:00时抑郁症患者的脱氢表雄酮水平降低。缓解组的值介于两者之间。上午8:00时的脱氢表雄酮水平与抑郁症严重程度呈负相关，与药物治疗或吸烟无关，但随年龄降低（如预期）。抑郁症患者晚上的皮质醇水平升高。皮质醇/脱氢表雄酮摩尔比也能区分抑郁症患者和对照组。
脱氢表雄酮水平降低是成人抑郁症的另一种状态异常。肾上腺类固醇变化因此不仅限于皮质醇。由于脱氢表雄酮可能拮抗皮质醇的某些作用且可能具有改善情绪的特性，这些发现可能对抑郁症的病理生理学具有重要意义。
