Department of Anatomy, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Gynaecology and Obstetrics, Rijnstate, Arnhem, The Netherlands.
Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
Psychoneuroendocrinology. 2018 Mar;89:216-222. doi: 10.1016/j.psyneuen.2018.01.001. Epub 2018 Jan 5.
Endometriosis is a chronic estrogen-dependent disease in which pelvic pain is the dominant symptom. The negative effects of endometriosis on the life of women with this disease can be a cause of stress. Stress levels can be measured in different ways, mostly reflecting acute stress responses. Hair cortisol measurements are a reflection of long-term systematic cortisol levels. In this study a first attempt is made to measure cortisol levels in hair of endometriosis patients in comparison with healthy controls. Moreover, it is explored whether chronic pain symptoms as well as different aspects of Health Related Quality of Life (HRQoL) are associated with hair cortisol levels in women with endometriosis. Results show that the mean hair cortisol level is significantly higher in women with endometriosis compared to healthy controls (p = 0.018). There is a positive correlation between hair cortisol level and HRQoL in patients but not in controls (Rho 0.426). The level of hair cortisol does not correlate with the reported pain intensity in patients (Rho -0.082). These results are indicative of an altered HPA-axis function in endometriosis patients, possibly caused by higher chronic stress level in these patients. Moreover, a potential explanation for the positive correlation of cortisol with the HRQoL in these patients is that patients with a high HRQoL have an adequate stress response by increasing their cortisol levels as a response to physical and emotional stress induced by the endometriosis.
子宫内膜异位症是一种慢性雌激素依赖性疾病，以盆腔疼痛为主要症状。这种疾病对女性生活的负面影响可能是导致压力的原因。压力水平可以通过多种方式测量，主要反映急性应激反应。头发皮质醇测量是长期系统皮质醇水平的反映。在这项研究中，首次尝试测量子宫内膜异位症患者的头发皮质醇水平，并与健康对照组进行比较。此外，还探讨了慢性疼痛症状以及健康相关生活质量（HRQoL）的不同方面是否与子宫内膜异位症女性的头发皮质醇水平相关。结果表明，与健康对照组相比，子宫内膜异位症患者的平均头发皮质醇水平显著升高（p=0.018）。患者的头发皮质醇水平与 HRQoL 呈正相关，但对照组没有（Rho 0.426）。头发皮质醇水平与患者报告的疼痛强度无关（Rho -0.082）。这些结果表明子宫内膜异位症患者的 HPA 轴功能发生改变，可能是由于这些患者的慢性压力水平较高所致。此外，患者的皮质醇水平与 HRQoL 呈正相关的一个潜在解释是，高 HRQoL 的患者通过增加皮质醇水平作为对子宫内膜异位症引起的身体和情绪压力的反应，从而具有足够的应激反应。
