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Vroegindeweij A, Eijkelkamp N, van den Berg SAA, van de Putte EM, Wulffraat NM, Swart JF, Nijhof SL. Lower hair cortisol concentration in adolescent and young adult patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Q-Fever Fatigue Syndrome compared to controls. Psychoneuroendocrinology 2024; 168:107117. [PMID: 38986244 DOI: 10.1016/j.psyneuen.2024.107117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/10/2024] [Accepted: 06/27/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND In patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), momentary cortisol concentrations in blood, urine, and saliva are lower compared to healthy controls. Long-term cortisol concentration can be assessed through hair, but it is unclear whether these concentrations are also lower. Additionally, it is unknown if lower cortisol extends to other patients suffering from persistent fatigue and how hair cortisol concentration (HCC) relates to fatigue levels. Therefore, this study examines HCC in fatigued patients with ME/CFS, Q fever Fatigue Syndrome (QFS), Post-COVID-19 condition (PCC), and Juvenile Idiopathic Arthritis (JIA). METHODS Adolescent and young adult patients with ME/CFS (n=12), QFS (n=20), PCC (n=8), JIA (n=19), and controls (n=57) were included. Patients participated in a randomized cross-over trial (RCT) targeting fatigue through lifestyle and dietary self-management strategies. HCC was measured pre-post RCT in patients and once in controls, quantified using a LC-MS/MS-based method. Fatigue severity was measured with the Checklist Individual Strength-8. HCC was compared between groups with ANOVAs. Relations between HCC, fatigue severity, and other variables were investigated using linear regression analyses. RESULTS The ME/CFS (p=.009) and QFS (p=.047) groups had lower HCC compared to controls. Overall, HCC was negatively associated with the presence of symptoms related to chronic fatigue syndromes (e.g., sleeping issues, often feeling tired, trouble thinking clearly; β=-0.018, p=.035), except in the QFS group (β=.063, p<.001). Baseline HCC did not predict fatigue improvement during the RCT (p=.449), and HCC increased during the trial (Mdif=.076, p=.021) regardless of clinically relevant fatigue improvement (p=.658). CONCLUSION Lower cortisol concentration can also be observed in the long-term. Lower HCC is not limited to ME/CFS, as it was also observed in QFS. The role of cortisol may differ between these diagnoses and appears to be unrelated to fatigue levels.
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Affiliation(s)
- Anouk Vroegindeweij
- Department of Paediatric Rheumatology/Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Niels Eijkelkamp
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Sjoerd A A van den Berg
- Department of Clinical Chemistry, Erasmus Medical Center, University Medical Centre Rotterdam, the Netherlands; Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam 3015 GD, the Netherlands
| | - Elise M van de Putte
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Nico M Wulffraat
- Department of Paediatric Rheumatology/Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Joost F Swart
- Department of Paediatric Rheumatology/Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Faculty of Medicine, Utrecht University, Utrecht, the Netherlands
| | - Sanne L Nijhof
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Faculty of Medicine, Utrecht University, Utrecht, the Netherlands
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Pham AT, van Dijk BAC, van der Valk ES, van der Vegt B, van Rossum EFC, de Bock GH. Chronic Stress Related to Cancer Incidence, including the Role of Metabolic Syndrome Components. Cancers (Basel) 2024; 16:2044. [PMID: 38893162 PMCID: PMC11171137 DOI: 10.3390/cancers16112044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/23/2024] [Accepted: 05/26/2024] [Indexed: 06/21/2024] Open
Abstract
Epidemiological results on the link between chronic stress and cancer initiation have been inconsistent. This study examined the relation between chronic biological stress, indicated as hair cortisol (HairF) and hair cortisone (HairE), and cancer incidence, adjusting for metabolic syndrome (MetS) components. We analyzed HairF and HairE samples from 6341 participants from the population-based cohort Lifelines in 2014. A linkage with the Dutch Nationwide Pathology Databank (Palga) provided the cancer incidence from 2015 to 2021. The association between dichotomized HairF and log-transformed HairE (LogHairE) and cancer incidence was estimated using Cox regression. MetS components were evaluated as confounders or moderators. Of the 2776 participants with known HairF levels and no cancer history, 238 developed cancer. The HairF level did not predict cancer incidence (HR: 0.993, 95%CI: 0.740-1.333). No confounders or moderators were identified. Among the 4699 participants with known HairE levels and no cancer history, 408 developed cancer. There was no association between LogHairE and cancer incidence (HR: 1.113, 95%CI: 0.738-1.678). When including age as a confounder and gender as a moderator, LogHairE was statistically significantly associated with cancer incidence (HR: 6.403, 95%CI: 1.110-36.92). In a population-based cohort, chronic biological stress, measured by HairE, was associated with cancer incidence, after controlling for age and gender.
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Affiliation(s)
- An Thanh Pham
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (B.A.C.v.D.); (G.H.d.B.)
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 700000, Vietnam
| | - Boukje A. C. van Dijk
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (B.A.C.v.D.); (G.H.d.B.)
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), 3511 CV Utrecht, The Netherlands
| | - Eline S. van der Valk
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (E.S.v.d.V.); (E.F.C.v.R.)
| | - Bert van der Vegt
- Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands;
| | - Elisabeth F. C. van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (E.S.v.d.V.); (E.F.C.v.R.)
| | - Geertruida H. de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (B.A.C.v.D.); (G.H.d.B.)
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Jia Y, Qi D, Wang T, Zhang Y, Chen X, Deng H, Meng D. The role of pre-onset hair hormone in predicting the prognosis of patients with severe pneumonia and acute COVID-19 outbreak. Heliyon 2024; 10:e30636. [PMID: 38765161 PMCID: PMC11098831 DOI: 10.1016/j.heliyon.2024.e30636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/01/2024] [Accepted: 05/01/2024] [Indexed: 05/21/2024] Open
Abstract
Numerous research works have investigated the potential impact of endocrine hormones on the severity of COVID-19-related pneumonia in individuals. However, there are few studies on the effect of pre-onset neuroendocrine hormones on the prognosis of COVID-19 patients. This study looked into the prognostic value of pre-onset hair hormone levels in COVID-19 infected individuals. This study included 27 patients with COVID-19 and collected patient information and laboratory indicators. The hormone levels in hair were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Within 28 days, 63 % of the patients in this study passed away. With 28-day mortality as the outcome index, urea nitrogen, CURB-65 score and pneumonia severity score (PSI) of 2 groups were statistically significant (P < 0.05). Among all hormone levels detected in hair, only progesterone level was substantially correlated negatively with COVID-19 patients' 28-day mortality(P < 0.05). The level of progesterone in hair was substantially adversely connected with the death rate at 28 days of COVID-19 patients, according to correlation and logistic regression analysis(P < 0.05). Among patients with COVID-19 pneumonia, hair progesterone levels were strongly associated with 28-day mortality, which emphasizes hair progesterone's importance as a prognostic factor.
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Affiliation(s)
- Yuanyuan Jia
- Rehabilitation Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Deyi Qi
- School of Biological Science & Medical Engineering, Southeast University, Nanjing, 211189, Jiangsu, China
| | - Tiantian Wang
- Rehabilitation Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Yuyao Zhang
- Rehabilitation Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Xufeng Chen
- Department of Emergency and Critical Care Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Huihua Deng
- School of Biological Science & Medical Engineering, Southeast University, Nanjing, 211189, Jiangsu, China
| | - Dianhuai Meng
- Rehabilitation Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, Jiangsu, China
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van der Valk ES, Mohseni M, Iyer AM, van den Hurk M, Lengton R, Kuckuck S, Wester VL, Leenen PJM, Dik WA, Visser JA, Kavousi M, Mirzaian M, van den Berg SAA, van Rossum EFC. Long-term glucocorticoid exposure and incident cardiovascular diseases - the Lifelines cohort. J Clin Endocrinol Metab 2024:dgae081. [PMID: 38500477 DOI: 10.1210/clinem/dgae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/10/2024] [Accepted: 02/06/2024] [Indexed: 03/20/2024]
Abstract
CONTEXT Long-term glucocorticoid levels in scalp hair (HairGCs), including cortisol and the inactive form cortisone, represent the cumulative systemic exposure to glucocorticoids over months. HairGCs have repeatedly shown associations with cardiometabolic and immune parameters, but longitudinal data are lacking. DESIGN We investigated 6341 hair samples of participants from the Lifelines cohort study for cortisol and cortisone levels, and associated these to incident cardiovascular diseases (CVD) during 5-7 years of follow-up. We computed the odds ratio (OR) of HairGC levels for incident CVD via logistic regression, adjusting for classical cardiovascular risk factors, and performed a sensitivity analysis in subcohorts of participants <60 years and >= 60 years. Also, we associated HairGC levels to immune parameters (total leukocytes and subtypes). RESULTS Hair cortisone levels (available in n = 4701) were independently associated with incident CVD (p < 0.001), particularly in younger individuals (multivariate-adjusted OR 4.21, 95% confidence interval (CI) 1.91-9.07 per point increase in 10-log cortisone concentration (pg/mg), p < 0.001). All immune parameters except eosinophils were associated with hair cortisone (all multivariate-adjusted p < 0.05). CONCLUSIONS In this large, prospective cohort study, we found that long-term cortisone levels, measured in scalp hair, represent a relevant and significant predictor for future cardiovascular diseases in younger individuals. These results highlight glucocorticoid action as possible treatment target for CVD prevention, where hair glucocorticoid measurements could help identify individuals that may benefit from such treatments.
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Affiliation(s)
- Eline S van der Valk
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mostafa Mohseni
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Anand M Iyer
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maartje van den Hurk
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Robin Lengton
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Susanne Kuckuck
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Vincent L Wester
- Department of Internal Medicine, division of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Pieter J M Leenen
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Willem A Dik
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Laboratory of Medical Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jenny A Visser
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mina Mirzaian
- Department of Clinical Chemistry, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sjoerd A A van den Berg
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Clinical Chemistry, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Elisabeth F C van Rossum
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Mirzaian M, van Zundert SKM, Schilleman WF, Mohseni M, Kuckuck S, van Rossum EFC, van Schaik RHN, van den Berg SAA. Determination of cortisone and cortisol in human scalp hair using an improved LC-MS/MS-based method. Clin Chem Lab Med 2024; 62:118-127. [PMID: 37485925 DOI: 10.1515/cclm-2023-0341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES Human scalp hair is an easily available but complex matrix for determination of cortisone and cortisol, and has been shown to reflect long-term glucocorticoid exposure. Hair glucocorticoid analysis has been used to detect hypo- and hypercortisolism. In this study, we describe the development and validation of a LC-MS/MS method for quantification of cortisone and cortisol in human scalp hair, and provide a novel approach for analysis and interpretation of the results. METHODS Improved sample preparation using pulverization and solid phase extraction allowed for low sample volumes (10 mg). Baseline chromatographic separation without matrix interference was achieved by reversed phase chromatography and MRM measurement in negative ion mode. Run-to-run time was 8 min. Mixed model analyses were performed to create individual patterns of cortisone and cortisol concentrations. RESULTS Matrix matched calibration curves showed excellent linearity up to 100 pg (analyte)/mg (hair) for both cortisone and cortisol (R2>0.995). LLOQ was 1.5 and 1.0 pg/mg for cortisone and cortisol, respectively. Matrix effect was negligible for hair color (recoveries 95-105 %). Cortisone and cortisol concentrations decreased from proximal to distal hair segments, following a predictable, but subject-specific pattern, with less individual variation for cortisone than for cortisol. CONCLUSIONS This improved LC-MS/MS method is able to accurately quantify cortisone and cortisol in human hair with minimum matrix interference. This new way of data analysis and interpretation including individual patterns of cortisone and cortisol will be of help with detection of pathological concentrations in both the high - and the low ranges of glucocorticoids.
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Affiliation(s)
- Mina Mirzaian
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sofie K M van Zundert
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Wim F Schilleman
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Mostafa Mohseni
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Susanne Kuckuck
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Ron H N van Schaik
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sjoerd A A van den Berg
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Salvator H, Lamy E, Roquencourt C, Bardin E, Devillier P, Grassin-Delyle S. Therapeutic drug monitoring of corticosteroids/β 2-agonists in the hair of patients with asthma: an open-label feasibility study. Front Pharmacol 2024; 14:1339835. [PMID: 38269282 PMCID: PMC10807032 DOI: 10.3389/fphar.2023.1339835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background: Although adherence to inhaled medication is critically important for treatment efficiency, around half of patients taking these drugs are non-adherent or make critical errors when using their delivery device. Segmental hair analysis might be a valuable tool for therapeutic monitoring because hair concentrations reflect exposure from month to month. The objective of the present proof-of-concept study was to establish the feasibility of segmental hair analysis of inhaled budesonide and formoterol in asthma patients. Methods: We conducted a prospective, open-label, interventional study of adult patients being treated with budesonide/formoterol for controlled, moderate-to-severe asthma (CorticHair, NCT03691961). Asthma control, lung function, and medication adherence were recorded. Hair samples were taken 4 months after enrolment and cut into four 1 cm segments. Results: Samples were available from 21 patients (20 women; median age: 53; median budesonide dose: 600 μg/d). Budesonide and formoterol were detected in samples from 18 to 13 patients, respectively. The median hair concentrations were 6.25 pg/mg for budesonide and 0.9 pg/mg for formoterol. The intrapatient coefficient of variation between hair segments was 21% for budesonide and 40% for formoterol. Pearson's coefficients for the correlations between the hair concentration and the self-reported drug dose and the prescribed drug dose were respectively 0.42 (p = 0.08) and 0.29 (p = 0.25) for budesonide and 0.24 (p = 0.44) and 0.17 (p = 0.57) for formoterol. Conclusion: Segmental hair analysis of inhaled medications was feasible, with low intrapatient variability. This innovative, non-invasive means of assessing monthly drug exposure might help physicians to personalize drug regimens for patients with difficult-to-treat asthma.
