Dutheil Frédéric, de Saint Vincent Sarah, Pereira Bruno, Schmidt Jeannot, Moustafa Farès, Charkhabi Morteza, Bouillon-Minois Jean-Baptiste, Clinchamps Maëlys
Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Environmental Medicine, Wittyfit, Clermont-Ferrand, France.
Université Clermont Auvergne, Occupational and Environmental Medicine, Clermont-Ferrand, France.
Front Psychiatry. 2021 Jul 6;12:688367. doi: 10.3389/fpsyt.2021.688367. eCollection 2021.
Psychosocial stress is a significant public health problem inducing consequences for quality of life. Results about the use of dehydroepiandrosterone (DHEA) as a biomarker of acute stress are conflicting. We conducted a systematic review and meta-analysis to demonstrate that DHEA levels could be a biomarker of stress. PubMed, Cochrane Library, Embase, and ScienceDirect databases were searched on March 19, 2021 using the keywords "acute stress" AND "DHEA" OR "Dehydroepiandrosterone." Articles needed to describe our primary outcome, i.e., induction of acute stress and at least two measures of DHEA. We included 14 studies, with a total of 631 participants, in our meta-analysis. The DHEA levels increased overtime after acute stress [standardized mean difference (SMD) = 1.56, 95%CI = 1.13-1.99]. Stratification by time showed a main peak at the end of stress (SMD = 2.43, 95%CI = 1.59-3.27), followed by a progressive decrease (coefficient = -0.11, 95%CI = -0.19 to -0.17, = 0.020). There was no significant change 1 h after the end of acute stress. Metaregressions showed an impact of mental stress (SMD = 2.04, 95%CI = 1.43-2.65), sex (SMD = 0.02, 95%CI = 0.00-0.04), age (SMD = -0.12, 95%CI = -0.2 to -0.05), and obesity (SMD = 0.31, 95%CI = -0.00 to 0.63). There was no difference whatever the type of fluid (blood or saliva) and the measurement technique used. DHEA is a biomarker of acute stress, with a short-term increase (1 h). DHEA increases following acute mental stress, whatever the type and duration of mental stress. Women, young people, and obese individuals had a higher response. Blood and saliva measures were comparable.
心理社会压力是一个重大的公共卫生问题，会对生活质量产生影响。关于使用脱氢表雄酮（DHEA）作为急性应激生物标志物的研究结果相互矛盾。我们进行了一项系统综述和荟萃分析，以证明DHEA水平可能是应激的生物标志物。2021年3月19日，我们使用关键词“急性应激”和“DHEA”或“脱氢表雄酮”在PubMed、Cochrane图书馆、Embase和ScienceDirect数据库中进行了检索。文章需要描述我们的主要结果，即急性应激的诱导以及至少两种DHEA的测量方法。我们的荟萃分析纳入了14项研究，共有631名参与者。急性应激后，DHEA水平随时间增加[标准化平均差（SMD）=1.56，95%置信区间=1.13-1.99]。按时间分层显示，应激结束时出现一个主要峰值（SMD=2.43，95%置信区间=1.59-3.27），随后逐渐下降（系数=-0.11，95%置信区间=-0.19至-0.17，P=0.020）。急性应激结束1小时后无显著变化。元回归显示心理应激（SMD=2.04，95%置信区间=1.43-2.65）、性别（SMD=0.02，95%置信区间=0.00-0.04）、年龄（SMD=-0.12，95%置信区间=-0.2至-0.05）和肥胖（SMD=0.31，95%置信区间=-0.00至0.63）有影响。无论使用何种液体类型（血液或唾液）和测量技术，均无差异。DHEA是急性应激的生物标志物，短期内会升高（1小时）。无论心理应激的类型和持续时间如何，急性心理应激后DHEA都会升高。女性、年轻人和肥胖个体的反应更高。血液和唾液测量结果具有可比性。
