数量是否具有其自身的质量?健康儿童中累积逆境与昼夜节律唾液皮质醇水平的上下调节。
Does quantity have a quality all its own? Cumulative adversity and up- and down-regulation of circadian salivary cortisol levels in healthy children.
机构信息
Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
出版信息
Psychoneuroendocrinology. 2010 Oct;35(9):1410-5. doi: 10.1016/j.psyneuen.2010.04.004. Epub 2010 May 5.
Findings have been divergent regarding the direction of basal cortisol dysregulations resulting from stressor exposure, and seem to differ between young people and adults. Accumulated stress exposure has been suggested to be a risk factor for the development of hypocortisolism. This cross-sectional study aims to examine the impact of cumulative adversity, i.e., the number of adversities, on diurnal salivary cortisol levels, including the cortisol awakening response (CAR), in children without psychiatric disorder. The sample consisted of 130 children (mean age 12.8 years), representing one in each twin pair included in the population-based Child and Adolescent Twin Study in Sweden (CATSS). Information about socioeconomic disadvantage, negative life events and potentially traumatic life events were collected by telephone interview and questionnaires, with parents as informants. Salivary cortisol sampling was performed in the home during two school days: at awakening, +30 min post-awakening, and at bedtime. Results showed that the number of adversities was related to the CAR, diurnal decline and +30 min post-awakening cortisol levels. Children with a moderate amount of cumulative adversity displayed high cortisol measures, while those with a high amount (3 or more) of adversities instead showed levels similar to the non-exposed group, yielding an inverse U-pattern of the association between cortisol and adversity. These results indicate that the accumulation of adversity might be an explanation of patterns of basal cortisol up-regulation in children and that those most severely exposed can exhibit an early stage of down-regulation, an issue which should be further examined in longitudinal studies.
研究结果表明,应激暴露导致的基础皮质醇失调的方向存在差异,而且在年轻人和成年人之间似乎也有所不同。累积的应激暴露被认为是低皮质醇症发展的一个风险因素。本横断面研究旨在探讨累积逆境(即逆境数量)对无精神障碍儿童日间唾液皮质醇水平(包括皮质醇觉醒反应(CAR))的影响。该样本包括 130 名儿童(平均年龄 12.8 岁),代表瑞典基于人群的儿童和青少年双胞胎研究(CATSS)中每对双胞胎中的一个。通过电话访谈和问卷调查收集了有关社会经济劣势、负面生活事件和潜在创伤性生活事件的信息,由父母作为信息提供者。在两个上学日的家中进行唾液皮质醇采样:觉醒时、觉醒后 30 分钟和睡前。结果表明,逆境数量与 CAR、日间下降和觉醒后 30 分钟皮质醇水平有关。遭受中度累积逆境的儿童皮质醇水平较高,而遭受大量(3 次或更多)逆境的儿童皮质醇水平与未暴露组相似,呈现出皮质醇与逆境之间的倒 U 型关联模式。这些结果表明,逆境的积累可能是儿童基础皮质醇上调模式的一个解释,而那些暴露最严重的儿童可能会出现早期的下调阶段,这一问题应在纵向研究中进一步探讨。