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Affiliation(s)
- Hélène Salvator
- Exhalomics, Hôpital Foch, Suresnes, France
- Service de Pneumologie, Hôpital Foch, Suresnes, France
- Laboratoire de Recherche en Pharmacologie Respiratoire—VIM Suresnes, UMR 0892, Université Paris-Saclay, Suresnes, France
| | - Elodie Lamy
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de La Santé, Montigny-le-Bretonneux, France
| | | | - Emmanuelle Bardin
- Exhalomics, Hôpital Foch, Suresnes, France
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de La Santé, Montigny-le-Bretonneux, France
- Institut Necker Enfants Malades, U1151, Paris, France
| | - Philippe Devillier
- Exhalomics, Hôpital Foch, Suresnes, France
- Laboratoire de Recherche en Pharmacologie Respiratoire—VIM Suresnes, UMR 0892, Université Paris-Saclay, Suresnes, France
| | - Stanislas Grassin-Delyle
- Exhalomics, Hôpital Foch, Suresnes, France
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de La Santé, Montigny-le-Bretonneux, France
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Adav SS, Ng KW. Recent omics advances in hair aging biology and hair biomarkers analysis. Ageing Res Rev 2023; 91:102041. [PMID: 37634889 DOI: 10.1016/j.arr.2023.102041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/27/2023] [Accepted: 08/23/2023] [Indexed: 08/29/2023]
Abstract
Aging is a complex natural process that leads to a decline in physiological functions, which is visible in signs such as hair graying, thinning, and loss. Although hair graying is characterized by a loss of pigment in the hair shaft, the underlying mechanism of age-associated hair graying is not fully understood. Hair graying and loss can have a significant impact on an individual's self-esteem and self-confidence, potentially leading to mental health problems such as depression and anxiety. Omics technologies, which have applications beyond clinical medicine, have led to the discovery of candidate hair biomarkers and may provide insight into the complex biology of hair aging and identify targets for effective therapies. This review provides an up-to-date overview of recent omics discoveries, including age-associated alterations of proteins and metabolites in the hair shaft and follicle, and highlights the significance of hair aging and graying biomarker discoveries. The decline in hair follicle stem cell activity with aging decreased the regeneration capacity of hair follicles. Cellular senescence, oxidative damage and altered extracellular matrix of hair follicle constituents characterized hair follicle and hair shaft aging and graying. The review attempts to correlate the impact of endogenous and exogenous factors on hair aging. We close by discussing the main challenges and limitations of the field, defining major open questions and offering an outlook for future research.
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Affiliation(s)
- Sunil S Adav
- School of Materials Science and Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Kee Woei Ng
- School of Materials Science and Engineering, Nanyang Technological University, Singapore 639798, Singapore; Nanyang Environment and Water Research Institute, Nanyang Technological University, 1 Cleantech Loop, CleanTech One, 637141, Singapore.
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Cohen NJ, Defina S, Rifas-Shiman SL, Faleschini S, Kirby RS, Chen H, Wilson R, Fryer K, Marroun HE, Cecil CAM, Hivert MF, Oken E, Tiemeier H, Alman AC. Associations of prenatal maternal depressive symptoms with cord blood glucocorticoids and child hair cortisol levels in the project viva and the generation R cohorts: a prospective cohort study. BMC Pediatr 2023; 23:540. [PMID: 37898740 PMCID: PMC10612353 DOI: 10.1186/s12887-023-04372-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Prior studies have reported conflicting results regarding the association of prenatal maternal depression with offspring cortisol levels. We examined associations of high levels of prenatal depressive symptoms with child cortisol biomarkers. METHODS In Project Viva (n = 925, Massachusetts USA), mothers reported their depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy, cord blood glucocorticoids were measured at delivery, and child hair cortisol levels were measured in mid-childhood (mean (SD) age: 7.8 (0.8) years) and early adolescence (mean (SD) age: 13.2 (0.9) years). In the Generation R Study (n = 1644, Rotterdam, The Netherlands), mothers reported depressive symptoms using the Brief Symptom Inventory (BSI) during pregnancy, and child hair cortisol was measured at a mean (SD) age of 6.0 (0.5) years. We used cutoffs of ≥ 13 for the EPDS and > 0.75 for the BSI to indicate high levels of prenatal depressive symptoms. We used multivariable linear regression models adjusted for child sex and age (at outcome), and maternal pre-pregnancy BMI, education, social support from friends/family, pregnancy smoking status, marital status, and household income to assess associations separately in each cohort. We also meta-analyzed childhood hair cortisol results from both cohorts. RESULTS 8.0% and 5.1% of women respectively experienced high levels of prenatal depressive symptoms in Project Viva and the Generation R Study. We found no associations between high levels of maternal depressive symptoms during pregnancy and child cortisol biomarkers in either cohort. CONCLUSIONS The present study does not find support for the direct link between high levels of maternal depressive symptoms and offspring cortisol levels.
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Affiliation(s)
- Nathan J Cohen
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Serena Defina
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sabrina Faleschini
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Russell S Kirby
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Henian Chen
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ronee Wilson
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Kimberly Fryer
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education, and Child Studies, Erasmus School of Social and Behavioral Sciences, Rotterdam, The Netherlands
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amy C Alman
- College of Public Health, University of South Florida, Tampa, FL, USA
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Galbally M, Watson SJ, van IJzendoorn MH, Tharner A, Luijk M, de Kloet ER, van Rossum EFC, Lewis AJ. Prenatal predictors of childhood anxiety disorders: An exploratory study of the role of attachment organization. Dev Psychopathol 2023; 35:1296-1307. [PMID: 34911592 DOI: 10.1017/s0954579421001206] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Childhood anxiety disorders (CAD) are a common childhood mental disorder and understanding early developmental pathways is key to prevention and early intervention. What is not understood is whether early life stress predictors of CAD might be both mediated by infant cortisol reactivity and moderated by infant attachment status. To address this question, this exploratory study draws on 190 women recruited in early pregnancy and followed together with their children until 4 years of age. Early life stress is operationalized as maternal depression measured using the Structured Clinical Interview for the DSM, Childhood Trauma Questionnaire, Parenting Stress Index, and antenatal maternal hair cortisol concentrations. Infant cortisol reactivity was measured at 12 months together with the Strange Situation Procedure and CAD assessed at 4 years of age using the Preschool Age Psychiatric Assessment. There was no direct association between attachment classification and CAD. Furthermore, infant cortisol reactivity neither mediated nor attachment moderated the association of early life stress predictors and CAD. However, only for infants with organized attachment classifications, higher maternal antenatal depression, and hair cortisol were associated with a higher risk of CAD.
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Affiliation(s)
- Megan Galbally
- Psychology, Murdoch University, Murdoch, Australia
- School of Medicine, University of Notre Dame, Australia
- King Edward Memorial Hospital, Subiaco, Perth, WA, Australia
| | - Stuart J Watson
- Psychology, Murdoch University, Murdoch, Australia
- School of Medicine, University of Notre Dame, Australia
| | - Marinus H van IJzendoorn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, UCL, UK
| | - Anne Tharner
- Department of Educational and Family Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maartje Luijk
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - E Ron de Kloet
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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10
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Wright K, van Rossum EFC, Zan E, Werner N, Harris A, Feelders RA, Agrawal N. Emerging diagnostic methods and imaging modalities in cushing's syndrome. Front Endocrinol (Lausanne) 2023; 14:1230447. [PMID: 37560300 PMCID: PMC10407789 DOI: 10.3389/fendo.2023.1230447] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/05/2023] [Indexed: 08/11/2023] Open
Abstract
Endogenous Cushing's syndrome (CS) is a rare disease characterized by prolonged glucocorticoid excess. Timely diagnosis is critical to allow prompt treatment and limit long-term disease morbidity and risk for mortality. Traditional biochemical diagnostic modalities each have limitations and sensitivities and specificities that vary significantly with diagnostic cutoff values. Biochemical evaluation is particularly complex in patients whose hypercortisolemia fluctuates daily, often requiring repetition of tests to confirm or exclude disease, and when delineating CS from physiologic, nonneoplastic states of hypercortisolism. Lastly, traditional pituitary MRI may be negative in up to 60% of patients with adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas (termed "Cushing's disease" [CD]) whereas false positive pituitary MRI findings may exist in patients with ectopic ACTH secretion. Thus, differentiating CD from ectopic ACTH secretion may necessitate dynamic testing or even invasive procedures such as bilateral inferior petrosal sinus sampling. Newer methods may relieve some of the diagnostic uncertainty in CS, providing a more definitive diagnosis prior to subjecting patients to additional imaging or invasive procedures. For example, a novel method of cortisol measurement in patients with CS is scalp hair analysis, a non-invasive method yielding cortisol and cortisone values representing long-term glucocorticoid exposure of the past months. Hair cortisol and cortisone have both shown to differentiate between CS patients and controls with a high sensitivity and specificity. Moreover, advances in imaging techniques may enhance detection of ACTH-secreting pituitary adenomas. While conventional pituitary MRI may fail to identify microadenomas in patients with CD, high-resolution 3T-MRI with 3D-spoiled gradient-echo sequence has thinner sections and superior soft-tissue contrast that can detect adenomas as small as 2 mm. Similarly, functional imaging may improve the identification of ACTH-secreting adenomas noninvasively; Gallium-68-tagged corticotropin-releasing hormone (CRH) combined with PET-CT can be used to detect CRH receptors, which are upregulated on corticotroph adenomas. This technique can delineate functionality of adenomas in patients with CD from patients with ectopic ACTH secretion and false positive pituitary lesions on MRI. Here, we review emerging methods and imaging modalities for the diagnosis of CS, discussing their diagnostic accuracy, strengths and limitations, and applicability to clinical practice.
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Affiliation(s)
- Kyla Wright
- New York University (NYU) Grossman School of Medicine, New York, NY, United States
| | - Elisabeth F. C. van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical College (MC), University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Elcin Zan
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Nicole Werner
- New York University (NYU) Grossman School of Medicine, New York, NY, United States
| | - Alan Harris
- Department of Medicine, Division of Endocrinology, New York University (NYU) Langone Medical Center, New York, NY, United States
| | - Richard A. Feelders
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical College (MC), University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Nidhi Agrawal
- Department of Medicine, Division of Endocrinology, New York University (NYU) Langone Medical Center, New York, NY, United States
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11
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Pardini S, Gabrielli S, Olivetto S, Fusina F, Dianti M, Forti S, Lancini C, Novara C. Personalized, Naturalistic Virtual Reality Scenarios Coupled With Web-Based Progressive Muscle Relaxation Training for the General Population: Protocol for a Proof-of-Principle Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e44183. [PMID: 37067881 PMCID: PMC10152380 DOI: 10.2196/44183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/15/2023] [Accepted: 02/28/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Virtual reality (VR) is an innovative tool that can facilitate exposure to either stressful or relaxing stimuli and enables individuals who have difficulties visualizing scenes to be involved in a more realistic sensorimotor experience. It also facilitates multisensory stimulation, a sense of presence, and achievement of relaxation. VR scenarios representing visual and auditory elements of natural relaxing environments can facilitate the learning of relaxation techniques such as the progressive muscle relaxation technique (PMRT). A complementary standardized technique deployed to reduce anxiety symptoms is the integration of PMRT and guided imagery (GI). Exposure to a pleasant imaginary environment helps the establishment of an association between a relaxing scenario and the relaxation technique, consequently promoting relaxation. Empirical evidence has shown that VR scenarios can increase the effects of relaxation techniques by enabling people to experience emotional conditions in more vivid settings. OBJECTIVE The main aim of this pilot study protocol is to investigate the impact on state anxiety of PMRT, associated with a personalized relaxing scenario in VR, and the role of VR scenarios in facilitating the recall of relaxing images and a sense of presence. A secondary aim is to understand if relaxing sessions administered via Zoom are more effective for managing anxiety and stress than a procedural setting based on audio-track guidance. METHODS Based on a longitudinal, between-subject design, 108 university students will be randomly exposed to one of three experimental conditions: (1) PMRT via Zoom and GI exposure, (2) PMRT via Zoom and personalized VR exposure, and (3) PMRT based on audio-track guidance and personalized VR exposure. Individuals are assessed before and after 7 training sessions based on self-report questionnaires investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data are also detected by an Mi Band 2 sensor. RESULTS The experimental procedure is ongoing. In this paper, preliminary data from a sample of 40 participants will be illustrated. The experimental phase is expected to conclude in May 2023, and the final results of the research will be presented in June 2023. CONCLUSIONS The results of this study will help shape the experimental design to apply it on a subsequent randomized controlled trial, also considering clinical samples. This work is expected to measure whether VR is a more engaging and helpful technique in promoting relaxation and decreasing anxiety levels than GI, by making the visualization process easier and by helping people to face more realistic sensory experiences. Assessing the efficacy of the PMRT in alternative delivery modes may extend its applications, especially in situations where the standard procedure is more challenging to be administered. To our knowledge, no equivalent study has been published so far on this matter. TRIAL REGISTRATION ClinicalTrials.gov NCT05478941; https://clinicaltrials.gov/ct2/show/NCT05478941. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44183.
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Affiliation(s)
- Susanna Pardini
- Department of General Psychology, University of Padova, Padova, Italy
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
- Human Inspired Technology Research Centre, University of Padova, Padova, Italy
| | - Silvia Gabrielli
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Silvia Olivetto
- Department of General Psychology, University of Padova, Padova, Italy
| | - Francesca Fusina
- Department of General Psychology, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Marco Dianti
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Stefano Forti
- Digital Health Lab, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Cristina Lancini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Caterina Novara
- Department of General Psychology, University of Padova, Padova, Italy
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12
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Galbally M, Watson S, Lewis AJ, Power J, Buus N, van IJzendoorn M. Maternal attachment state of mind and perinatal emotional wellbeing: Findings from a pregnancy cohort study. J Affect Disord 2023; 333:297-304. [PMID: 37062497 DOI: 10.1016/j.jad.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/02/2023] [Accepted: 04/10/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVES Maternal attachment state of mind is an important potential predictor of risk and resilience to perinatal emotional wellbeing and early parenting. To explore maternal attachment in relation to perinatal depression and emotional wellbeing. METHODS This study drew on data collected within an ongoing cohort from 170 women recruited in early pregnancy, including 67 who met criteria for Major Depression. Maternal attachment state of mind was assessed with the Adult Attachment Interview (AAI) in pregnancy. Additional measures included the Structured Clinical Interview for the DSM (SCID), at 12 months the Strange Situation Procedure (SSP), Child Trauma Questionnaire (CTQ), Parenting Stress Index, and antenatal maternal hair cortisol concentrations (HCC). LIMITATIONS Sample size to be able to undertake all analyses using the 4 way classifications, cortisol measurement is limited to hair only and there is no prospectively collected measure of childhood trauma in mothers. CONCLUSIONS This study found that maternal attachment, specifically the Non-Autonomous states of mind, adjusted for clinical depression, was associated with higher cortisol in pregnancy and higher depressive symptoms across pregnancy and the postpartum. Furthermore, separately those with depression and Non-Autonomous states of mind also had higher postpartum parenting stress. There was no significant intergenerational concordance between AAI and SSP attachment classifications. Our findings support future research exploring the role of maternal attachment state of mind in understanding perinatal depression and emotional wellbeing.
