Kuehl Linn K, Hinkelmann Kim, Muhtz Christoph, Dettenborn Lucia, Wingenfeld Katja, Spitzer Carsten, Kirschbaum Clemens, Wiedemann Klaus, Otte Christian
Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
Psychoneuroendocrinology. 2015 Jan;51:365-70. doi: 10.1016/j.psyneuen.2014.09.012. Epub 2014 Oct 23.
Findings on the association between hypothalamic-pituitary-adrenal (HPA) axis activity and metabolic risk are equivocal. Different methods of measuring HPA activity might indicate adverse vs. beneficial effects of HPA activity on metabolic risk thus contributing to heterogenous findings. In this study, we aimed to determine whether (1) the salivary cortisol awakening response (CAR) as a marker of awakening-induced activation of the HPA axis and (2) hair cortisol as a marker of long-term cortisol secretion are associated with criteria of the metabolic syndrome. Therefore, we recruited 41 healthy individuals (26 women, mean age: 41.2 years) and 44 patients with major depression (28 women, 41.4 years) and assessed CAR and hair cortisol values as well as all criteria of the metabolic syndrome (abdominal obesity, blood pressure, plasma glucose, triglycerides and high-density cholesterol levels) according to the International Diabetes Federation. CAR and hair cortisol values were divided into tertiles. Across groups, participants with hair cortisol or hair cortisone in the highest tertile showed significantly more criteria of the metabolic syndrome compared to participants in the medium or low tertile (F2,64=3.37, p=.04). These results were corroborated by significant positive correlations between mean hair cortisol values with waist circumference (r=.29, p=.03), triglycerides (r=.34, p=.01) and systolic blood pressure (r=.29, p=.04) and between mean hair cortisone and triglycerides (r=.46, p<.01). In contrast, mean CAR values correlated negatively with diastolic (r=-.29, p=.03) and systolic blood pressure (r=-.32, p=.02). Our results indicate that higher hair cortisol and hair cortisone levels but lower CAR values are associated with an unfavorable metabolic and cardiovascular risk profile.
下丘脑-垂体-肾上腺（HPA）轴活动与代谢风险之间的关联研究结果并不明确。测量HPA活动的不同方法可能表明HPA活动对代谢风险有不良或有益影响，从而导致研究结果的异质性。在本研究中，我们旨在确定：（1）作为HPA轴觉醒诱导激活标志物的唾液皮质醇觉醒反应（CAR），以及（2）作为长期皮质醇分泌标志物的毛发皮质醇，是否与代谢综合征的标准相关。因此，我们招募了41名健康个体（26名女性，平均年龄：41.2岁）和44名重度抑郁症患者（28名女性，41.4岁），并根据国际糖尿病联盟评估了CAR和毛发皮质醇值以及代谢综合征的所有标准（腹部肥胖、血压、血浆葡萄糖、甘油三酯和高密度胆固醇水平）。CAR和毛发皮质醇值被分为三分位数。在所有组中，毛发皮质醇或毛发可的松处于最高三分位数的参与者与处于中等或低三分位数的参与者相比，表现出更多的代谢综合征标准（F2,64 = 3.37，p = 0.04）。平均毛发皮质醇值与腰围（r = 0.29，p = 0.03）、甘油三酯（r = 0.34，p = 0.01）和收缩压（r = 0.29，p = 0.04）之间，以及平均毛发可的松与甘油三酯之间（r = 0.46，p < 0.01）存在显著正相关，这证实了上述结果。相反，平均CAR值与舒张压（r = -0.29，p = 0.03）和收缩压（r = -0.32，p = 0.02）呈负相关。我们的结果表明，较高的毛发皮质醇和毛发可的松水平但较低的CAR值与不良的代谢和心血管风险状况相关。
