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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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Nyengaard R, Kallesøe KH, Rimvall MK, Ørnbøl E, Wellnitz KB, Olsen EM, Wyller VBB, Rask CU. Hair cortisol and self-perceived stress in adolescents with multi-system functional somatic disorders. BMC Psychiatry 2024; 24:101. [PMID: 38317120 PMCID: PMC10840144 DOI: 10.1186/s12888-024-05518-4] [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: 04/29/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Long-term stress causing altered hypothalamic-pituitary-adrenal (HPA) axis dynamics with cortisol dysfunction may be involved in the pathophysiology of functional somatic disorders (FSD), but studies on adolescents with multi-system FSD are lacking. Therefore, we investigated: 1) whether hair cortisol concentration (HCC) differentiates adolescents with multi-system FSD from a) a population-based sample and b) a subgroup derived from the sample reporting a high physical symptom load, and 2) whether FSD population HCC is associated with primary symptom presentations and self-perceived stress. METHODS We used data from a clinical sample with multi-system FSD (N = 91, age 15-19 years) and a population-based sample (N = 1,450, age 16-17 years) including a subgroup with top 10% total scores on physical symptoms (N = 147). Density plots and multiple linear regression were applied to compare HCC between groups. In the clinical sample, multiple linear regression was employed to assess the association between HCC and primary symptom clusters and self-perceived stress. RESULTS Median HCC was lower in the clinical sample than in the population-based sample (β = 0.80 (95%CI: 0.66, 0.97)), but not significantly different from median HCC in the derived subgroup (β = 0.84 (95%CI: 0.66, 1.07)). In the clinical sample, HCC was not significantly associated with primary symptom clusters (F(2, 82) = 0.13, p = 0.88) or self-perceived stress (F(4, 83) = 1.18, p = 0.33). CONCLUSION Our findings indicate that HCC is lowered in adolescents with multi-system FSD but not significantly associated with primary symptom presentations or self-perceived stress. Future studies including multiple measures of HPA axis dynamics alongside psychological measures may further elucidate the role of long-term stress in FSD. TRIAL REGISTRATION The AHEAD study was pre-registered at ClinicalTrials.gov (NCT02346071), 26/01/2015.
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Affiliation(s)
- Rebecca Nyengaard
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
| | - Karen Hansen Kallesøe
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark.
| | - Martin Køster Rimvall
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Kildegaardsvej 28, Entrance 3A, 1st Floor, 2900, Hellerup, Denmark
- Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, Ny Østergade 12, 4000, Roskilde, Denmark
| | - Eva Ørnbøl
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus N, 8200, Denmark
| | - Kaare Bro Wellnitz
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus N, 8200, Denmark
| | - Else Marie Olsen
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Ndr. Fasanvej 57, 1st Floor, Building 14, 2000, Frederiksberg, Denmark
- Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Maglevænget 2, 2750, Ballerup, Denmark
| | - Vegard Bruun Bratholm Wyller
- Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Postboks 1000, 1478, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Blindern, P.O box 1171, 0318, Oslo, Norway
| | - Charlotte Ulrikka Rask
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
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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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Li Y, Jia W, Yan N, Hua Y, Han T, Yang J, Ma L, Ma L. Associations between chronic stress and hair cortisol in children: A systematic review and meta-analysis. J Affect Disord 2023; 329:438-447. [PMID: 36868386 DOI: 10.1016/j.jad.2023.02.123] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
OBJECTIVES This review systematically examined the associations between chronic stress and hair cortisol concentration (HCC) in children, and the potential modification effects of type, measurement period and scales of chronic stress, child age and sex, hair length and HCC measurement method, characteristics of study site, and congruence between time periods measured for chronic stress and HCC. METHODS Pubmed, Wed of Science, and APA PsycINFO were systematically searched for articles examining the association between chronic stress and HCC. RESULTS Thirteen studies from five countries with 1,455 participants were included in the systematic review and nine studies were included in the meta-analysis. Meta-analysis revealed that chronic stress was associated with HCC (pooled-r = 0.09, 95 % CI: 0.03, 0.16). Stratified analyses revealed that type, measurement time and scales of chronic stress, hair length and measurement method of HCC, and the congruence between time periods measured for chronic stress and HCC modified such correlations. The positive correlations between chronic stress and HCC were significant for studies measuring chronic stress as stressful life events, assessing chronic stress within the past six months, extracting HCC from 1 cm, 3 cm, or 6 cm of hair, measuring HCC by LC-MS/MS, or having congruence between time periods measured for chronic stress and HCC. The potential modifying effects of sex and country developmental status could not be concluded due to the limited number of studies included. CONCLUSIONS Chronic stress was positively correlated with HCC, varying by characteristics and measurements of chronic stress and HCC. HCC could be a biomarker for chronic stress among children.
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Affiliation(s)
- Ying Li
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wanru Jia
- Department of Disease Prevention and Control, Xi 'an Children's Hospital, Xi'an, China
| | - Na Yan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, China
| | - Yiming Hua
- Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Tuo Han
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Juan Yang
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Lu Ma
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, China.
| | - Le Ma
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, China.
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Lee S, Park JT, Bang M, An SK, Namkoong K, Park HY, Lee E. Theory of mind and hair cortisol in healthy young adults: the moderating effects of childhood trauma. Eur J Psychotraumatol 2022; 13:2116826. [PMID: 36186166 PMCID: PMC9518292 DOI: 10.1080/20008066.2022.2116826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Experiences of negative social interactions and childhood trauma (CT) can lead to aberrant hypothalamic-pituitary-adrenal functions. Poor theory of mind (ToM) ability is related to increased social stress levels; however, studies on the relationship between ToM and cortisol remain scarce. Objective: This study aimed to evaluate the relationship between ToM and the hair cortisol concentration (HCC) in healthy young adults considering the moderating role of CT. Method: A total of 206 healthy young adults were divided into two groups based on an experience of moderate-to-severe childhood trauma (CT+ and CT-). To determine whether CT moderated the relationship between ToM and HCC, moderation analysis was conducted controlling for age, sex, years of education, and scores of perceived stress, depression, and anxiety. Results: CT+ individuals reported higher subjective stress perception and depressive symptoms than CT- individuals, whereas anxiety-related symptoms, ToM, and HCC were not different between the groups. The experience of CT significantly moderated the relationship between ToM and HCC. The association between poorer ToM ability and higher HCC was significant only in CT+ group. Conclusion: CT is a moderator of the association between ToM and HCC, indicating the importance of CT in social cognition and the stress response.
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Affiliation(s)
- Suonaa Lee
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minji Bang
- Department of Psychiatry, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kee Namkoong
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Yoon Park
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Eun Lee
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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