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Affiliation(s)
- Megan Galbally
- School of Health Sciences, Monash University, Australia; Health Futures Institute, Murdoch University, Australia; Research Department of Clinical, Education and Health Psychology, Faculty of Brain Sciences, UCL, UK.
| | - Stuart Watson
- School of Health Sciences, Monash University, Australia; Health Futures Institute, Murdoch University, Australia
| | - Andrew J Lewis
- Institute of Health and Wellbeing, Federation University, Australia
| | | | - Niels Buus
- School of Nursing and Midwifery, Monash University, Australia; Department of Regional Health Research, University of Southern Denmark, Denmark
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13
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Maternal opioid addiction: A potential cause of elevated 17-OH progesterone in neonatal screening. Arch Pediatr 2023; 30:77-82. [PMID: 36526499 DOI: 10.1016/j.arcped.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 06/10/2022] [Accepted: 11/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Congenital adrenal hyperplasia (CAH) is a disease that is part of neonatal screening. There are many causes of false-positive results on neonatal screening, and maternal opioid consumption during pregnancy is suspected to increase 17-hydroxyprogesterone (17-OHP) levels at birth. The aim of this study was to determine the effect of maternal drug consumption on 17-OHP values on neonatal screening. MATERIAL AND METHODS We studied 17-OHP levels of term newborns with reported maternal drug consumption born at the Maternity Hospital of Nancy between 2002 and 2018. These infants were matched with newborns of mothers without drug addiction. The 17-OHP levels, withdrawal syndromes, birth parameters, and maternal characteristics were compared between the two groups. RESULTS The study included 241 patients (121 in the drug-exposed group, 120 in the control group). The mean 17-OHP levels in newborns of mothers with substance addiction were 9.83 nmol/L compared to 4.90 nmol/L (p=0.0001) in the control group. Newborns exposed to drugs were smaller (p=0.0001), lighter (p=0.0001), had smaller head circumference (p=0.0001), and had lower Apgar scores (p=0.004 at 1 min and p=0.0001 at 5 min). The 17-OHP level did not differ in cases of withdrawal syndrome in drug-exposed newborn (p=0.911). CONCLUSION A significant increase in 17-OHP levels was observed in newborns exposed to drugs, with no influence of withdrawal syndrome on 17-OHP levels. Maternal substance addiction may be associated with moderately increased 17-OHP levels during neonatal screening.
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14
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Broeks CW, Molenaar N, Brouwer M, van den Akker EL, van Rossum EF, Van R, van den Berg SA, Hillegers M, Hoogendijk WJ, Burger H, Bockting C, Kamperman AM, Lambregtse-Van den Berg MP. Intergenerational impact of childhood trauma on hair cortisol concentrations in mothers and their young infants. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 14:100167. [PMID: 36819463 PMCID: PMC9930158 DOI: 10.1016/j.cpnec.2023.100167] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/22/2023] Open
Abstract
Background Alterations in stress regulation and function of the hypothalamic-pituitary-adrenal (HPA) axis during infancy may be a risk factor for the development of psychopathology later in life. Maternal childhood trauma, depression, anxiety and stressful life events are individually associated with HPA axis dysregulation. Less is known about their interdependent influence on maternal and infant stress regulation in at risk populations. In a sample of mothers with a history of depressive-, and/or anxiety disorders and their infants we explored if a history of maternal childhood trauma, current depressive and anxiety symptomatology, and recent life events were associated with maternal and infant long-term cortisol levels three months postpartum. Methods Data were available of 89 mothers and 49 infants. All mothers fulfilled criteria for a lifetime depressive or anxiety disorder. Diagnosis was established with a diagnostic interview. Current depressive symptomatology was assessed with the Edinburgh Postnatal Depression Scale (EPDS), current anxiety with the State-Trait Anxiety Inventory (STAI), maternal childhood trauma with the Childhood Trauma Questionnaire (CTQ) and recent life events with the Everyday Problem Checklist (EPC). Maternal and infant hair cortisol concentrations (HCC) were quantified with liquid chromatography with tandem mass spectrometry (LC-MS/MS) three months after birth. Total scores of the CTQ and subscales, EPDS, STAI, and EPC were regressed on maternal and infant HCC using regression analyses. Differences in HCC regarding trauma history were tested with t-tests. Potential confounders were identified and adjusted for. Results In regression analyses, a positive curvilinear relationship was found between CTQ total score and maternal HCC (n = 83, B = 0.076, SE 0.033, p = .021), but not for current depression (n = 88, B = -0.001, SE 0.011, p = .931), current anxiety (n = 88, B = 0.002, SE 0.004, p = .650) or recent life events (n = 89, B = 0.018, SE 0.032, p = .568). Analyses were adjusted for confounders. A negative linear relationship was found between maternal CTQ score and infant HCC (n = 49, β = -0.264, B = -0.006, SE 0.003, p = .052), but not for current maternal depression (n = 45, β = -0.182, B = -0.011, SE 0.008, p = .164), current maternal anxiety (n = 45, β = -0.209, B = -0.005, SE 0.003, p = .113) or recent life events (n = 46, β = -0.128, B = -0.022, SE 0.023, p = .325). Analyses were adjusted for relevant infant hair characteristics. Specifically, maternal emotional and physical neglect were related to HCC in both mothers and infants. Conclusions Results suggest that maternal childhood trauma is more prominent in altering maternal and infant long-term cortisol levels than perinatal depressive and anxiety symptomatology or recent life stressors in mothers with a history of depressive and/or anxiety disorders, and their infants. As infants of mothers with psychopathology are at increased risk for later psychiatric disease, future studies should investigate the interplay of possible risk factors for transgenerational transmission, intra-uterine programming of the HPA axis, including (epi-)genetic phenomena, of the HPA axis, and the influence of parenting impairment.
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Affiliation(s)
- Carlinde W. Broeks
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Nina Molenaar
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - Marlies Brouwer
- University Medical Centre Groningen, University of Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands,University of Amsterdam, Centre for Urban Mental Health, Amsterdam, the Netherlands
| | - Erica L.T. van den Akker
- Department of Pediatrics, Division of Pediatric Endocrinology, Sophia Children's Hospital and Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Elisabeth F.C. van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rien Van
- Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Sjoerd A.A. van den Berg
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Witte J.G. Hoogendijk
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Huibert Burger
- University Medical Centre Groningen, University of Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands
| | - Claudi Bockting
- University Medical Centre Groningen, University of Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands,University of Amsterdam, Centre for Urban Mental Health, Amsterdam, the Netherlands
| | - Astrid M. Kamperman
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Epidemiological and Social Psychiatric Research Institute, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mijke P. Lambregtse-Van den Berg
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands,Corresponding author. P.O. Box 2040, 3000, CA, Rotterdam, the Netherlands.
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Savas M, Mehta S, Agrawal N, van Rossum EFC, Feelders RA. Approach to the Patient: Diagnosis of Cushing Syndrome. J Clin Endocrinol Metab 2022; 107:3162-3174. [PMID: 36036941 PMCID: PMC9681610 DOI: 10.1210/clinem/dgac492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Indexed: 12/27/2022]
Abstract
Cushing syndrome results from supraphysiological exposure to glucocorticoids and is associated with significant morbidity and mortality. The pathogenesis includes administration of corticosteroids (exogenous Cushing syndrome) or autonomous cortisol overproduction, whether or not ACTH-dependent (endogenous Cushing syndrome). An early diagnosis of Cushing syndrome is warranted; however, in clinical practice, it is very challenging partly because of resemblance with other common conditions (ie, pseudo-Cushing syndrome). Initial workup should start with excluding local and systemic corticosteroid use. First-line screening tests including the 1-mg dexamethasone suppression test, 24-hour urinary free cortisol excretion, and late-night salivary cortisol measurement should be performed to screen for endogenous Cushing syndrome. Scalp-hair cortisol/cortisone analysis helps in the assessment of long-term glucocorticoid exposure as well as in detection of transient periods of hypercortisolism as observed in cyclical Cushing syndrome. Interpretation of results can be difficult because of individual patient characteristics and hence requires awareness of test limitations. Once endogenous Cushing syndrome is established, measurement of plasma ACTH concentrations differentiates between ACTH-dependent (80%-85%) or ACTH-independent (15%-20%) causes. Further assessment with different imaging modalities and dynamic biochemical testing including bilateral inferior petrosal sinus sampling helps further pinpoint the cause of Cushing's syndrome. In this issue of "Approach to the patient," the diagnostic workup of Cushing syndrome is discussed with answering the questions when to screen, how to screen, and how to differentiate the different causes. In this respect, the latest developments in biochemical and imaging techniques are discussed as well.
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Affiliation(s)
| | | | - Nidhi Agrawal
- Division of Endocrinology, NYU Langone Medical Center/ Bellevue Hospital Center, New York, NY
| | - Elisabeth F C van Rossum
- Correspondence: Elisabeth F.C. van Rossum, MD, PhD, Medicine, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Richard A Feelders
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Ma L, Liu X, Yan N, Gan Y, Wu Y, Li Y, Chu M, Chiu DT, Ma L. Associations Between Different Cortisol Measures and Adiposity in Children: A Systematic Review and Meta-Analysis. Front Nutr 2022; 9:879256. [PMID: 35811977 PMCID: PMC9260431 DOI: 10.3389/fnut.2022.879256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/30/2022] [Indexed: 12/12/2022] Open
Abstract
This study examined associations between hair, salivary, serum, and urinary cortisol concentration with adiposity-related indicators in children, and explored their potential effects modification by age, sex, cortisol measurement method, and country developmental context. We systematically searched PubMed, Web of Science, and Embase for studies examining at least one of the four aforementioned cortisol with objectively measured adiposity-related outcomes in children. Meta-analyses of cross-sectional studies revealed that hair cortisol concentration was associated with fat mass index (FMI)-standard deviation score (SDS)/FMI z-score (pooled-β = 0.04, 95% CI: 0.01, 0.08) and BMI/BMI z-score (pooled-β = 0.15, 95% CI: 0.06, 0.25), and these associations were significant among children aged ≤ 12 years (pooled-β = 0.15, 95% CI: 0.05, 0.26) and >12 years (pooled-β = 0.13, 95% CI: 0.04, 0.22), children from developed countries (pooled β = 0.12, 95% CI: 0.03, 0.21) and developing countries (pooled-β = 0.193, 95% CI: 0.188, 0.198), and in studies extracting cortisol via LC-MS/MS (pooled-β = 0.18, 95% CI: 0.06, 0.29) but not ELISA (pooled-β = 0.08, 95% CI: −0.06, 0.22). Meta-analyses of both cohort and cross-sectional studies revealed non-significant associations of morning salivary cortisol concentration and total daily cortisol output with BMI/BMI z-score. Serum cortisol concentration was not associated with BMI or waist circumference. Meta-analysis of urinary cortisol concentration and adiposity was hindered by insufficient data. These findings further corroborate understanding of chronic stress’ physiological contribution to increased pediatric obesity risk.
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Affiliation(s)
- Lu Ma
- School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Xi Liu
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Na Yan
- School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Yiqun Gan
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Yue Wu
- Department of Cardiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, China
- Key Laboratory of Molecular Cardiology, Xi’an, China
| | - Ying Li
- Department of Cardiology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Meng Chu
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Dorothy T. Chiu
- Community Health Sciences Division, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
- *Correspondence: Dorothy T. Chiu,
| | - Le Ma
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- Le Ma,
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Zhu M, Yuan L, Wu Y, Chu L, Wang W, Zhang H, Liao W, Peng X, Deng H. Simultaneous LC-MS/MS quantification of glucocorticoids, melatonin and its metabolites in hair. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1196:123217. [DOI: 10.1016/j.jchromb.2022.123217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/21/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
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18
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A quantitative ultra-performance liquid chromatography high-resolution mass spectrometry analysis of steroids from human scalp hair. J Pharm Biomed Anal 2022; 215:114768. [DOI: 10.1016/j.jpba.2022.114768] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/25/2022] [Accepted: 04/12/2022] [Indexed: 11/19/2022]
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19
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van de Poll-Franse LV, Horevoorts N, Schoormans D, Beijer S, Ezendam NPM, Husson O, Oerlemans S, Schagen SB, Hageman GJ, Van Deun K, van den Hurk C, van Eenbergen M, Mols F. Measuring Clinical, Biological, and Behavioral Variables to Elucidate Trajectories of Patient (Reported) Outcomes: The PROFILES Registry. J Natl Cancer Inst 2022; 114:800-807. [PMID: 35201353 PMCID: PMC9194631 DOI: 10.1093/jnci/djac047] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/05/2021] [Accepted: 02/17/2022] [Indexed: 11/14/2022] Open
Abstract
To take cancer survivorship research to the next level, it's important to gain insight in trajectories of changing patient (reported) outcomes and impaired recovery after cancer. This is needed as the number of survivors is increasing and a large proportion is confronted with changing health after treatment. Mechanistic research can facilitate the development of personalized risk-stratified follow-up care and tailored interventions to promote healthy cancer survivorship. We describe how these trajectories can be studied by taking the recently extended Dutch population-based PROFILES (Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship) registry as an example. PROFILES combines longitudinal assessment of patient-reported outcomes with novel, ambulatory and objective measures (e.g., activity trackers; blood draws; hair samples; online food diaries; online cognitive tests; weighing scales; online symptoms assessment), and cancer registry and pharmacy databases. Furthermore, we discuss methods to optimize the use of a multidomain data collection like return of individual results to participants which may not only improve patient empowerment but also long-term cohort retention. Also, advanced statistical methods are needed to handle high-dimensional longitudinal data (with missing values) and provide insight into trajectories of changing patient (reported) outcomes after cancer. Our coded data can be used by academic researchers around the world. Registries like PROFILES, that go beyond boundaries of disciplines and institutions, will contribute to better predictions of who will experience changes and why. This is needed to prevent and mitigate long-term and late effects of cancer (treatment) and to identify new interventions to promote health.
