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儿童创伤的神经生物学——社区样本中的醛固酮与血压变化

The neurobiology of childhood trauma-aldosterone and blood pressure changes in a community sample.

作者信息

Terock Jan, Hannemann Anke, Klinger-König Johanna, Janowitz Deborah, Grabe Hans J, Murck Harald

机构信息

Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.

Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Stralsund, Germany.

出版信息

World J Biol Psychiatry. 2022 Oct;23(8):622-630. doi: 10.1080/15622975.2021.2018724. Epub 2022 Jan 14.

DOI:10.1080/15622975.2021.2018724
PMID:34906037
Abstract

OBJECTIVE

Childhood trauma is an important risk factor for the onset and course of psychiatric disorders and particularly major depression. Recently, the renin-angiotensin-aldosterone system, one of the core stress hormone systems, has been demonstrated to be modified by childhood trauma.

METHODS

Childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ) in a community-dwelling sample ( = 2038). Plasma concentrations of renin and aldosterone were measured in subjects with childhood trauma (CT;  = 385) subjects without this experience (NoCT;  = 1653). Multivariable linear regression models were calculated to assess the associations between CTQ, systolic and diastolic blood pressure, renin and aldosterone concentrations, and the ratio of aldosterone and systolic blood pressure (A/SBP).

RESULTS

CT subjects demonstrated higher plasma aldosterone (A) concentrations, a lower systolic and diastolic blood pressure, and a higher A/SBP. In addition, both aldosterone concentrations, as well as A/SBP, correlated with the severity of childhood trauma. These findings could not be attributed to differences in concomitant medication.

CONCLUSIONS

In conclusion, childhood trauma was associated with neurobiological markers, which may impact the risk for psychiatric disorders, primarily major depression. The altered A/SBP ratio points to a desensitisation of peripheral mineralocorticoid receptor function, which may be a target for therapeutic interventions.

摘要

目的

童年创伤是精神疾病尤其是重度抑郁症发病及病程的重要风险因素。最近,肾素 - 血管紧张素 - 醛固酮系统作为核心应激激素系统之一,已被证明会因童年创伤而发生改变。

方法

使用儿童创伤问卷(CTQ)在一个社区居住样本(n = 2038)中获取童年创伤情况。对有童年创伤经历的受试者(CT;n = 385)和无此经历的受试者(NoCT;n = 1653)测量血浆肾素和醛固酮浓度。计算多变量线性回归模型,以评估CTQ、收缩压和舒张压、肾素和醛固酮浓度以及醛固酮与收缩压之比(A/SBP)之间的关联。

结果

有童年创伤经历的受试者表现出血浆醛固酮(A)浓度较高、收缩压和舒张压较低以及A/SBP较高。此外,醛固酮浓度以及A/SBP均与童年创伤的严重程度相关。这些发现不能归因于伴随用药的差异。

结论

总之,童年创伤与神经生物学标志物相关,这可能会影响精神疾病尤其是重度抑郁症的风险。A/SBP比值的改变表明外周盐皮质激素受体功能脱敏,这可能是治疗干预的一个靶点。

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