Hollister Brittany M, Zilbermint Mihail, Minniti Caterina P, Buscetta Ashley J, Abdallah Khadijah E, You Shuo, Soldin Steven J, Meyer Jerrold S, Stratakis Constantine A, Bonham Vence L
Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health Bethesda, Maryland, USA.
The University of Florida Genetics Institute Gainesville, Florida, USA.
Am J Blood Res. 2021 Apr 15;11(2):140-148. eCollection 2021.
Sickle cell disease (SCD) is a chronic illness that presents with a wide range of phenotypic variation. Stress may be a contributing factor to differences that are found in this population.
Our objective is to determine the relationship between hair cortisol content (HCC), a biomarker of stress, and other clinical measures in individuals with SCD.
We collected hair samples and other clinical measures from 73 subjects with SCD (mean age: 39 ± 12 years, 63% female).
HCC was lower among individuals who had greater than 30% hemoglobin S, compared with those who had less than 30% hemoglobin S (W=272.5, P=0.01). Lower HCC was also associated with report of not being on a chronic transfusion program (β=48.34, SE=14.09, P=0.001) and higher ferritin levels (β=-0.006, SE=0.002, P=0.02). Furthermore, HCC was significantly correlated with serum cortisol (r=0.26, P=0.03) and corticosterone (r=0.29, P=0.01). We also observed a consistent pattern of low steroid values among our population.
Our findings suggest that individuals with higher hemoglobin S and ferritin, both markers of severe SCD, may have decreased cortisol levels. This is consistent with the relationship we observed between higher HCC among individuals who are on a chronic blood transfusion program, which typically increases quality of life. Our results suggest that hair cortisol may be an indicator in patients with SCD who could be at risk for developing adrenal insufficiency. We recommend that clinicians treating patients with SCD follow the Endocrine Society guidelines for testing for adrenal insufficiency and treat accordingly.
镰状细胞病（SCD）是一种慢性疾病，表现出广泛的表型变异。压力可能是该人群中发现的差异的一个促成因素。
我们的目的是确定应激生物标志物头发皮质醇含量（HCC）与SCD个体的其他临床指标之间的关系。
我们收集了73名SCD受试者（平均年龄：39±12岁，63%为女性）的头发样本和其他临床指标。
血红蛋白S大于30%的个体的HCC低于血红蛋白S小于30%的个体（W=272.5，P=0.01）。较低的HCC还与未接受慢性输血治疗的报告相关（β=48.34，标准误=14.09，P=0.001）以及较高的铁蛋白水平相关（β=-0.006，标准误=0.002，P=0.02）。此外，HCC与血清皮质醇（r=0.26，P=0.03）和皮质酮（r=0.29，P=0.01）显著相关。我们还在我们的人群中观察到低类固醇值的一致模式。
我们的研究结果表明，血红蛋白S和铁蛋白较高的个体，这两者都是严重SCD的标志物，可能皮质醇水平降低。这与我们在接受慢性输血治疗的个体中观察到的较高HCC之间的关系一致，慢性输血通常会提高生活质量。我们的结果表明，头发皮质醇可能是SCD患者发生肾上腺功能不全风险的一个指标。我们建议治疗SCD患者的临床医生遵循内分泌学会关于肾上腺功能不全检测的指南并相应地进行治疗。
