Department of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
PLoS One. 2019 Jun 14;14(6):e0215763. doi: 10.1371/journal.pone.0215763. eCollection 2019.
Patients with sarcoidosis often experience fatigue and psychological distress, but little is known about the etiology of these conditions. While serum and saliva steroid hormones are used to monitor acute steroid levels, scalp hair analysis is a relatively new method enabling measurement of long-term steroid levels, including hair cortisol reflecting chronic stress. We investigated whether scalp hair cortisol and testosterone levels differ between sarcoidosis patients both with and without fatigue and general population controls. Additionally, we studied if these hormones could serve as objective biomarkers for psychological distress in patients with sarcoidosis.
We measured hair steroid levels using liquid chromatography-tandem mass spectrometry in glucocorticoid naïve sarcoidosis patients. Patients completed the Perceived Stress Scale, Fatigue Assessment Scale, Hospital Anxiety and Depression Scale and Short Form 36 (SF-36). Hair steroid levels from 293 participants of the population-based Lifelines cohort study served as controls.
Thirty-two patients (14 males) were included. Hair cortisol, but not testosterone, concentrations were significantly higher in patients with sarcoidosis than in general population controls (mean 6.6 versus 2.7 pg/mg, p<0.001). No differences were found in hair cortisol and testosterone levels between fatigued and non-fatigued patients with sarcoidosis. Hair cortisol of sarcoidosis patients correlated significantly with anxiety (r = 0.47, p = 0.01), depression (r = 0.46, p = 0.01), and SF-36 mental domain (r = -0.38, p = 0.03), but not with fatigue.
Patients with sarcoidosis have chronically higher levels of the stress hormone cortisol than the normal population, while testosterone levels in hair did not differ. Hair cortisol levels were positively related to subjective measures of psychological distress, but not to fatigue. Our study shows that hair cortisol is a promising non-invasive biomarker for psychological distress in patients with sarcoidosis.
ClinicalTrials.gov: NCT03108547. Registered 31 March 2017, retrospectively registered.
类肉瘤病患者常经历疲劳和心理困扰，但这些情况的病因知之甚少。虽然血清和唾液类固醇激素用于监测急性类固醇水平，但头皮毛发分析是一种相对较新的方法，可测量长期类固醇水平，包括反映慢性应激的毛发皮质醇。我们调查了类肉瘤病患者中是否存在伴有或不伴有疲劳的患者与普通人群对照之间的头皮毛发皮质醇和睾酮水平的差异。此外，我们研究了这些激素是否可以作为类肉瘤病患者心理困扰的客观生物标志物。
我们使用液相色谱-串联质谱法测量糖皮质激素-naïve 类肉瘤病患者的毛发类固醇水平。患者完成了感知压力量表、疲劳评估量表、医院焦虑和抑郁量表以及简短形式 36 项健康调查（SF-36）。来自基于人群的 Lifelines 队列研究的 293 名参与者的毛发类固醇水平作为对照。
纳入了 32 名患者（14 名男性）。与普通人群对照相比，类肉瘤病患者的毛发皮质醇浓度显著升高（平均值为 6.6 与 2.7 pg/mg，p<0.001），但皮质醇与睾酮水平在伴有或不伴有类肉瘤病疲劳的患者之间无差异。类肉瘤病患者的毛发皮质醇与焦虑（r = 0.47，p = 0.01）、抑郁（r = 0.46，p = 0.01）和 SF-36 心理领域（r = -0.38，p = 0.03）显著相关，但与疲劳无关。
类肉瘤病患者的应激激素皮质醇水平长期高于正常人群，而毛发中的睾酮水平没有差异。毛发皮质醇水平与主观心理困扰测量呈正相关，但与疲劳无关。我们的研究表明，毛发皮质醇是类肉瘤病患者心理困扰的一种有前途的非侵入性生物标志物。
ClinicalTrials.gov：NCT03108547。2017 年 3 月 31 日注册，回顾性注册。