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Affiliation(s)
- Lonneke V van de Poll-Franse
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,CoRPS - Center of Research on Psychological disorders and Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Psychosocial Research, Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Nicole Horevoorts
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,CoRPS - Center of Research on Psychological disorders and Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Dounya Schoormans
- CoRPS - Center of Research on Psychological disorders and Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Sandra Beijer
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Nicole P M Ezendam
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,CoRPS - Center of Research on Psychological disorders and Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Olga Husson
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Simone Oerlemans
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Sanne B Schagen
- Department of Psychosocial Research, Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Geja J Hageman
- Department of Pharmacology & Toxicology, Research Institute NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Katrijn Van Deun
- Department of methodology and statistics, Tilburg University, Tilburg, The Netherlands
| | - Corina van den Hurk
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Mies van Eenbergen
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Floortje Mols
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,CoRPS - Center of Research on Psychological disorders and Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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20
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Galbally M, Watson SJ, van Rossum EFC, Chen W, de Kloet ER, Lewis AJ. The perinatal origins of childhood anxiety disorders and the role of early-life maternal predictors. Psychol Med 2022; 52:506-514. [PMID: 32597740 DOI: 10.1017/s0033291720002147] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND The development of childhood anxiety disorders (CADs) is likely to depend on pathways that can be programmed by early-life risk factors. We test the hypothesis that early-life maternal factors can predict this programming effect on CAD. METHODS Data were obtained from 198 women and children from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a cohort study with data collected across pregnancy, postpartum and until 4 years of age. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV), together with antenatal hair cortisol concentrations, maternal childhood trauma and parenting stress at 6 months postpartum. CAD was assessed with the Preschool Age Psychiatric Assessment and the Child Behaviour Checklist. RESULTS Antenatal depression, a history of maternal childhood trauma and lower gestational age at birth were each associated with anxiety disorders at 4 years of age in their children. A multivariate binary logistic model with these early predictors explained approximately 9% of variance in CAD outcome at 4 years of age; however, only maternal trauma and gestational age were significant predictors in the model. The effect of early parenting stress on CAD was found to vary by the concentration of maternal antenatal hair cortisol, whereby postpartum parenting stress was associated with CAD only when there were higher maternal antenatal cortisol levels. CONCLUSIONS This study suggests the importance of maternal factors pre-conception, pregnancy and in the postnatal period, which predict CADs and this is consistent with a developmental programming hypothesis for CAD.
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Affiliation(s)
- Megan Galbally
- 1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
- School of Medicine, University of Notre Dame, Fremantle, Australia
- King Edward Memorial Hospital, Subiaco, Australia
| | - Stuart J Watson
- 1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
- School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wai Chen
- School of Medicine, University of Notre Dame, Fremantle, Australia
- Graduate School of Education, University of Western Australia, Crawley, Australia
| | - Edo Ronald de Kloet
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrew J Lewis
- 1. The College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
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21
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Jalaba S, Trudeau H, Carlson S. Obesity Prevention. PHYSICIAN ASSISTANT CLINICS 2022. [DOI: 10.1016/j.cpha.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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22
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Puglisi S, Leporati M, Amante E, Parisi A, Pia AR, Berchialla P, Terzolo M, Vincenti M, Reimondo G. Limited Role of Hair Cortisol and Cortisone Measurement for Detecting Cortisol Autonomy in Patients With Adrenal Incidentalomas. Front Endocrinol (Lausanne) 2022; 13:833514. [PMID: 35222288 PMCID: PMC8863572 DOI: 10.3389/fendo.2022.833514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/12/2022] [Indexed: 11/24/2022] Open
Abstract
Several studies demonstrated the diagnostic accuracy of hair glucocorticoid measurement in patients with overt Cushing syndrome, but few data are available for patients with adrenal incidentaloma (AI) and cortisol autonomy. The aim of our study was to assess whether measurement of 5 corticosteroid hormones with the ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method in the keratin matrix is useful to stratify patients with AI by the presence of autonomous cortisol secretion [ACS] (defined as serum cortisol after 1 mg dexamethasone suppression test (DST) > 138 nmol/l) or possible ACS [PACS] (defined as serum cortisol after 1 mg DST > 50 nmol/l but ≤138 nmol/l). We analysed data of 67 AI patients (32 with cortisol autonomy) and 81 healthy subjects. We did not find any significant statistical difference comparing hair cortisol, cortisone, and 20β-dihydrocortisol concentrations between healthy controls and AI patients, while 6β-hydroxycortisol and 11-deoxycortisol were undetectable. Moreover, no significant difference was found in hair cortisol, cortisone, and 20β-dihydrocortisol levels of AI patients with or without cortisol autonomy. Finally, we did not find any correlation in patients with AI between hormonal concentrations in the keratin matrix and serum, salivary, and urinary cortisol levels, or with body mass index. In conclusion, our findings suggest that hair glucocorticoid measurement is not suitable as a diagnostic test for cortisol autonomy (ACS and PACS).
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Affiliation(s)
- Soraya Puglisi
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
- *Correspondence: Soraya Puglisi,
| | - Marta Leporati
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Turin, Italy
| | | | - Alice Parisi
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Anna Rosa Pia
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Paola Berchialla
- Statistical Unit, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Massimo Terzolo
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Turin, Italy
- Department of Chemistry, University of Turin, Turin, Italy
| | - Giuseppe Reimondo
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
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23
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Mourtakos S, Vassiliou G, Kontoangelos K, Philippou A, Tzavellas E, Tornero-Aguilera JF, Clemente-Suárez VJ, Papageorgiou C, Sidossis LS, Papageorgiou C. Endocannabinoids and Heart Rate Variability Alterations after Exposure to Prolonged Intensive Physical Exercise of the Hellenic Navy SEALs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010028. [PMID: 35010291 PMCID: PMC8750887 DOI: 10.3390/ijerph19010028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/16/2021] [Accepted: 12/18/2021] [Indexed: 12/25/2022]
Abstract
Background: Recent research indicates that both endocannabinoids (eCB) and heart rate variability (HRV) are associated with stress-induced experiences. However, these underlying mechanisms are not elucidated. The present study aims to investigate whether exposure to acute and chronic stress conditions can give rise to measurable changes, both to the peripheral eCB ligands and HRV. Methods: Thirteen candidates under intense preparation for their enlistment in the Hellenic Navy SEALs (HNS) participated in the study. All subjects underwent mental state examination, while HRV variables in time and frequency domain recordings were acquired. Furthermore, at baseline and 30 days after prolonged and intensive physical exercise, hair was collected to measure eCB ligands, such as anandamide (AEA), 2-arachidonoylglycerol (2-AG), and the N-acyl ethanolamine (NAE) molecules: palmitoylethanolamide (PEA) and oleoylethanolamide (OEA). Results: Comparing basal hair concentrations of eCB ligands before and after intense physical exercise, we found that AEA, PEA, and OEA were notably increased, whereas no differences were observed regarding the ligand 2-AG. Furthermore, there were observed associations between the concentrations of peripheral eCB ligands, both at baseline and after the prolonged physical exercise and the time and frequency domains of HRV. Conclusions: These findings suggest that endocannabinoid–HRV interrelations might share a short-term, and long-term adaptability of the changes in self-regulation associated with stress. Further studies will be required to determine the validity of peripheral eCB signaling and HRV as a biomarker for different aspects of the stress response.
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Affiliation(s)
- Stamatis Mourtakos
- Department of Psychiatry, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (G.V.); (K.K.); (E.T.); (C.P.)
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
- Correspondence: ; Tel.: +30-6937065522
| | - Georgia Vassiliou
- Department of Psychiatry, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (G.V.); (K.K.); (E.T.); (C.P.)
- Neurosciences and Precision Medicine Research Institute “Costas Stefanis”, University Mental Health, 115 27 Athens, Greece
| | - Konstantinos Kontoangelos
- Department of Psychiatry, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (G.V.); (K.K.); (E.T.); (C.P.)
- Neurosciences and Precision Medicine Research Institute “Costas Stefanis”, University Mental Health, 115 27 Athens, Greece
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | - Elias Tzavellas
- Department of Psychiatry, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (G.V.); (K.K.); (E.T.); (C.P.)
| | | | - Vicente Javier Clemente-Suárez
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (J.F.T.-A.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
| | - Charalabos Papageorgiou
- Department of Psychiatry, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (G.V.); (K.K.); (E.T.); (C.P.)
- Neurosciences and Precision Medicine Research Institute “Costas Stefanis”, University Mental Health, 115 27 Athens, Greece
| | - Labros S. Sidossis
- Department of Nutrition and Dietetics, Harokopio University of Athens, 115 27 Athens, Greece;
- Department of Kinesiology and Health, Division of Life Sciences, Rutgers University, New Brunswick, NJ 08901, USA
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24
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Mazgelytė E, Rekienė V, Dereškevičiūtė E, Petrėnas T, Songailienė J, Utkus A, Chomentauskas G, Karčiauskaitė D. Effects of Virtual Reality-Based Relaxation Techniques on Psychological, Physiological, and Biochemical Stress Indicators. Healthcare (Basel) 2021; 9:healthcare9121729. [PMID: 34946455 PMCID: PMC8701384 DOI: 10.3390/healthcare9121729] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 12/17/2022] Open
Abstract
Various relaxation techniques could benefit from merging with virtual reality (VR) technologies, as these technologies are easily applicable, involving, and user-friendly. To date, it is unclear which relaxation technique using biofeedback combined with VR technology is the most effective. The study aimed to compare the effectiveness of brief VR-based biofeedback-assisted relaxation techniques including electroencephalographic biofeedback, mindfulness-based biofeedback, galvanic skin response biofeedback, and respiratory biofeedback. Forty-three healthy volunteers (age 34.7 ± 7.2 years), comprising 28 (65%) women and 15 (35%) men, were enrolled in the study. All the participants were exposed to four distinct relaxation sessions according to a computer-generated random sequence. The efficacy of relaxation methods was evaluated by examining psychological, physiological, and biochemical stress indicators. All VR-based relaxation techniques reduced salivary steroid hormone (i.e., cortisol, cortisone, and total glucocorticoid) levels and increased galvanic skin response values. Similarly, all interventions led to a significantly reduced subjectively perceived psychological strain level. Three out of the four interventions (i.e., electroencephalographic, respiratory, and galvanic skin response-based biofeedback relaxation sessions) resulted in a decreased self-reported fatigue level. We suggest that newly developed VR-based relaxations techniques are potential tools for stress reduction and might be particularly suitable for individuals who are not capable of adhering to a strict and time-consuming stress management intervention schedule.
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Affiliation(s)
- Eglė Mazgelytė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania;
- Correspondence:
| | - Virginija Rekienė
- Human Study Center, LT-01132 Vilnius, Lithuania; (V.R.); (E.D.); (G.C.)
| | | | - Tomas Petrėnas
- Department of Human and Medical Genetics, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, LT-03101 Vilnius, Lithuania; (T.P.); (J.S.); (A.U.)
| | - Jurgita Songailienė
- Department of Human and Medical Genetics, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, LT-03101 Vilnius, Lithuania; (T.P.); (J.S.); (A.U.)
| | - Algirdas Utkus
- Department of Human and Medical Genetics, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, LT-03101 Vilnius, Lithuania; (T.P.); (J.S.); (A.U.)
| | | | - Dovilė Karčiauskaitė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania;
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25
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The Association between Endogenous Hair Steroid Hormones and Social Environmental Factors in a Group of Conscripts during Basic Military Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212239. [PMID: 34831996 PMCID: PMC8625620 DOI: 10.3390/ijerph182212239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 12/30/2022]
Abstract
This study aimed to analyse the association between endogenous hair steroid hormones as reliable biological indicators of an individual’s stress level and the social environmental factors experienced during military training that are manifested at the beginning of compulsory military service. Hair steroid hormone concentrations—cortisol, cortisone, dehydroepiandrosterone (DHEA), and testosterone—in a group of 185 conscripts were measured using the ultra-high performance liquid chromatography-tandem mass spectrometry method. Six subjective social environmental factors in the military—attitude towards the military and military service, adaptation to the military environment, team, task, and norm cohesion, as well as psychological (un)safety in the group—were evaluated using military-specific research questionnaires. Weak but significant negative correlations were identified between cortisol and adaptation (r = −0.176, p < 0.05), attitude (r = −0.147, p < 0.05) as well as between testosterone and task cohesion (r = −0.230, p < 0.01) levels. Additionally, a multiple forward stepwise regression analysis highlighted that cortisone variation might be partially explained by task cohesion; the DHEA—determined by psychological (un)safety in the group, attitude towards the military and military service, and norm cohesion; and the testosterone—determined by task cohesion and adaptation to the new military environment. The results of this study suggest that subjective measures of social factors can be used to predict hair steroid hormone levels as objective measures of the chronic stress perceived by conscripts during their basic military training.
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26
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Schuurmans AAT, Nijhof KS, Scholte R, Popma A, Otten R. Effectiveness of game-based meditation therapy on neurobiological stress systems in adolescents with posttraumatic symptoms: a randomized controlled trial. Stress 2021; 24:1042-1049. [PMID: 34761730 DOI: 10.1080/10253890.2021.1998444] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Many adolescents in residential care have experienced traumatic events and suffer from posttraumatic stress. Prolonged activation of neurobiological stress systems as the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis can result in long-lasting maladaptive alternations. This study investigated the effectiveness of Muse, a game-based meditation intervention, on the sympathetic nervous system (SNS), parasympathetic nervous system (PNS), and cortisol basal activity and reactivity to acute stress among adolescents with posttraumatic symptoms in residential care. The intervention consisted of two gameplay sessions a week, for 6 consecutive weeks. Seventy-seven adolescents with clinical levels of posttraumatic symptoms (10-18 years old) received either Muse as an addition to treatment as usual (n = 40) or treatment as usual alone (n = 37). We expected reduced basal activity for the SNS and cortisol and increased basal activity for the PNS. As for the response to acute stress, we expected decreased PNS and increased HPA axis reactivity. The Muse group exhibited lower basal activity for the SNS and increased HPA reactivity to acute stress. There were no differences between conditions on SNS and HPA axis activity during rest and on SNS and PNS reactivity to acute stress. Game-based meditation therapy is a promising intervention for the treatment of adolescents with posttraumatic symptoms in residential care. Implications for clinical relevance and trauma-focused treatment purposes are discussed.
