Klusmann Hannah, Schulze Lars, Engel Sinha, Bücklein Elise, Daehn Daria, Lozza-Fiacco Serena, Geiling Angelika, Meyer Caroline, Andersen Elizabeth, Knaevelsrud Christine, Schumacher Sarah
Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Schwendenerstraße 27, 14195 Berlin, Germany.
Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany.
Front Neuroendocrinol. 2022 Jul;66:100998. doi: 10.1016/j.yfrne.2022.100998. Epub 2022 May 18.
Differential HPA axis function has been proposed to underlie sex-differences in mental disorders; however, the impact of fluctuating sex hormones across the menstrual cycle on HPA axis activity is still unclear. This meta-analysis investigated basal cortisol concentrations as a marker for HPA axis activity across the menstrual cycle. Through a systematic literature search of five databases, 121 longitudinal studies were included, summarizing data of 2641 healthy, cycling participants between the ages of 18 and 45. The meta-analysis showed higher cortisol concentrations in the follicular vs. luteal phase (d = 0.12, p =.004, [0.04 - 0.20]). Comparisons between more precise cycle phases were mostly insignificant, aside from higher concentrations in the menstrual vs. premenstrual phase (d = 0.17, [0.02 - 0.33], p =.03). In all included studies, nine samples used established cortisol parameters to indicate HPA axis function, specifically diurnal profiles (k = 4) and the cortisol awakening response (CAR) (k = 5). Therefore, the meta-analysis highlights the need for more rigorous investigation of HPA axis activity and menstrual cycle phase.
不同的下丘脑-垂体-肾上腺（HPA）轴功能被认为是精神障碍性别差异的基础；然而，月经周期中波动的性激素对HPA轴活动的影响仍不清楚。这项荟萃分析研究了基础皮质醇浓度，将其作为整个月经周期中HPA轴活动的一个标志物。通过对五个数据库进行系统的文献检索，纳入了121项纵向研究，汇总了2641名年龄在18至45岁之间的健康、有月经周期的参与者的数据。荟萃分析显示，卵泡期的皮质醇浓度高于黄体期（d = 0.12，p = 0.004，[0.04 - 0.20]）。除了月经期与经前期相比皮质醇浓度更高（d = 0.17，[0.02 - 0.33]，p = 0.03）外，更精确的周期阶段之间的比较大多无显著差异。在所有纳入的研究中，九个样本使用既定的皮质醇参数来指示HPA轴功能，特别是昼夜节律（k = 4）和皮质醇觉醒反应（CAR）（k = 5）。因此，荟萃分析强调需要对HPA轴活动和月经周期阶段进行更严格的研究。
