Bouma Esther M C, Riese Harriëtte, Ormel Johan, Verhulst Frank C, Oldehinkel Albertine J
Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center Groningen CC 72, University of Groningen, Groningen, The Netherlands.
Psychoneuroendocrinology. 2009 Jul;34(6):884-93. doi: 10.1016/j.psyneuen.2009.01.003. Epub 2009 Feb 4.
Studies on the influence of sex hormones on cortisol responses to awakening and stress have mainly been conducted in adults, while reports on adolescents are scarce. We studied the effects of gender, menstrual cycle phase and oral contraceptive (OC) use on cortisol responses in a large sample of adolescents. Data come from TRAILS (TRacking Adolescents' Individual Lives Survey), a prospective population study of Dutch adolescents. This study uses data of 644 adolescents (age 15-17 years, 54.7% boys) who participated in a laboratory session including a performance-related social stress task (public speaking and mental arithmetic). Free cortisol levels were assessed by multiple saliva samples, both after awakening and during the laboratory session. No significant effects of gender and menstrual phase on cortisol responses to awakening were found, while girls using OC displayed a slightly blunted response (F(1, 244)=5.30, p=.02). Cortisol responses to social stress were different for boys and free-cycling girls (F(3, 494)=9.73, p<.001), and OC users and free-cycling girls (F(3, 279)=15.12, p<.001). Unexpectedly, OC users showed no response at all but displayed linearly decreasing levels F(1, 279)=19.03, p<.001) of cortisol during the social stress test. We found no effect of menstrual cycle phase on cortisol responses to social stress (F(3, 157)=0.58, p=.55). The absence of a gender difference in the adolescents' cortisol awakening response found in this study is consistent with previous reports. Our results further suggest that adolescent OC users display slightly blunted cortisol responses after awakening, and that gender differences in cortisol responses to social stress during adolescence are comparable to those described for adult populations, that is, stronger responses in men than in women. Whereas previous work in adults suggested blunted stress responses in OC users compared to men and free-cycling women, adolescent OC users showed no cortisol response. Effects of type of OC could not be studied because of low numbers of OC that were only progestin based.
关于性激素对觉醒和应激时皮质醇反应影响的研究主要在成年人中进行,而关于青少年的报道很少。我们在大量青少年样本中研究了性别、月经周期阶段和口服避孕药(OC)的使用对皮质醇反应的影响。数据来自TRAILS(追踪青少年个体生活调查),这是一项对荷兰青少年的前瞻性人群研究。本研究使用了644名青少年(年龄15 - 17岁,54.7%为男孩)的数据,他们参加了一个包含与表现相关的社会应激任务(公开演讲和心算)的实验室环节。通过多次唾液样本评估觉醒后和实验室环节期间的游离皮质醇水平。未发现性别和月经阶段对觉醒时皮质醇反应有显著影响,而使用OC的女孩表现出略微减弱的反应(F(1, 244)=5.30,p = 0.02)。男孩和未使用OC的女孩在对社会应激的皮质醇反应上存在差异(F(3, 494)=9.73,p < 0.001),使用OC的女孩和未使用OC的女孩之间也存在差异(F(3, 279)=15.12,p < 0.001)。出乎意料的是,使用OC的女孩在社会应激测试期间根本没有反应,但皮质醇水平呈线性下降(F(1, 279)=19.03,p < 0.001)。我们未发现月经周期阶段对社会应激时皮质醇反应有影响(F(3, 157)=0.58,p = 0.55)。本研究中青少年皮质醇觉醒反应不存在性别差异,这与之前的报道一致。我们的结果进一步表明,青少年使用OC者觉醒后皮质醇反应略有减弱,并且青少年在对社会应激的皮质醇反应上的性别差异与成年人群体中描述的类似,即男性反应比女性更强。虽然之前在成年人中的研究表明,与男性和未使用OC的女性相比,使用OC者的应激反应减弱,但青少年使用OC者没有皮质醇反应。由于仅基于孕激素的OC数量较少,无法研究OC类型的影响。