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Affiliation(s)
- Angela A T Schuurmans
- Department of Research and Development, Pluryn, Nijmegen, the Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Karin S Nijhof
- Department of Research and Development, Pluryn, Nijmegen, the Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Ron Scholte
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands
- Praktikon, Nijmegen, the Netherlands
- Tranzo, Tilburg University, Tilburg, the Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry, VUmc/De Bascule, Amsterdam, the Netherlands
| | - Roy Otten
- Department of Research and Development, Pluryn, Nijmegen, the Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands
- ASU REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
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Schuurmans AAT, Nijhof KS, Cima M, Scholte R, Popma A, Otten R. Alterations of autonomic nervous system and HPA axis basal activity and reactivity to acute stress: a comparison of traumatized adolescents and healthy controls. Stress 2021; 24:876-887. [PMID: 33860734 DOI: 10.1080/10253890.2021.1900108] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Alterations in neurobiological stress systems such as the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis contribute to the development and maintenance of psychological and behavioral problems after traumatic experiences. Investigating neurobiological parameters and how these relate to each other may provide insight into the complex mechanisms at play. Whereas the preponderance of studies focuses on either the ANS or the HPA axis separately, the current study is the first to evaluate relations between posttraumatic stress and both basal activity during rest and stress reactivity of the ANS as well as the HPA axis in a sample of traumatized adolescents and healthy controls. The traumatized sample (n = 77), based on clinical levels of posttraumatic stress, was a convenience sample that was recruited within residential institutions, was compared to a healthy control sample (n = 48) recruited within the general community. For the ANS, we expected increased SNS and decreased PNS activity during rest and increased SNS and decreased PNS reactivity to social stress among traumatized adolescents compared to healthy controls. Regarding the HPA axis, we expected increased basal cortisol levels and decreased cortisol reactivity to stress in the traumatized sample. Compared to healthy controls, traumatized adolescents exhibited significantly higher sympathetic and lower parasympathetic activation during rest and increased sympathetic reactivity to acute stress (ANS parameters). Outcomes on the HPA axis (i.e. cortisol) indicated that traumatized adolescents showed increased cortisol levels during rest and blunted cortisol reactivity to acute stress. Implications for clinical relevance and trauma-focused treatment purposes are discussed.
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Affiliation(s)
- Angela A T Schuurmans
- Department of Research and Development, Pluryn, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Karin S Nijhof
- Department of Research and Development, Pluryn, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Maaike Cima
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Ron Scholte
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
- Praktikon, Nijmegen, The Netherlands
- Tranzo, Tilburg University, Tilburg, The Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry, Amsterdam Public Health - Mental Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Roy Otten
- Department of Research and Development, Pluryn, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
- ASU REACH Institute, Department of Psychology, Arizona State University, Tempe, AZ, USA
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28
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Decker Soares DR, Bastiani MF, Schneider A, Hahn RZ, Lizot LF, Perassolo MS, Antunes MV, Linden R. Determination of cortisol in hair using UHPLC-MS/MS: application to patients admitted for ethanol dependence treatment. Bioanalysis 2021; 13:1559-1568. [PMID: 34636657 DOI: 10.4155/bio-2021-0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/21/2021] [Indexed: 11/17/2022] Open
Abstract
Aim: Cortisol hair levels can be used to evaluate chronic stress status. In this context, an improved UHPLC-MS/MS assay for the determination of cortisol in hair was developed and validated. Materials & methods: Hair was extracted with methanol for 4 h at 25°C. Chromatographic run time was 5.5 min. The assay was linear in the range of 1-250 pg mg-1. Precision was 3.6-12.2% and accuracy 97.1-103.8%. The method was applied in hair from 19 volunteers admitted at a rehabilitation clinic, with ethanol consumption classified using ethyl glucuronide hair levels. Conclusion: Abstinent/chronic moderate ethanol consumers had significantly lower cortisol hair levels than chronic excessive consumers. This is the first study evaluating cortisol hair levels in ethanol abuse patients using an objective marker for ethanol consumption.
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Affiliation(s)
- Daniella Rheingantz Decker Soares
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil
- Graduate Program on Toxicology & Analytical Toxicology, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | | | - Anelise Schneider
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil
| | - Roberta Zilles Hahn
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil
| | | | - Magda Susana Perassolo
- Graduate Program on Toxicology & Analytical Toxicology, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | - Marina Venzon Antunes
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil
- Graduate Program on Toxicology & Analytical Toxicology, Universidade Feevale, Novo Hamburgo, RS, Brazil
| | - Rafael Linden
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil
- Graduate Program on Toxicology & Analytical Toxicology, Universidade Feevale, Novo Hamburgo, RS, Brazil
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Damen L, Donze SH, Grootjen LN, Hokken-Koelega ACS. Long-term cortisol levels in hair of children and adolescents with Prader-Willi Syndrome. Psychoneuroendocrinology 2021; 132:105335. [PMID: 34225184 DOI: 10.1016/j.psyneuen.2021.105335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/06/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
CONTEXT Prader-Willi syndrome (PWS) is characterized by hypothalamic dysfunction. In children with PWS, stress-induced central adrenal insufficiency (CAI) has been described, however, daily life cortisol production may be normal. Hair cortisol concentration (HCC) is a marker of long-term systemic cortisol production. Cortisol awakening response (CAR) is the increase in cortisol level after awakening. A negative CAR might suggest hypothalamic-pituitary-adrenal (HPA)-axis reactivity problems. Little is known about HCC and CAR in children with PWS. OBJECTIVE To investigate long-term cortisol levels in hair and CAR in children with PWS. DESIGN Cross-sectional study. PATIENTS 41 children with PWS. SETTING Dutch PWS Reference Center. MAIN OUTCOME MEASURES HCC and salivary cortisol measured by LCMS. RESULTS Median (IQR) HCC was 1.90 (1.02-3.30) pg/mg at a median (IQR) age of 14.5 (8.20-19.0) years, with median HCC in age-matched references being 2.63 pg/mg. Five patients (13.2%) had HCC < 2.5th percentile for age and these patients had a repeatedly negative CAR. Median HCC was significantly lower in patients with negative CAR than in patients with normal CAR (1.00 (0.22-1.59) vs. 2.25 (1.47-3.26) pg/mg, p = 0.007). One patient had both HCC < 2.5th percentile and repeatedly low morning salivary cortisol levels and negative CAR, and was diagnosed with adrenal insufficiency by overnight metyrapone test. CONCLUSIONS HCC were normal in the majority of children with PWS. Our data suggest that children with HCC < 2.5th percentile and (repeatedly) negative CAR might possibly have adrenal insufficiency or delayed HPA-axis responsiveness.
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Affiliation(s)
- L Damen
- Dutch Growth Research Foundation, Rotterdam, The Netherlands; Department of Pediatrics, Subdivision of Endocrinology Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Dutch Reference Center for Prader-Willi Syndrome, The Netherlands.
| | - S H Donze
- Dutch Growth Research Foundation, Rotterdam, The Netherlands; Department of Pediatrics, Subdivision of Endocrinology Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Dutch Reference Center for Prader-Willi Syndrome, The Netherlands
| | - L N Grootjen
- Dutch Growth Research Foundation, Rotterdam, The Netherlands; Department of Pediatrics, Subdivision of Endocrinology Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Dutch Reference Center for Prader-Willi Syndrome, The Netherlands
| | - A C S Hokken-Koelega
- Dutch Growth Research Foundation, Rotterdam, The Netherlands; Department of Pediatrics, Subdivision of Endocrinology Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands; Dutch Reference Center for Prader-Willi Syndrome, The Netherlands
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van der Valk ES, van der Voorn B, Iyer AM, Mohseni M, Leenen PJM, Dik WA, van den Berg SAA, de Rijke YB, van den Akker ELT, Penninx BWJH, van Rossum EFC. Hair cortisol, obesity and the immune system: Results from a 3 year longitudinal study. Psychoneuroendocrinology 2021; 134:105422. [PMID: 34666286 DOI: 10.1016/j.psyneuen.2021.105422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Higher long-term glucocorticoid levels, measured in scalp hair (HairGC), are associated with obesity. This may represent the state of obesity (perhaps interrelated with chronic immune activation), but could also promote further weight gain. We studied whether hair cortisol (HairF) and hair cortisone (HairE) predict changes in body mass index (BMI) and waist circumference (WC) over time, and assessed the association between HairGC and common immune parameters. METHODS We measured HairGC in 1604 participants of the Netherlands Study of Depression and Anxiety (NESDA), and investigated their associations to BMI, WC, and immune parameters (interleukin-6 (IL-6), C-reactive protein (CRP), and leukocyte subsets). Also, we assessed whether baseline HairGC predict changes in BMI and WC at follow-up (three years later). RESULTS In cross-sectional analyses, HairF and HairE were positively associated to BMI (β = 2.06 kg/m2, 95% confidence interval (CI)= 1.22-2.90 kg/m2) and β = 2.84 kg/m2 (95%CI 1.75-3.93 kg/m2) respectively) and WC (β = 5.36 cm (95%CI 3.09-7.62 cm) and β = 8.54 cm (95%CI 5.60-11.48 cm) respectively, all p < 0.001). HairF was also positively associated to IL-6 (β = 0.15 (95%CI 0.003-0.292) p < 0.05) and leukocyte count (β = 0.57 (95%CI 0.234-0.909), p < 0.01), and HairE to IL-6 (β = 0.21 (95%CI 0.016-0.399), p < 0.05). In the longitudinal analyses, higher HairF was associated with yearly increases in BMI (β = 0.58% BMI change per year (95%CI 0.14-1.01%), p = 0.009) and higher HairE with increases in WC (β = 0.84% WC change per year (95%CI 0.02-1.69%), p = 0.049). Adjusting for baseline IL-6 or leukocytes did not change the found associations between HairGC and WC or BMI change. CONCLUSIONS HairGC levels are positively associated to BMI, WC, IL-6 and leukocyte numbers in cross-sectional analyses, and to increases in BMI and WC in longitudinal analyses. Although causality is yet to be proven, higher long-term glucocorticoid levels could represent a relevant risk factor for the development of obesity.
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Affiliation(s)
- Eline S van der Valk
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Bibian van der Voorn
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anand M Iyer
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mostafa Mohseni
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Pieter J M Leenen
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Willem A Dik
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Laboratory Medical Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sjoerd A A van den Berg
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Clinical Chemistry, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Yolanda B de Rijke
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Clinical Chemistry, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Erica L T van den Akker
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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Vehmeijer FOL, Santos S, de Rijke YB, van den Akker ELT, Felix JF, van Rossum EFC, Jaddoe VWV. Associations of Hair Cortisol Concentrations With Cardiometabolic Risk Factors in Childhood. J Clin Endocrinol Metab 2021; 106:e3400-e3413. [PMID: 34050761 PMCID: PMC8372666 DOI: 10.1210/clinem/dgab379] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Indexed: 12/17/2022]
Abstract
CONTEXT Biological stress is related to cardiovascular disease in adults. The associations of stress with cardiovascular and metabolic diseases may originate in childhood. OBJECTIVE This work aims to examine the associations of hair cortisol concentrations at age 6 years with cardiometabolic risk factors at ages 6 and 10 years. METHODS Cortisol concentrations were measured in hair of 6-year-old children (n = 2598) participating in the Generation R Study, a population-based prospective cohort study in Rotterdam, the Netherlands. Main outcome measures included blood pressure, heart rate, concentrations of insulin, glucose, lipids, and C-reactive protein in blood at ages 6 and 10 years. RESULTS Higher hair cortisol concentrations at age 6 years were associated with higher systolic blood pressure at age 10 years (difference 0.17 SD score; 95% CI, 0.03-0.31). The association attenuated into nonsignificance after adjustment for childhood body mass index (BMI) at age 6 years. Higher hair cortisol concentrations at age 6 years were associated with an increase in total and low-density lipoprotein cholesterol between ages 6 and 10 years but not with those measurements at age 6 or 10 years. Hair cortisol concentrations were not associated with other cardiometabolic risk factors at age 6 or 10 years. CONCLUSION Hair cortisol concentrations were not independent of BMI associated with cardiometabolic risk factors at 6 or 10 years. The associations of biological stress with cardiometabolic risk factors may develop at later ages.
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Affiliation(s)
- Florianne O L Vehmeijer
- The Generation R Study Group, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
| | - Yolanda B de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
| | - Erica L T van den Akker
- Department of Pediatrics, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
| | - Elisabeth F C van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, CA Rotterdam, the Netherlands
- Correspondence: Vincent W. V. Jaddoe, MD, PhD, Erasmus MC (Na 29-08), PO Box 2040, 3000 CA Rotterdam, the Netherlands.
