青少年的睾酮、雌二醇、DHEA 和皮质醇与焦虑和抑郁评分的关系。
Testosterone, estradiol, DHEA and cortisol in relation to anxiety and depression scores in adolescents.
机构信息
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; School of Public Health, San Diego State University, San Diego, CA 92182, USA.
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
出版信息
J Affect Disord. 2021 Nov 1;294:838-846. doi: 10.1016/j.jad.2021.07.026. Epub 2021 Jul 22.
Background Adrenal and sex hormone dysregulation have been independently associated with increased depression and anxiety. Cortisol can modify production of sex hormones and hormone-mood associations. This study evaluated associations and interplay of sex and adrenal hormones with depression and anxiety. Methods We assessed 545 Ecuadorian adolescents (11-17y, 50.4% female, ESPINA) for depression and anxiety symptoms using standardized scales. Testosterone, cortisol, dehydroepiandrosterone (DHEA), and estradiol (boys only) were measured in saliva. We performed logistic regression modeling to calculate odds ratios (OR) of elevated depression or anxiety (scores ≥60) comparing participants with low (<10th percentile) and elevated hormones (≥90th percentile) to normal concentrations (10th-90th percentile). Effect modification by cortisol and testosterone was assessed. Models adjusted for demographic, anthropometric, and circadian measures. Results In all participants, elevated testosterone (OR [95%CI:]=1.78 [0.98, 3.23]) and cortisol (OR=1.69 [0.95, 2.99]) were marginally associated with elevated anxiety scores. In boys, elevated estradiol was associated with elevated depression (OR=4.75 [1.95, 11.56]) and anxiety scores (OR=2.43 [1.01, 5.84]). In linear regression, estradiol was positively associated with depression (difference/10% hormone increase (β=0.45 [0.15, 0.75]) and anxiety scores (β=0.42 [0.13, 0.72]). Higher cortisol levels strengthened the depression association with estradiol in boys (β=0.54 [0.12, 0.96]), and with testosterone (β= -0.19 [-0.35, -0.03]) and DHEA (β= -0.12 [-0.22, -0.02]) in girls. Testosterone also modified associations. Limitations This was a cross-sectional analysis. Discussion Elevated testosterone, cortisol, and estradiol (≥90th percentile) were associated with altered mood. Cortisol and testosterone were considerable effect modifiers to the associations of most hormones with depression and anxiety.
背景
肾上腺和性激素失调与抑郁和焦虑的发生率增加独立相关。皮质醇可以改变性激素的产生，以及激素与情绪的关联。本研究旨在评估性激素和肾上腺激素与抑郁和焦虑的关联和相互作用。
方法
我们使用标准化量表评估了 545 名厄瓜多尔青少年（11-17 岁，50.4%为女性，ESPINA）的抑郁和焦虑症状。使用唾液测量睾酮、皮质醇、脱氢表雄酮（DHEA）和雌二醇（仅男孩）。我们进行了逻辑回归建模，以计算抑郁或焦虑（评分≥60）的优势比（OR），将激素水平低（<10 百分位数）和高（≥90 百分位数）的参与者与正常浓度（10-90 百分位数）进行比较。评估了皮质醇和睾酮的效应修饰作用。模型调整了人口统计学、人体测量学和昼夜节律测量因素。
结果
在所有参与者中，睾酮水平升高（OR [95%CI]：1.78 [0.98，3.23]）和皮质醇水平升高（OR=1.69 [0.95，2.99]）与焦虑评分升高呈边缘相关。在男孩中，雌二醇水平升高与抑郁（OR=4.75 [1.95，11.56]）和焦虑评分（OR=2.43 [1.01，5.84]）升高相关。在线性回归中，雌二醇与抑郁呈正相关（每增加 10%激素的差异/β=0.45 [0.15，0.75]）和焦虑评分（β=0.42 [0.13，0.72]）。在男孩中，较高的皮质醇水平增强了雌二醇与抑郁的关联（β=0.54 [0.12，0.96]），以及与睾酮（β= -0.19 [-0.35，-0.03]）和 DHEA（β= -0.12 [-0.22，-0.02]）的关联。睾酮也改变了关联。
局限性
这是一项横断面分析。
结论
升高的睾酮、皮质醇和雌二醇（≥90 百分位数）与情绪改变有关。皮质醇和睾酮是大多数激素与抑郁和焦虑关联的重要效应修饰因子。
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