雄激素和性激素结合球蛋白与普通人群中男性和女性 12 个月、终生和新发焦虑和抑郁障碍的前瞻性关联。
Prospective associations of androgens and sex hormone-binding globulin with 12-month, lifetime and incident anxiety and depressive disorders in men and women from the general population.
机构信息
Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany; Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
出版信息
J Affect Disord. 2019 Feb 15;245:905-911. doi: 10.1016/j.jad.2018.11.052. Epub 2018 Nov 9.
BACKGROUND
Findings on associations of androgens and sex hormone-binding globulin (SHBG) with anxiety and depressive disorders in the general population remain inconclusive.
METHODS
We used data of n = 993 men and n = 980 women from the Study of Health in Pomerania (SHIP, a prospective-longitudinal general population study from northeastern Germany). Immunoassay-measured serum concentrations of total testosterone, androstenedione and SHBG were assessed when participants were aged 20-80. 12-month, lifetime and incident DSM-IV anxiety and depressive disorders were assessed with the DIA-X/M-CIDI at 10-year follow-up, when participants were aged 29-89. Logistic regressions were adjusted for age, smoking, alcohol consumption, physical activity, waist circumference, hypertension and oral contraceptive use (women only) at baseline and follow-up interval.
RESULTS
In men and women, androgens and SHBG were not associated significantly with incident anxiety and depressive disorders. In men, higher total testosterone predicted any 12-month (OR = 1.46) and lifetime (OR = 1.34) anxiety disorder, lifetime social phobia (OR = 2.15), and 12-month (OR = 1.48) and lifetime (OR = 1.39) specific phobia, but neither 12-month nor lifetime depression. Moreover, androstenedione in men interacted with age in predicting lifetime anxiety disorders (OR = 0.98): Higher androstenedione more strongly predicted lifetime anxiety in younger vs. older men. These findings, however, did not survive correction for multiple testing. In women, androgens and SHBG were not associated significantly with 12-month and lifetime anxiety and depressive disorders.
LIMITATIONS
The follow-up period was relatively long and other factors might have affected the examined associations.
CONCLUSIONS
Higher serum total testosterone in men and androstenedione in younger men may relate to an increased risk of anxiety disorders.
背景
目前，关于雄激素和性激素结合球蛋白（SHBG）与普通人群焦虑和抑郁障碍之间关联的研究结果尚无定论。
方法
我们使用了来自德国东北部波罗的海健康研究（SHIP）的 n=993 名男性和 n=980 名女性的数据（这是一项前瞻性纵向的普通人群研究）。当参与者年龄在 20-80 岁时，使用免疫测定法测量血清总睾酮、雄烯二酮和 SHBG 的浓度。在 10 年随访时（参与者年龄在 29-89 岁时），使用 DIA-X/M-CIDI 评估 12 个月、终生和新发 DSM-IV 焦虑和抑郁障碍。在基线和随访间隔时，使用逻辑回归模型调整了年龄、吸烟、饮酒、体力活动、腰围、高血压和口服避孕药（仅限女性）等因素。
结果
在男性和女性中，雄激素和 SHBG 与新发焦虑和抑郁障碍无显著关联。在男性中，较高的总睾酮水平预示着任何 12 个月（OR=1.46）和终生（OR=1.34）的焦虑障碍、终生社交恐惧症（OR=2.15）、12 个月（OR=1.48）和终生（OR=1.39）特定恐惧症，但与 12 个月或终生的抑郁症无关。此外，男性的雄烯二酮与年龄存在交互作用，预测终生焦虑障碍（OR=0.98）：较高的雄烯二酮在较年轻的男性中与终生焦虑障碍的相关性更强。然而，这些发现并未通过多重检验校正。在女性中，雄激素和 SHBG 与 12 个月和终生的焦虑和抑郁障碍无显著关联。
局限性
随访期相对较长，其他因素可能影响了所检查的关联。
结论
男性血清总睾酮水平较高，年轻男性的雄烯二酮水平较高，可能与焦虑障碍的风险增加有关。
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