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Plasma androgens and the presence and course of depression in a large cohort of men. Psychoneuroendocrinology 2021; 130:105278. [PMID: 34049017 DOI: 10.1016/j.psyneuen.2021.105278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/10/2021] [Accepted: 05/17/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Hypoandrogenic men showed a higher prevalence of major depressive disorder (MDD), which could be ascribed to overlapping symptoms such as sexual dysfunction, or additionally to core emotional symptoms such as sadness and anhedonia. We examined whether androgen levels 1) differ between men with and without MDD cross-sectionally, 2) are associated with an elevated risk for onset of MDD prospectively, and 3) associate with all individual MDD symptoms, or only with hypogonadism overlapping symptoms. METHODS In 823 men (mean age 43.5 years), baseline plasma levels of total testosterone, 5α-dihydrotestosterone (5α-DHT), and androstenedione were determined with liquid chromatography-tandem mass spectrometry, and dehydroepiandrosterone-sulphate (DHEAS) and sex hormone binding globulin with radioimmunoassay, whereas free testosterone was calculated. MDD status was assessed at baseline and after two years using structured interviews and individual MDD symptoms were self-rated at baseline, and after one and two years. RESULTS None of the androgen levels were associated with current or onset (incidence or recurrence) of MDD. Free testosterone was only inversely associated with interest in sex. Also, androstenedione and DHEAS were positively associated with some individual MDD symptoms, and 5α-DHT levels showed non-linear associations (both with low and high levels) with MDD symptom severity and several individual MDD symptoms. CONCLUSIONS These results support the idea that circulating androgens synthesised by the testes are of limited clinical relevance to MDD in adult men, but levels of androstenedione, DHEAS and 5α-DHT may be associated with some individual MDD symptoms.
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Cajachagua-Torres KN, Jaddoe VWV, de Rijke YB, van den Akker ELT, Reiss IKM, van Rossum EFC, El Marroun H. Parental cannabis and tobacco use during pregnancy and childhood hair cortisol concentrations. Drug Alcohol Depend 2021; 225:108751. [PMID: 34051550 DOI: 10.1016/j.drugalcdep.2021.108751] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/19/2021] [Accepted: 04/03/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Fetal exposure to cannabis and tobacco during pregnancy leads to adverse fetal and childhood outcomes. We hypothesized that fetal exposure to cannabis and tobacco have persistent programming effects on hypothalamic pituitary adrenal (HPA) axis functioning in childhood. Therefore, we examined the associations of parental cannabis and tobacco use during pregnancy with childhood hair cortisol and cortisone concentrations at 6 years, as biomarkers of long-term HPA-axis functioning. METHOD In a population-based prospective birth cohort among 2577 mothers and their children, information of parental cannabis and tobacco use was collected by questionnaires, and maternal urine samples were additionally analyzed to detect cannabis metabolite concentrations. Cortisol and cortisone were measured in hair samples at 6 years. Linear regression analysis with adjustment for several confounders was used to test our hypothesis. RESULTS As compared to non-exposed children, offspring exposed to cannabis during pregnancy (in combination with tobacco) had higher childhood cortisol concentrations (log-10 transformed difference 0.16, 95 % Confidence Interval 0.04 to 0.28). This association was not mediated by birth weight. No differences in cortisone concentrations among cannabis-exposed children were observed. Maternal tobacco use during pregnancy was not associated with childhood cortisol or cortisone concentrations. Further, paternal cannabis or tobacco use was not associated with childhood cortisol or cortisone concentrations. CONCLUSIONS Our findings suggest that maternal cannabis use, combined with tobacco, during pregnancy is associated with alterations in offspring HPA-axis functioning. Further studies need to replicate these findings, and assess the causality and long-term consequences of these associations.
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Affiliation(s)
- Kim N Cajachagua-Torres
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands.
| | - Yolanda B de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, 3015GD, Rotterdam, the Netherlands; Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, 3000CA, Rotterdam, the Netherlands
| | - Erica L T van den Akker
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands; Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, 3000CA, Rotterdam, the Netherlands
| | - Irwin K M Reiss
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Elisabeth F C van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, 3000CA, Rotterdam, the Netherlands; Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, 3000CA, Rotterdam, the Netherlands
| | - Hanan El Marroun
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Center Rotterdam, 3000CB, Rotterdam, the Netherlands; Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, 3062PA, Rotterdam, the Netherlands
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Broeks CW, Kok R, Choenni V, Van R, Hoogendijk W, Hillegers M, Kamperman A, Lambregtse-Van den Berg MP. Salivary cortisol reactivity in 6-month-old infants of mothers with severe psychiatric disorders: findings from the face-to-Face Still-Face paradigm. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 7:100078. [PMID: 35757057 PMCID: PMC9216463 DOI: 10.1016/j.cpnec.2021.100078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/10/2021] [Accepted: 08/02/2021] [Indexed: 11/21/2022] Open
Abstract
Background. Maternal psychopathology is associated with altered HPA axis functioning in offspring. Most studies have focused on mildly affected populations, but less is known about the effect of severe maternal psychopathology. In our explorative study we investigated in a heterogenic sample of mothers with severe and long-lasting psychiatric disorders, if a diagnosis of depression and severity of general maternal psychiatric symptomatology were associated with infant salivary cortisol reactivity to the Face-to-Face Still-Face (FFSF) paradigm at 6 months of age. Methods. A clinical sample of 36 mother-infant dyads was explored. All mothers fulfilled criteria for a severe psychiatric disorder and had psychiatric complaints for the last two consecutive years. Maternal diagnosis was established during pregnancy using a diagnostic interview and general maternal psychiatric symptom severity was established by self-report at the time of the FFSF procedure. The FFSF paradigm was used to assess infants’ response to social stress at the age of 6 months. Infant saliva samples were collected at three time points: 5 min before and 15 and 30 min after the social stressor. Cortisol reactivity was operationalized as incremental Area Under the Curve (AUCi). Potential confounders were identified and adjusted for. Results. In regression analyses, a negative relationship was found between infant cortisol reactivity (AUCi) during the FFSF paradigm at 6 months and general maternal symptom severity at time of the FFSF paradigm (unadjusted n = 36, ß = −0.331, B = −9.758, SE 4.8, p = .048; adjusted n = 36, ß = −0.335, B = −9.868, SE 4.5, p = .039) and for diagnosis of perinatal depression at trend level (unadjusted n = 36, ß = −0.293, B = −8.640, SE 4.8, p = .083; adjusted n = 36, ß = −0.317, B = −9.347, SE 4.6, p = .052). Analyses were adjusted for gestational age. Conclusions. Preliminary results on cortisol reactivity in 6-month-old infants of mothers with severe and long-lasting psychiatric disorders show a significant reduction in the group of mothers who experienced a high level of psychiatric symptoms in the post-partum period, compared to mothers with lower levels of psychiatric symptomatology. The same trend was found for mothers with and without a diagnosis of perinatal depression. Since these infants are considered to be at increased risk for later psychopathology, our study suggests that future longitudinal studies should investigate whether reduced cortisol reactivity in babies could be a marker for any adverse outcomes, besides other possible risk factors (e.g. (epi)genetic phenomena). Psychiatric symptom severity in mothers might affect infant cortisol reactivity during the Face-to-Face-Still-Face (FFSF) paradigm. Infants of mothers with a diagnosis of depression show borderline diminished reactivity of cortisol during the FFSF paradigm. Under-activation of cortisol reactivity in infants of severely affected mothers might point to early patterns of blunted HPA-axis functioning.
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Affiliation(s)
- Carlinde W. Broeks
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, the Netherlands
- Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Rianne Kok
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands
| | - Vandhana Choenni
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Rien Van
- Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Witte Hoogendijk
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Astrid Kamperman
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, the Netherlands
- Epidemiological and Social Psychiatric Research Institute, Erasmus MC, Rotterdam, the Netherlands
| | - Mijke P. Lambregtse-Van den Berg
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, the Netherlands
- Corresponding author. PhD Address: P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
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Parental Stress and Scalp Hair Cortisol in Excessively Crying Infants: A Case Control Study. CHILDREN-BASEL 2021; 8:children8080662. [PMID: 34438553 PMCID: PMC8391563 DOI: 10.3390/children8080662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/14/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Caring for an excessively crying infant (ECI) can be stressful for mothers and fathers and is associated with mental and bonding problems. Hair cortisol offers a unique measure for the biological reaction of the body to stress over time. METHODS In this case-control study, scalp hair cortisol concentrations (HCC) were measured using liquid chromatography-tandem mass spectrometry (LC-MS) in 35 mothers and 23 fathers and their ECIs. The control group consisted of 64 mothers and 63 fathers of non-ECIs of similar age. Parental stress, depression, anxiety and bonding were assessed using validated questionnaires. RESULTS Mean HCC were significantly lower in mothers and fathers of ECIs (2.3 pg/mg, 95% CI 1.8-2.9 and 1.6 pg/mg, 95% CI 1.3-2.0) than that in control mothers and fathers (3.2 pg/mg, 95% CI 3.0-3.7 and 2.9 pg/mg, 95% CI 2.5-3.5). In the total group of parents and within the parents of ECIs, HCC were not associated with negative feelings. In the control group, HCC showed a positive association with stress and depression (r = 0.207, p = 0.020 and r = 0.221, p = 0.013). In infants, no differences were found in mean HCC between the ECI group and the control group. No associations were found between maternal and infant HCC, paternal and infant HCC and maternal and paternal HCC. CONCLUSION Parents of ECIs showed significantly lower HCC than control parents, reflecting a diminished response of the hypothalamic-pituitary-adrenal (HPA) axis. More research is needed to examine whether this decrease in response is pre-existing or caused by excessive infant crying.
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Determination of cortisol in hair using liquid chromatography-tandem mass spectrometry: a short review. Bioanalysis 2021; 13:1145-1155. [PMID: 34187201 DOI: 10.4155/bio-2021-0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Cortisol is considered a particularly relevant biomarker in the context of stress evaluation. This study aims to review of the available literature on the determination of cortisol in hair using LC-MS/MS. Currently, there is no standardized procedure for the measurement of cortisol concentrations in hair, and different sample preparation, chromatographic separation and mass spectrometric detection conditions were described. Simple methanolic extraction, reversed-phase separation and MRM detection in negative ion mode are the most common employed analytical approaches. Reported assays presented acceptable sensitivity for clinical purposes. The increasing use of mass spectrometry in clinical laboratories may contribute to the establishment of LC-MS/MS as the method of choice for the determination of cortisol concentrations in hair.
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Hamers PCM, Savas M, van Rossum EFC, de Rijke YB, Bindels PJE, Festen DAM, Hermans H. Hair glucocorticoids in adults with intellectual disabilities and depressive symptoms pre- and post-bright light therapy: First explorations. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1549-1559. [PMID: 34047425 PMCID: PMC8597165 DOI: 10.1111/jar.12899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/22/2021] [Accepted: 04/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Depressive symptoms and stress are common in adults with intellectual disabilities. Our aim was to explore long-term biological stress levels, assessed by hair cortisol (HairF) and cortisone (HairE) concentrations, in adults with intellectual disabilities and depressive symptoms and to investigate the effects of bright light therapy (BLT) on hair glucocorticoids. METHOD Scalp hair samples (n = 14) were retrospectively examined at baseline and post-BLT (10.000 and 300 lux). Liquid chromatography-tandem mass spectrometry was used to measure hair glucocorticoids. RESULTS A significant correlation was found between baseline HairF and depression scores (r = .605, p = .028). Post-intervention HairE levels were significantly increased ([95% CI: 11.2-17.4 pg/mg], p = .003), in particular after dim light (300 lux) ([95% CI: 10.0-18.3 pg/mg], p = .020). CONCLUSIONS This study showed that retrospectively examining biological levels of stress in adults with intellectual disabilities seems a potentially promising and objective method to gain insight in the stress level of adults with intellectual disabilities.
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Affiliation(s)
- Pauline C M Hamers
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Amarant, Healthcare Organization for People with Intellectual Disabilities, Tilburg, The Netherlands
| | - Mesut Savas
- Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Yolanda B de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Patrick J E Bindels
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dederieke A M Festen
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Ipse de Bruggen, Healthcare Organization for People with Intellectual Disabilities, Zoetermeer, The Netherlands
| | - Heidi Hermans
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Amarant, Healthcare Organization for People with Intellectual Disabilities, Tilburg, The Netherlands
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Kaleta M, Oklestkova J, Novák O, Strnad M. Analytical Methods for the Determination of Neuroactive Steroids. Biomolecules 2021; 11:553. [PMID: 33918915 PMCID: PMC8068886 DOI: 10.3390/biom11040553] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 12/27/2022] Open
Abstract
Neuroactive steroids are a family of all steroid-based compounds, of both natural and synthetic origin, which can affect the nervous system functions. Their biosynthesis occurs directly in the nervous system (so-called neurosteroids) or in peripheral endocrine tissues (hormonal steroids). Steroid hormone levels may fluctuate due to physiological changes during life and various pathological conditions affecting individuals. A deeper understanding of neuroactive steroids' production, in addition to reliable monitoring of their levels in various biological matrices, may be useful in the prevention, diagnosis, monitoring, and treatment of some neurodegenerative and psychiatric diseases. The aim of this review is to highlight the most relevant methods currently available for analysis of neuroactive steroids, with an emphasis on immunoanalytical methods and gas, or liquid chromatography combined with mass spectrometry.
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Affiliation(s)
| | - Jana Oklestkova
- Laboratory of Growth Regulators, Faculty of Science and Institute of Experimental Botany of the Czech Academy of Sciences, Palacký University, Šlechtitelů 27, CZ-78371 Olomouc, Czech Republic; (M.K.); (O.N.); (M.S.)
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Oresta S, Vinkers CH, van Rossum EFC, Penninx BWJH, Nawijn L. How childhood trauma and recent adverse events are related to hair cortisol levels in a large adult cohort. Psychoneuroendocrinology 2021; 126:105150. [PMID: 33515910 DOI: 10.1016/j.psyneuen.2021.105150] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Exposure to adversity is a risk factor for many mental and somatic health problems. Hypothalamic-pituitary-adrenal (HPA) axis dysregulation is a potential mechanism linking adversity exposure and negative health outcomes. However, associations between adversity exposure and HPA-axis activity have been inconsistent. To understand the impact of adversity on the HPA-axis, we examined associations between early-life and recent adversity with hair cortisol concentration, an indicator of long-term systemic cortisol levels. METHODS We included 1166 adult participants of the Netherlands Study of Depression and Anxiety (NESDA). Hair cortisol was measured in 3 cm of proximal hair, representing cortisol exposure during the previous 3 months. Childhood maltreatment, childhood negative life events, and recent negative life events were retrospectively assessed using interview and self-report questionnaires. Linear regression analyses were performed to assess the associations between childhood maltreatment, childhood life events and recent life events with hair cortisol. Associations with cumulative adversity exposure and with subtypes of childhood maltreatment, childhood and recent negative life events were also investigated, as were interaction effects between adversity and sex, age and psychopathology. RESULTS Childhood maltreatment (β = 0.034, p = 0.243), childhood life events (β = - 0.017, p = 0.544), and recent life events (β = - 0.021, p = 0.456) were not significantly associated with hair cortisol levels. Subtypes of childhood maltreatment and specific childhood and recent life events were not significantly associated with hair cortisol (pFDR>0.05). There were no significant interaction effects between adversity exposure and sex, age or depression/anxiety diagnostic status on hair cortisol. CONCLUSIONS There were no significant associations between childhood and recent adversity with systemic cortisol levels in adults. Effects of early-life and adult adversity are complex and may not directly impact on long-term systemic cortisol levels as measured in hair.
