Department of Mood Disorders, Parnassia NAH, Rotterdam, The Netherlands.
Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Psychoneuroendocrinology. 2020 Sep;119:104658. doi: 10.1016/j.psyneuen.2020.104658. Epub 2020 Apr 28.
Regulation of the hypothalamic-pituitary-adrenal (HPA) axis is implicated in the pathogenesis of bipolar disorder (BD). However, the relationship between HPA-activity and disease severity is not fully elucidated. In this pilot study we aimed to explore the temporal relationship between HPA-activity and the risk of a manic episode in BD patients type I, by assessing long-term hair cortisol concentrations (HCC). Second, we explored the relation between HCC and the number of previous episodes.
Hair samples were collected from 45 BD I patients in euthymic or manic state and compared to 17 controls. From each participant, two hair samples of 3 cm length were used to measure long-term cortisol, reflecting retrospect time frames of 1-3 months and 4-6 months respectively prior to sampling.
HCC in the BD group was slightly higher than in the control group in both hair segments (p = 0.049 and 0.03; after adjustment for age, sex, BMI and hair washing frequency p = 0.222 and 0.139). A significant peak in hair cortisol was observed prior to a manic episode (p = 0.036). Furthermore, we found a positive correlation between the number of mood episodes HCC (p = 0.03).
Our results indicate that long-term cortisol levels are slightly higher in BD, and in particular elevated in the months prior to a manic relapse. In addition HCC are positively associated with the number of previous mood episodes in the course of BD type I.
下丘脑-垂体-肾上腺（HPA）轴的调节与双相情感障碍（BD）的发病机制有关。然而，HPA 活性与疾病严重程度之间的关系尚未完全阐明。在这项初步研究中，我们旨在通过评估长期头发皮质醇浓度（HCC）来探索 I 型 BD 患者 HPA 活性与躁狂发作风险之间的时间关系。其次，我们探讨了 HCC 与既往发作次数之间的关系。
从 45 名处于缓解期或躁狂期的 I 型 BD 患者和 17 名对照者中采集头发样本。从每位参与者中使用 3cm 长的两个头发样本分别测量长期皮质醇，反映采样前 1-3 个月和 4-6 个月的回顾时间框架。
在两个头发段中，BD 组的 HCC 略高于对照组（p=0.049 和 0.03；在调整年龄、性别、BMI 和洗发频率后，p=0.222 和 0.139）。在躁狂发作前观察到头发皮质醇明显升高（p=0.036）。此外，我们发现 HCC 与心境发作次数之间存在正相关（p=0.03）。
我们的结果表明，BD 患者的长期皮质醇水平略高，尤其是在躁狂复发前的几个月内升高。此外，HCC 与 I 型 BD 病程中的既往心境发作次数呈正相关。
