Department of Psychiatry and Behavioral Health, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
Neural and Behavioral Sciences, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA,
Neuropsychobiology. 2022;81(1):51-59. doi: 10.1159/000517343. Epub 2021 Jul 28.
Hypothalamic-pituitary-adrenal (HPA) axis dysregulation may contribute to the symptom burden in bipolar disorder (BD). Further characterization of cortisol secretion is needed to improve understanding of the connection between mood, sleep, and the HPA axis. Here, we observe diurnal cortisol patterns in individuals with BD and healthy controls (HCs) to determine time points where differences may occur.
Salivary cortisol was measured at 6 time points (wake, 15, 30, and 45 min after wake, between 2:00 and 4:00 p.m. and 10:00 p.m.) for 3 consecutive days in individuals with symptomatic BD (N = 27) and HC participants (N = 31). A general linear model with correlated errors was utilized to determine if salivary cortisol changed differently throughout the day between the 2 study groups.
A significant interaction (F = 2.74, df = 5, and p = 0.02) was observed between the time of day and the study group (BD vs. HC) when modeling salivary cortisol over time, indicating that salivary cortisol levels throughout the day significantly differed between the study groups. Specifically, salivary cortisol in BD was elevated compared to HCs at the 10:00 p.m. time point (p = 0.01).
Significantly higher levels of cortisol in participants with BD in the night-time suggest that the attenuation of cortisol observed in healthy individuals may be impaired in those with BD. Reregulation of cortisol levels may be a target of further study and treatment intervention for individuals with BD.
下丘脑-垂体-肾上腺（HPA）轴失调可能导致双相情感障碍（BD）患者的症状负担加重。进一步描述皮质醇分泌情况，有助于提高我们对情绪、睡眠和 HPA 轴之间联系的理解。在这里，我们观察了 BD 患者和健康对照者（HCs）的日间皮质醇模式，以确定可能出现差异的时间点。
在连续 3 天内，于 6 个时间点（醒来时、醒来后 15、30 和 45 分钟、下午 2 点至 4 点和晚上 10 点）测量 27 名有症状 BD 患者和 31 名 HCs 参与者的唾液皮质醇。采用相关误差的一般线性模型，确定唾液皮质醇在 2 组研究对象全天是否以不同的方式变化。
当对全天的唾液皮质醇进行建模时，观察到时间与研究组（BD 与 HC）之间存在显著的交互作用（F = 2.74，df = 5，p = 0.02），表明两组研究对象全天的唾液皮质醇水平显著不同。具体来说，BD 患者的唾液皮质醇在晚上 10 点时明显高于 HCs（p = 0.01）。
BD 患者夜间皮质醇水平显著升高，表明健康个体中观察到的皮质醇衰减可能在 BD 患者中受损。皮质醇水平的重新调节可能是进一步研究和治疗干预 BD 患者的目标。