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Affiliation(s)
- Stefania Oresta
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Christiaan H Vinkers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Erasmus MC, Erasmus University Rotterdam, Department of Internal Medicine, Division of Endocrinology, Rotterdam, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Laura Nawijn
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.
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Castro-Vale I, Durães C, van Rossum EFC, Staufenbiel SM, Severo M, Lemos MC, Carvalho D. The Glucocorticoid Receptor Gene ( NR3C1) 9β SNP Is Associated with Posttraumatic Stress Disorder. Healthcare (Basel) 2021; 9:healthcare9020173. [PMID: 33562675 PMCID: PMC7915937 DOI: 10.3390/healthcare9020173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 11/30/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) has been associated with glucocorticoid (GC) hypersensitivity. Although genetic factors account for 30–46% of the variance in PTSD, no associations have been found between single nucleotide polymorphisms (SNPs) of the GC receptor (GR) gene (NR3C1) and risk for this disorder. We studied the association of five SNPs in the GR gene (rs10052957, rs6189/rs6190, rs6195, rs41423247, and rs6198) and haplotypes with PTSD, in a group of Portuguese male war veterans (33 with lifetime PTSD, 28 without). To determine whether the 9β SNP (rs6198) was associated with chronically altered cortisol levels, we evaluated hair cortisol concentrations (HCC) in a sample of 69 veterans’ offspring. The 9β variant (G allele) was significantly associated with lifetime PTSD under a dominant model of inheritance. The 9β variant was also significantly associated with severity of current PTSD symptoms. The haplotype analysis revealed an association between a common haplotype comprising the 9β risk allele and lifetime PTSD. Carriers of the 9β risk allele had significantly lower HCC than non-carriers. We found the 9β risk allele and a haplotype comprising the 9β risk allele of the GR gene to be associated with PTSD in veterans. This 9β risk allele was also associated with lower HCC in their offspring.
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Affiliation(s)
- Ivone Castro-Vale
- Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- i3S—Instituto de Investigação e Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, 4200-135 Porto, Portugal; (C.D.); (D.C.)
- Correspondence: ; Tel.: +351-220426920
| | - Cecília Durães
- i3S—Instituto de Investigação e Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, 4200-135 Porto, Portugal; (C.D.); (D.C.)
- Ipatimup—Institute of Molecular Pathology and Immunology of the University of Porto, 4200-135 Porto, Portugal
| | - Elisabeth F. C. van Rossum
- Erasmus MC, Division of Endocrinology, Department of Internal Medicine, University Medical Center Rotterdam, 3015 CE Rotterdam, The Netherlands; (E.F.C.v.R.); (S.M.S.)
| | - Sabine M. Staufenbiel
- Erasmus MC, Division of Endocrinology, Department of Internal Medicine, University Medical Center Rotterdam, 3015 CE Rotterdam, The Netherlands; (E.F.C.v.R.); (S.M.S.)
| | - Milton Severo
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- Department of Medical Education and Simulation, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Manuel C. Lemos
- CICS-UBI—Health Sciences Research Centre, University of Beira Interior, 6200-506 Covilhã, Portugal;
| | - Davide Carvalho
- i3S—Instituto de Investigação e Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, 4200-135 Porto, Portugal; (C.D.); (D.C.)
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar S. João, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
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Olesti E, Boccard J, Visconti G, González-Ruiz V, Rudaz S. From a single steroid to the steroidome: Trends and analytical challenges. J Steroid Biochem Mol Biol 2021; 206:105797. [PMID: 33259940 DOI: 10.1016/j.jsbmb.2020.105797] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/02/2020] [Accepted: 11/24/2020] [Indexed: 12/23/2022]
Abstract
For several decades now, the analysis of steroids has been a key tool in the diagnosis and monitoring of numerous endocrine pathologies. Thus, the available methods used to analyze steroids in biological samples have dramatically evolved over time following the rapid pace of technology and scientific knowledge. This review aims to synthetize the advances in steroids' analysis, from classical approaches considering only a few steroids or a limited number of steroid ratios, up to the new steroid profiling strategies (steroidomics) monitoring large sets of steroids in biological matrices. In this context, the use of liquid chromatography coupled to mass spectrometry has emerged as the technique of choice for the simultaneous determination of a high number of steroids, including phase II metabolites, due to its sensitivity and robustness. However, the large dynamic range to be covered, the low natural abundance of some key steroids, the selectivity of the analytical methods, the extraction protocols, and the steroid ionization remain some of the current challenges in steroid analysis. This review provides an overview of the different analytical workflows available depending on the number of steroids under study. Special emphasis is given to sample treatment, acquisition strategy, data processing, steroid identification and quantification using LC-MS approaches. This work also outlines how the availability of steroid standards, the need for complementary analytical strategies and the improvement of calibration approaches are crucial for achieving complete steroidome quantification.
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Affiliation(s)
- Eulalia Olesti
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Switzerland; School of Pharmaceutical Sciences, University of Geneva, Switzerland; Swiss Centre for Applied Human Toxicology (SCAHT), Switzerland
| | - Julien Boccard
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Switzerland; School of Pharmaceutical Sciences, University of Geneva, Switzerland; Swiss Centre for Applied Human Toxicology (SCAHT), Switzerland
| | - Gioele Visconti
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Switzerland; School of Pharmaceutical Sciences, University of Geneva, Switzerland
| | - Víctor González-Ruiz
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Switzerland; School of Pharmaceutical Sciences, University of Geneva, Switzerland; Swiss Centre for Applied Human Toxicology (SCAHT), Switzerland
| | - Serge Rudaz
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Switzerland.
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Vehmeijer FOL, Santos S, Gaillard R, de Rijke YB, Voortman T, van den Akker ELT, Felix JF, van Rossum EFC, Jaddoe VWV. Associations of Hair Cortisol Concentrations with General and Organ Fat Measures in Childhood. J Clin Endocrinol Metab 2021; 106:e551-e561. [PMID: 33119748 DOI: 10.1210/clinem/dgaa785] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Indexed: 12/15/2022]
Abstract
CONTEXT Stress may lead to an adverse body fat distribution from childhood onwards. OBJECTIVE To examine the associations of hair cortisol concentration (HCC) at 6 years with general and organ fat measures, risk of overweight, and nonalcoholic fatty liver disease (NAFLD) at 10 years and to assess whether these were independent of adiposity measures at 6 years. DESIGN, SETTING AND PARTICIPANTS HCCs were measured in hair of 6-year-old children (n = 2042) participating in the Generation R Study, a population-based prospective cohort study. MAIN OUTCOME MEASURES Body mass index (BMI), fat mass index measured by dual-energy X-ray absorptiometry scan, and visceral fat index, pericardial fat index, liver fat fraction measured by magnetic resonance imaging and risk of overweight and NAFLD were obtained at 10 years. RESULTS The associations of higher HCC at 6 years, with higher BMI, fat mass index, and increased risk of overweight at age 10 years are explained by the relationships observed at 6 years. HCCs at 6 years were associated with a higher liver fat fraction (difference 0.11 liver fat fraction standard deviation score; 95% confidence interval [CI] 0.03, 0.18) and a higher risk of NAFLD at 10 years (odds ratio 1.95; 95% CI 1.06, 3.56), independent of fat mass index at 6 years. HCCs were not associated with pericardial or visceral fat indices. CONCLUSIONS Higher HCCs at 6 years were associated with higher BMI, fat mass index, liver fat fraction, and higher risks of overweight and NAFLD at 10 years. Only the associations for liver fat fraction and NAFLD were independent of fat mass index at 6 years.
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Affiliation(s)
- Florianne O L Vehmeijer
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Yolanda B de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center, Rotterdam, The Netherlands and Sint Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Erica L T van den Akker
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center, Rotterdam, The Netherlands and Sint Franciscus Gasthuis, Rotterdam, The Netherlands
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center, Rotterdam, The Netherlands and Sint Franciscus Gasthuis, Rotterdam, The Netherlands
- Section of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Broeks CW, Choenni V, Kok R, van der Voorn B, de Kruijff I, van den Akker ELT, van Rossum EFC, Hoogendijk WJG, Hillegers MHJ, Kamperman AM, Lambregtse-Van den Berg MP. An exploratory study of perinatal hair cortisol concentrations in mother-infant dyads with severe psychiatric disorders versus healthy controls. BJPsych Open 2021; 7:e28. [PMID: 33407971 PMCID: PMC8058941 DOI: 10.1192/bjo.2020.159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Maternal psychopathology during pregnancy is associated with negative outcomes in offspring. Increased placental transfer of maternal cortisol may contribute to mediate this association. Hair cortisol concentrations (HCCs) appear to be a good biomarker of long-term prenatal stress exposure. Little is known about the associations between severe maternal psychopathology and perinatal infant HCCs. AIMS We assessed HCCs in the perinatal period in mother-infant dyads with and without severe psychiatric disorders. METHOD We examined group differences in HCCs of mother-infant dyads (n = 18) subjected to severe maternal psychiatric disorders versus healthy control dyads (n = 27). We assessed the correlation of HCCs between mother and infant within both groups, and the association between current maternal symptoms and HCCs in patient dyads. RESULTS Median (interquartile range) and distribution of HCC differed in patients compared with control mothers (U = 468.5, P = 0.03). HCCs in infants of patients did not differ from control infants (U = 250.0, P = 0.67). Subsequently, we found that HCCs within healthy control dyads were correlated (n = 27, r 0.55 (0.14), P = 0.003), but were not within patient dyads (n = 18, r 0.082 (0.13), P = 0.746). HCCs in infants of patients showed a positive correlation with maternal symptoms (n = 16, r = 0.63 (0.06), P = 0.008). CONCLUSIONS These preliminary findings suggest that infant HCC reflect perinatal stress exposure. In infants, these early differences could influence lifetime hypothalamic-pituitary-adrenal axis functioning, which might be associated with increased susceptibility to later disease.
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Affiliation(s)
- Carlinde W Broeks
- Department of Psychiatry, Erasmus University Medical Center, the Netherlands; and Department of Psychiatry, Arkin Institute for Mental Health, the Netherlands
| | - Vandhana Choenni
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, the Netherlands
| | - Rianne Kok
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands
| | - Bibian van der Voorn
- Department of Pediatric Endocrinology, Obesity Center CGG, Erasmus MC-Sophia Children's Hospital, the Netherlands; and Division of Endocrinology, Department of Internal Medicine, Erasmus University Medical Center, the Netherlands
| | - Ineke de Kruijff
- Department of Pediatrics, St Antonius Hospital Nieuwegein, the Netherlands
| | | | - Elisabeth F C van Rossum
- Division of Endocrinology, Department of Internal Medicine, Erasmus University Medical Center, the Netherlands
| | | | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, the Netherlands
| | - Astrid M Kamperman
- Department of Psychiatry, Erasmus University Medical Center, the Netherlands; and Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Center, the Netherlands
| | - Mijke P Lambregtse-Van den Berg
- Department of Psychiatry, Erasmus University Medical Center, the Netherlands; and Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, the Netherlands
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Tarantola M, Biasato I, Biasibetti E, Biagini D, Capra P, Guarda F, Leporati M, Malfatto V, Cavallarin L, Miniscalco B, Mioletti S, Vincenti M, Gastaldo A, Capucchio MT. Beef cattle welfare assessment: use of resource and animal-based indicators, blood parameters and hair 20β-dihydrocortisol. ITALIAN JOURNAL OF ANIMAL SCIENCE 2020. [DOI: 10.1080/1828051x.2020.1743783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Martina Tarantola
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Ilaria Biasato
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Elena Biasibetti
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’Aosta, Torino, Italy
| | - Davide Biagini
- Dipartimento di Scienze Agrarie, Forestali e Alimentari, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Pierluigi Capra
- Istituto di Scienze delle Produzioni Alimentari (ISPA-CNR), Grugliasco, Torino, Italy
| | - Franco Guarda
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Marta Leporati
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Regione Gonzole 10/1, Orbassano, Torino, Italy
| | - Vanda Malfatto
- Dipartimento di Scienze Agrarie, Forestali e Alimentari, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Laura Cavallarin
- Istituto di Scienze delle Produzioni Alimentari (ISPA-CNR), Grugliasco, Torino, Italy
| | - Barbara Miniscalco
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Silvia Mioletti
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Regione Gonzole 10/1, Orbassano, Torino, Italy
- Dipartimento di Chimica, Università degli Studi di Torino, Torino, Italy
| | | | - Maria Teresa Capucchio
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
- Istituto di Scienze delle Produzioni Alimentari (ISPA-CNR), Grugliasco, Torino, Italy
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Witteveen AB, Henrichs J, Walker AL, Bohlmeijer ET, Burger H, Fontein-Kuipers Y, Schellevis FG, Stramrood CAI, Olff M, Verhoeven CJ, de Jonge A. Effectiveness of a guided ACT-based self-help resilience training for depressive symptoms during pregnancy: Study protocol of a randomized controlled trial embedded in a prospective cohort. BMC Pregnancy Childbirth 2020; 20:705. [PMID: 33213400 PMCID: PMC7676420 DOI: 10.1186/s12884-020-03395-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/04/2020] [Indexed: 01/30/2023] Open
Abstract
Background During pregnancy, about 10 to 20% of women experience depressive symptoms. Subclinical depression increases the risk of peripartum depression, maternal neuro-endocrine dysregulations, and adverse birth and infant outcomes. Current treatments often comprise face-to-face psychological or pharmacological treatments that may be too intensive for women with subclinical depression leading to drop-out and moderate effectiveness. Therefore, easily accessible, resilience enhancing and less stigmatizing interventions are needed to prevent the development of clinical depression. This paper describes the protocol of a prospective cohort study with an embedded randomized controlled trial (RCT) that aims to improve mental resilience in a sample of pregnant women through a self-help program based on the principles of Acceptance and Commitment Therapy (ACT). Maternal and offspring correlates of the trajectories of peripartum depressive symptoms will also be studied. Methods Pregnant women (≥ 18 years) receiving care in Dutch midwifery practices will participate in a prospective cohort study (n ~ 3500). Between 12 and 18 weeks of pregnancy, all women will be screened for depression with the Edinburgh Postnatal Depression Scale (EPDS). Women with an EPDS score ≥ 11 will be evaluated with a structured clinical interview. Participants with subclinical depression (n = 290) will be randomized to a 9-week guided self-help ACT-training or to care as usual (CAU). Primary outcomes (depressive symptoms and resilience) and secondary outcomes (e.g. anxiety and PTSD, bonding, infant development) will be collected via online questionnaires at four prospective assessments around 20 weeks and 30 weeks gestation and at 6 weeks and 4 months postpartum. Maternal hair cortisol concentrations will be assessed in a subsample of women with a range of depressive symptoms (n = 300). The intervention’s feasibility will be assessed through qualitative interviews in a subsample of participants (n = 20). Discussion This is the first study to assess the effectiveness of an easy to administer intervention strategy to prevent adverse mental health effects through enhancing resilience in pregnant women with antepartum depressive symptomatology. This longitudinal study will provide insights into trajectories of peripartum depressive symptoms in relation to resilience, maternal cortisol, psychological outcomes, and infant developmental milestones. Trial registration Netherlands Trial Register (NTR), NL7499. Registered 5 February 2019.
