Carnegie Rebecca, Araya Ricardo, Ben-Shlomo Yoav, Glover Vivette, O'Connor Thomas G, O'Donnell Kieran J, Pearson Rebecca, Lewis Glyn
Rebecca Carnegie, BSc, MBChB, Ricardo Araya, MRCPsych, PhD, Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol, UK; Yoav Ben-Shlomo, BSc, MBBS, MSc, PhD, FFPH, School of Social and Community Medicine, University of Bristol, UK; Vivette Glover, MA, PhD, DSc, Institute of Reproductive and Developmental Biology, Imperial College London, UK; Thomas G. O'Connor, PhD, Wynne Center for Family Research, Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA; Kieran J. O'Donnell, PhD, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada; Rebecca Pearson, PhD, Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol, UK; Glyn Lewis, PhD, Mental Health Sciences Unit, University College London, UK.
Br J Psychiatry. 2014 Feb;204(2):137-43. doi: 10.1192/bjp.bp.113.126250. Epub 2013 Dec 5.
Some studies have found an association between elevated cortisol and subsequent depression, but findings are inconsistent. The cortisol awakening response may be a more stable measure of hypothalamic-pituitary-adrenal function and potentially of stress reactivity.
To investigate whether salivary cortisol, particularly the cortisol awakening response, is associated with subsequent depression in a large population cohort.
Young people (aged 15 years, n = 841) from the Avon Longitudinal Study of Parents and Children (ALSPAC) collected salivary cortisol at four time points for 3 school days. Logistic regression was used to calculate odds ratios for developing depression meeting ICD-10 criteria at 18 years.
We found no evidence for an association between salivary cortisol and subsequent depression. Odds ratios for the cortisol awakening response were 1.24 per standard deviation (95% CI 0.93-1.66, P = 0.14) before and 1.12 (95% CI 0.73-1.72, P = 0.61) after adjustment for confounding factors. There was no evidence that the other cortisol measures, including cortisol at each time point, diurnal drop and area under the curve, were associated with subsequent depression.
Our findings do not support the hypothesis that elevated salivary cortisol increases the short-term risk of subsequent depressive illness. The results suggest that if an association does exist, it is small and unlikely to be of clinical significance.
一些研究发现皮质醇升高与随后发生的抑郁症之间存在关联，但研究结果并不一致。皮质醇觉醒反应可能是下丘脑-垂体-肾上腺功能以及潜在应激反应性的更稳定指标。
在一个大型人群队列中研究唾液皮质醇，尤其是皮质醇觉醒反应，是否与随后发生的抑郁症相关。
来自埃文亲子纵向研究（ALSPAC）的15岁年轻人（n = 841）在3个上学日的4个时间点采集唾液皮质醇。采用逻辑回归计算18岁时符合ICD - 10标准的抑郁症发病比值比。
我们没有发现唾液皮质醇与随后发生的抑郁症之间存在关联的证据。在调整混杂因素之前，皮质醇觉醒反应的比值比为每标准差1.24（95%可信区间0.93 - 1.66，P = 0.14），调整后为1.12（95%可信区间0.73 - 1.72，P = 0.61）。没有证据表明其他皮质醇测量指标，包括每个时间点的皮质醇、昼夜下降幅度和曲线下面积，与随后发生的抑郁症相关。
我们的研究结果不支持唾液皮质醇升高会增加随后发生抑郁症短期风险的假设。结果表明，如果确实存在关联，这种关联很小且不太可能具有临床意义。
