Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
Department of Mathematics & Statistics, University of Guelph, Guelph, ON, Canada.
Int J Bipolar Disord. 2016 Dec;4(1):12. doi: 10.1186/s40345-016-0053-5. Epub 2016 May 26.
Differences in cortisol secretion may differentiate individuals at high compared to low genetic risk for bipolar disorder (BD) and predict the onset or recurrence of mood episodes. The objectives of this study were to determine if salivary cortisol measures are: (1) different in high-risk offspring of parents with BD (HR) compared to control offspring of unaffected parents (C), (2) stable over time, (3) associated with the development of mood episode onset/recurrence, and (4) influenced by comorbid complications.
Fifty-three HR and 22 C completed salivary cortisol sampling annually for up to 4 years in conjunction with semi-structured clinical interviews. The cortisol awakening response (CAR), daytime cortisol [area under the curve (AUC)], and evening cortisol (8:00 p.m.) were calculated.
There were no differences in baseline CAR, AUC and evening cortisol between HR and C (p = 0.38, p = 0.30 and p = 0.84), respectively. CAR, AUC and evening cortisol were stable over yearly assessments in HR, while in Cs, evening cortisol increased over time (p = 0.008), and CAR and AUC remained stable. In HR, AUC and evening cortisol increased the hazard of a new onset mood disorder/recurrence by 2.7 times (p = 0.01), and 3.5 times (p = 0.01), respectively, but this was no longer significant after accounting for multiple comparisons.
Salivary cortisol is stable over time within HR offspring. However, between individuals, basal salivary cortisol is highly variable. More research is needed, with larger samples of prospectively studied HR youth using a more reliable method of cortisol measurement, to determine the potential role of cortisol in the development of mood disorders.
皮质醇分泌的差异可能将双相情感障碍（BD）高遗传风险个体与低遗传风险个体区分开来，并预测情绪发作的开始或复发。本研究的目的是确定唾液皮质醇测量值是否：（1）在父母患有 BD 的高风险后代（HR）与未受影响父母的对照后代（C）之间存在差异，（2）随时间稳定，（3）与情绪发作开始/复发的发展相关，（4）受共病并发症影响。
53 名 HR 和 22 名 C 在长达 4 年的时间内每年完成唾液皮质醇采样，同时进行半结构化临床访谈。计算皮质醇觉醒反应（CAR）、日间皮质醇[曲线下面积（AUC）]和 8:00 时的皮质醇（晚上 8 点）。
HR 和 C 之间的基线 CAR、AUC 和晚上皮质醇没有差异（p=0.38，p=0.30 和 p=0.84）。HR 中 CAR、AUC 和晚上皮质醇在每年评估中均稳定，而在 C 中，晚上皮质醇随时间增加（p=0.008），而 CAR 和 AUC 保持稳定。在 HR 中，AUC 和晚上皮质醇使新发情绪障碍/复发的风险增加了 2.7 倍（p=0.01）和 3.5 倍（p=0.01），但在进行多次比较后，这不再具有统计学意义。
HR 后代的唾液皮质醇随时间稳定。然而，在个体之间，基础唾液皮质醇的变异性很大。需要更多的研究，使用更可靠的皮质醇测量方法，对前瞻性研究的 HR 青少年进行更大样本量的研究，以确定皮质醇在情绪障碍发展中的潜在作用。
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