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Affiliation(s)
- Anke B Witteveen
- Department of Midwifery Science, AVAG/Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Jens Henrichs
- Department of Midwifery Science, AVAG/Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Annika L Walker
- Department of Midwifery Science, AVAG/Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Ernst T Bohlmeijer
- Department of Psychology, Health and Technology , University of Twente , Drienerlolaan 5, 7522 NB, Enschede, Netherlands
| | - Huibert Burger
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Hanzeplein 1, Groningen, 9713GZ, Netherlands
| | - Yvonne Fontein-Kuipers
- Institute for Healthcare - School of Midwifery , Rotterdam University of Applied Sciences , Rochussenstraat 198, 3015 EK, Rotterdam, Netherlands
| | - Francois G Schellevis
- Department of General Practice , Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Public Health Research Institute , Van der Boechorststraat 7, 1081 BT, Amsterdam, Netherlands.,NIVEL Netherlands Institute for Health Services Research , Otterstraat 118, 3513 CR, Utrecht, Netherlands
| | - Claire A I Stramrood
- Department of Obstetrics and Gynaecology, OLVG, Oosterpark 9, 1091 AC, Amsterdam, Netherlands
| | - Miranda Olff
- Department of Psychiatry UMC, location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.,ARQ National Psychotrauma Centre , Nienoord 5, 1112 XE, Diemen, Netherlands
| | - Corine J Verhoeven
- Department of Midwifery Science, AVAG/Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Department of Obstetrics and Gynecology Maxima Medical Centre , Veldhoven, Netherlands.,Division of Midwifery School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Ank de Jonge
- Department of Midwifery Science, AVAG/Amsterdam Public Health Research Institute, Amsterdam UMC, location VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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Shukur HH, de Rijke YB, van Rossum EFC, Hussain-Alkhateeb L, Höybye C. Hair cortisol-a method to detect chronic cortisol levels in patients with Prader-Willi syndrome. BMC Endocr Disord 2020; 20:166. [PMID: 33167936 PMCID: PMC7654170 DOI: 10.1186/s12902-020-00646-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a multisymptomatic, rare, genetic, neurodevelopmental disorder in adults mainly characterized by hyperphagia, cognitive dysfunction, behavioral problems and risk of morbid obesity. Although endocrine insufficiencies are common, hypocortisolism is rare and knowledge on long-term cortisol concentrations is lacking. The aim of this study was to evaluate long-term cortisol levels in PWS by measurements of hair cortisol. METHODS Twenty-nine adults with PWS, 15 men and 14 women, median age 29 years, median BMI 27 kg/m2, were included. Scalp hair samples were analyzed for cortisol content using liquid-chromatography tandem-mass spectrometry. In addition, a questionnaire on auxology, medication and stress were included. For comparison, 105 age- and sex-matched participants from the population-based Lifelines Cohort study were included as controls. The mean hair cortisol between the groups were compared and associations between BMI and stress were assessed by a generalized linear regression model. RESULTS In the PWS group large variations in hair cortisol was seen. Mean hair cortisol was 12.8 ± 25.4 pg/mg compared to 3.8 ± 7.3 pg/mg in controls (p = 0.001). The linear regression model similarly showed higher cortisol levels in patients with PWS, which remained consistent after adjusting for BMI and stress (p = 0.023). Furthermore, hair cortisol increased with BMI (p = 0.012) and reported stress (p = 0.014). CONCLUSION Long-term cortisol concentrations were higher in patients with PWS compared to controls and increased with BMI and stress, suggesting an adequate cortisol response to chronic stress. Hair cortisol demonstrate promising applications in the context of PWS treatment and disease management.
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Affiliation(s)
- Hasanain Hamid Shukur
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
| | - Yolanda B de Rijke
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Medicine, Division of Endocrinology, Erasmus MC, University medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Laith Hussain-Alkhateeb
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Charlotte Höybye
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Patient Area Endocrinology and Nephrology, Inflammation and Infection Theme, Karolinska University Hospital, Stockholm, Sweden
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47
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Castro-Vale I, van Rossum EFC, Staufenbiel SM, Severo M, Mota-Cardoso R, Carvalho D. Hair Cortisol as a Marker of Intergenerational Heritage of War? A Study of Veterans and Their Offspring. Psychiatry Investig 2020; 17:976-986. [PMID: 33017887 PMCID: PMC7596280 DOI: 10.30773/pi.2020.0212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/06/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) has been associated with lower circulating cortisol levels in specific subgroups, which have also been found in the offspring of people with PTSD. The analysis of hair cortisol concentrations (HCC) is a recent methodology which is used to assess long-term systemic cortisol levels. We aimed to study veterans with war-related lifetime PTSD and their respective offspring with regards to HCC. We also studied the influence of lifetime major depressive disorder (MDD), war experiences, and childhood adversities on HCC in these groups. METHODS 31 male veterans with PTSD and 28 without PTSD and 69 adult offspring were studied. HCC were quantified by liquid chromatography tandem-mass spectrometry. RESULTS No differences in HCC were found between veterans with and without PTSD, or between their respective offspring. Veterans without MDD showed a positive association between total war exposure and HCC. Veterans reporting more frequent childhood physical abuse had lower HCC. Veterans-with-PTSD's offspring with MDD had increased HCC compared to offspring without MDD. Offspring's exposure to more frequent childhood physical abuse was negatively associated with HCC in those without MDD. CONCLUSION HCC did not appear to constitute a marker of intergenerational heritage of war-related PTSD, except in the case of veteranswith-PTSD's offspring with MDD. Our data suggest that HCC is a marker of adult reported childhood physical abuse.
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Affiliation(s)
- Ivone Castro-Vale
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal.,i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sabine M Staufenbiel
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Milton Severo
- Department of Clinical Epidemiology, Predictive Medicine and Public Health and Department of Medical Education and Simulation, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rui Mota-Cardoso
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Davide Carvalho
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Department of Endocrinology, Diabetes and Metabolism, São João University Hospital Centre, Faculty of Medicine, University of Porto, Porto, Portugal
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48
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Towards Best Practice in Hair Metabolomic Studies: Systematic Investigation on the Impact of Hair Length and Color. Metabolites 2020; 10:metabo10100381. [PMID: 32993123 PMCID: PMC7601250 DOI: 10.3390/metabo10100381] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 11/16/2022] Open
Abstract
Untargeted metabolomic studies are used for large-scale analysis of endogenous compounds. Due to exceptional long detection windows of incorporated substances in hair, analysis of hair samples for retrospective monitoring of metabolome changes has recently been introduced. However, information on the general behavior of metabolites in hair samples is scarce, hampering correct data interpretation so far. The presented study aimed to investigate endogenous metabolites depending on hair color and along the hair strand and to propose recommendations for best practice in hair metabolomic studies. A metabolite selection was analyzed using untargeted data acquisition in genuine hair samples from different hair colors and after segmentation in 3 cm segments. Significant differences in metabolites among hair colors and segments were found. In conclusion, consideration of hair color and hair segments is necessary for hair metabolomic studies and, subsequently, recommendations for best practice in hair metabolomic studies were proposed.
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Schuurmans AAT, Nijhof KS, Scholte R, Popma A, Otten R. Game-Based Meditation Therapy to Improve Posttraumatic Stress and Neurobiological Stress Systems in Traumatized Adolescents: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e19881. [PMID: 32965226 PMCID: PMC7542410 DOI: 10.2196/19881] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/16/2020] [Accepted: 08/01/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Many adolescents in residential care have been exposed to prolonged traumatic experiences such as violence, neglect, or abuse. Consequently, they suffer from posttraumatic stress. This not only negatively affects psychological and behavioral outcomes (eg, increased anxiety, depression, and aggression) but also has adverse effects on physiological outcomes, in particular on their neurobiological stress systems. Although current evidence-based treatment options are effective, they have their limitations. An alternative to traditional trauma treatment is meditation-based treatment that focuses on stress regulation and relaxation. Muse is a game-based meditation intervention that makes use of adolescents' intrinsic motivation. The neurofeedback element reinforces relaxation abilities. OBJECTIVE This paper describes the protocol for a randomized controlled trial in which the goal is to examine the effectiveness of Muse (InteraXon Inc) in reducing posttraumatic stress and normalizing neurobiological stress systems in a sample of traumatized adolescents in residential care. METHODS This will be a multicenter, multi-informant, and multimethod randomized controlled trial. Participants will be adolescents (N=80), aged 10 to 18 years, with clinical levels of posttraumatic symptoms, who are randomized to receive either the Muse therapy sessions and treatment as usual (intervention) or treatment as usual alone (control). Data will be collected at 3 measurement instances: pretest (T1), posttest (T2), and at 2-month follow-up. Primary outcomes will be posttraumatic symptoms (self-report and mentor report) and stress (self-report) at posttest. Secondary outcomes will be neurobiological stress parameters under both resting and acute stress conditions, and anxiety, depression, and aggression at posttest. Secondary outcomes also include all measures at 2-month follow-up: posttraumatic symptoms, stress, anxiety, depression aggression, and neurobiological resting parameters. RESULTS The medical-ethical committee Arnhem-Nijmegen (NL58674.091.16) approved the trial on November 15, 2017. The study was registered on December 2, 2017. Participant enrollment started in January 2018, and the results of the study are expected to be published in spring or summer 2021. CONCLUSIONS Study results will demonstrate whether game-based meditation therapy improves posttraumatic stress and neurobiological stress systems, and whether it is more effective than treatment as usual alone for traumatized adolescents. TRIAL REGISTRATION Netherlands Trial Register NL6689 (NTR6859); https://www.trialregister.nl/trial/6689. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19881.
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Affiliation(s)
- Angela A T Schuurmans
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Department of Research and Development, Pluryn, Nijmegen, Netherlands
| | - Karin S Nijhof
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Department of Research and Development, Pluryn, Nijmegen, Netherlands
| | - Ron Scholte
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Praktikon, Nijmegen, Netherlands.,Tranzo, Tilburg University, Tilburg, Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry, Vrije Universiteit medisch centrum De Bascule, Amsterdam, Netherlands
| | - Roy Otten
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Department of Research and Development, Pluryn, Nijmegen, Netherlands.,Research and Education Advancing Children's Health Institute, Department of Psychology, Arizona State University, Tempe, AZ, United States
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50
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van den Berg MT, Wester VL, Vreeker A, Koenders MA, Boks MP, van Rossum EFC, Spijker AT. Higher cortisol levels may proceed a manic episode and are related to disease severity in patients with bipolar disorder. Psychoneuroendocrinology 2020; 119:104658. [PMID: 32521383 DOI: 10.1016/j.psyneuen.2020.104658] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/28/2019] [Accepted: 03/18/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Regulation of the hypothalamic-pituitary-adrenal (HPA) axis is implicated in the pathogenesis of bipolar disorder (BD). However, the relationship between HPA-activity and disease severity is not fully elucidated. In this pilot study we aimed to explore the temporal relationship between HPA-activity and the risk of a manic episode in BD patients type I, by assessing long-term hair cortisol concentrations (HCC). Second, we explored the relation between HCC and the number of previous episodes. METHODS Hair samples were collected from 45 BD I patients in euthymic or manic state and compared to 17 controls. From each participant, two hair samples of 3 cm length were used to measure long-term cortisol, reflecting retrospect time frames of 1-3 months and 4-6 months respectively prior to sampling. RESULTS HCC in the BD group was slightly higher than in the control group in both hair segments (p = 0.049 and 0.03; after adjustment for age, sex, BMI and hair washing frequency p = 0.222 and 0.139). A significant peak in hair cortisol was observed prior to a manic episode (p = 0.036). Furthermore, we found a positive correlation between the number of mood episodes HCC (p = 0.03). CONCLUSIONS Our results indicate that long-term cortisol levels are slightly higher in BD, and in particular elevated in the months prior to a manic relapse. In addition HCC are positively associated with the number of previous mood episodes in the course of BD type I.
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Affiliation(s)
| | - Vincent L Wester
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Annabel Vreeker
- Brain Center Rudolf Magnus, Department of Psychiatry, Medical Center Utrecht, Utrecht, The Netherlands
| | - Manja A Koenders
- Department of Mood Disorders, Parnassia NAH, Rotterdam, The Netherlands
| | - Marco P Boks
- Brain Center Rudolf Magnus, Department of Psychiatry, Medical Center Utrecht, Utrecht, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anne T Spijker
- Department of Mood Disorders, Parnassia NAH, Rotterdam, The Netherlands
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