Oskis A, Loveday C, Hucklebridge F, Thorn L, Clow A
Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK.
Psychoneuroendocrinology. 2009 Apr;34(3):307-16. doi: 10.1016/j.psyneuen.2008.09.009. Epub 2008 Oct 25.
When examining the diurnal profile of the hormone cortisol in children and adolescents developmental issues are particularly relevant. Previous findings regarding relationships between cortisol secretory activity and reproductive (pubertal) maturation lack clarity and may reflect methodological inconsistencies between studies. This study examined the diurnal cortisol profile across female adolescence, with a particular focus on an obvious and unique marker of development: menarche. In a cross-sectional design, 61 healthy female adolescents aged 9-18 years (mean age 13.89 years, S.D.+/-2.72) collected eight saliva samples per day on two consecutive weekdays. Samples were collected at awakening, 15, 30 and 45min and 3, 6, 9 and 12h post-awakening in order to capture both the cortisol awakening response (CAR) and the subsequent period of decline. Demographic information was recorded and participants also completed the Spielberger State-Trait Anxiety Inventory. Patterns of cortisol secretion exhibited good intra-individual stability across the two sampling days. Participants evidenced a robust diurnal pattern, with cortisol levels peaking approximately 30-45min post-awakening (the CAR) and steadily declining concentrations over the remainder of the day. Differences according to developmental status (in terms of whether or not participants had experienced first menses: menarche) were observed in the time of peak secretion of the CAR, and these distinct patterns could not be accounted for by group differences in demographic, situational or psychological characteristics measured in this study. This effect for the CAR was associated with the onset of menarche alone, unlike cortisol levels over the remainder of the day. For those who had undergone menarche, were older and of greater BMI, cortisol levels remained higher over the day. There was a significant difference in cortisol concentrations at 6h post-awakening between pre- and post-menarche groups. Again, these differences in daytime cortisol secretory activity could not be attributed to situational or psychological factors. Establishing patterns of cortisol secretion in healthy female adolescents provides an important baseline from which to investigate hypothalamic-pituitary-adrenal (HPA) physiology, measured via salivary cortisol, in adolescent populations with known or suspected psychopathology.
在研究儿童和青少年激素皮质醇的昼夜变化时，发育问题尤为重要。先前关于皮质醇分泌活动与生殖（青春期）成熟之间关系的研究结果并不明确，可能反映出不同研究之间方法上的不一致。本研究考察了女性青春期的皮质醇昼夜变化情况，特别关注一个明显且独特的发育标志：初潮。在一项横断面设计中，61名年龄在9至18岁（平均年龄13.89岁，标准差±2.72）的健康女性青少年在连续两个工作日每天采集8份唾液样本。样本在醒来时、醒来后15、30和45分钟以及3、6、9和12小时采集，以捕捉皮质醇觉醒反应（CAR）以及随后的下降期。记录了人口统计学信息，参与者还完成了斯皮尔伯格状态 - 特质焦虑量表。在两个采样日期间，皮质醇分泌模式在个体内部表现出良好的稳定性。参与者呈现出明显的昼夜模式，皮质醇水平在醒来后约30 - 45分钟达到峰值（CAR），并在当天剩余时间稳步下降。根据发育状态（即参与者是否经历了初潮）观察到CAR分泌峰值时间存在差异，而本研究中测量的人口统计学、情境或心理特征的组间差异无法解释这些不同模式。CAR的这种效应仅与初潮的开始有关，与一天中其余时间皮质醇水平不同。对于那些已经经历初潮、年龄较大且BMI较高的人，全天皮质醇水平仍然较高。初潮前和初潮后组在醒来后6小时的皮质醇浓度存在显著差异再次表明，白天皮质醇分泌活动的这些差异不能归因于情境或心理因素。确定健康女性青少年的皮质醇分泌模式为研究已知或疑似有精神病理学问题的青少年群体中通过唾液皮质醇测量的下丘脑 - 垂体 - 肾上腺（HPA）生理学提供了重要的基线。
