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绝经过渡期雌二醇波动、应激敏感性与抑郁症状:一项初步研究

Estradiol Fluctuation, Sensitivity to Stress, and Depressive Symptoms in the Menopause Transition: A Pilot Study.

作者信息

Gordon Jennifer L, Peltier Alexis, Grummisch Julia A, Sykes Tottenham Laurie

机构信息

Department of Psychology, University of Regina, Regina, SK, Canada.

出版信息

Front Psychol. 2019 Jun 12;10:1319. doi: 10.3389/fpsyg.2019.01319. eCollection 2019.

Abstract

The menopause transition is associated with an increased risk of depressed mood. Preliminary evidence suggests that increased sensitivity to psychosocial stress, triggered by exaggerated perimenopausal estradiol fluctuation, may play a role. However, accurately quantifying estradiol fluctuation while minimizing participant burden has posed a methodological challenge in the field. The current pilot project aimed to test the feasibility of capturing perimenopausal estradiol fluctuation via 12 weekly measurements of estrone-3-glucuronide (E1G), a urinary metabolite of estradiol, using participant-collected urine samples in 15 euthymic perimenopausal women ages 45-55 years. Furthermore, it aimed to correlate E1G fluctuation (standard deviation across the 12 E1G measurements) with weekly mood and cardiovascular, salivary cortisol, and subjective emotional responses to the Trier Social Stress Test (TSST) at weeks 4, 8, and 12. Protocol acceptability and adherence was high; furthermore, E1G fluctuation was positively associated with anhedonic depressive symptoms and weekly negative affect. E1G fluctuation was also associated with increased heart rate throughout the TSST as well as higher levels of rejection, anger, and sadness. E1G fluctuation was not significantly associated with TSST blood pressure or cortisol levels. This study suggests a feasible method of assessing estradiol fluctuation in the menopause transition and provides support for the hypothesis that perimenopausal estradiol fluctuation increases sensitivity to psychosocial stress and vulnerability to depressed mood.

摘要

围绝经期过渡与情绪低落风险增加相关。初步证据表明,围绝经期雌二醇波动加剧引发的对心理社会压力敏感性增加可能起了作用。然而,在尽量减少参与者负担的同时准确量化雌二醇波动在该领域构成了方法学挑战。当前的试点项目旨在测试通过对15名年龄在45至55岁的处于情绪正常围绝经期的女性参与者自行采集的尿液样本每周进行12次雌酮-3-葡萄糖醛酸苷(E1G,雌二醇的一种尿液代谢物)测量来捕捉围绝经期雌二醇波动的可行性。此外,该项目旨在将E1G波动(12次E1G测量的标准差)与第4、8和12周时的每周情绪、心血管状况、唾液皮质醇以及对特里尔社会应激测试(TSST)的主观情绪反应进行关联。方案的可接受性和依从性很高;此外,E1G波动与快感缺失性抑郁症状及每周的消极情绪呈正相关。E1G波动还与整个TSST过程中的心率增加以及更高水平的被拒、愤怒和悲伤情绪相关。E1G波动与TSST时的血压或皮质醇水平无显著关联。本研究提出了一种评估围绝经期过渡中雌二醇波动的可行方法,并为围绝经期雌二醇波动会增加对心理社会压力的敏感性及情绪低落易感性这一假说提供了支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e1/6581734/e78ddb8c557f/fpsyg-10-01319-g001.jpg

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