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Peschel SKV, Fürtjes S, Sigrist C, Voss C, Berwanger J, Ollmann TM, Kische H, Rückert F, Koenig J, Pieper L, Beesdo-Baum K. Tension and disordered eating behaviors in the daily lives of adolescents and young adults from the general population: Associations and moderating role of trait emotion regulation. Scand J Psychol 2024; 65:252-263. [PMID: 37850537 DOI: 10.1111/sjop.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/10/2023] [Accepted: 09/15/2023] [Indexed: 10/19/2023]
Abstract
Experiences of tension and difficulties in emotion regulation have been linked to eating pathology in clinical samples and are targeted in respective treatment approaches. The present study aimed to investigate the impact of tension on engagement in disordered eating behaviors (DEBs) and potential moderating effects of trait emotion regulation in young people from the general population. A subsample of 971 adolescents and young adults from an epidemiological cohort study reported on levels of tension and four different DEBs (skipping eating, restrained eating, eating large amounts of food, loss-of-control-eating) via ecological momentary assessment (EMA), as well as on trait emotion regulation via questionnaire. In multilevel models, momentary tension did not predict levels of subsequent DEBs. However, higher average levels of tension across the EMA period predicted higher levels of all DEBs. No interactions with emotion regulation emerged. Individuals experiencing overall higher levels of tension appear to be more prone to engaging in DEBs.
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Affiliation(s)
- Stephanie K V Peschel
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sophia Fürtjes
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christine Sigrist
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Johanna Berwanger
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Theresa M Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Kische H, Voss C, Haring R, Ollmann TM, Pieper L, Kirschbaum C, Beesdo-Baum K. Correction to: Hair androgen concentrations and depressive disorders in adolescents from the general population. Eur Child Adolesc Psychiatry 2024; 33:953-954. [PMID: 35587288 PMCID: PMC10894163 DOI: 10.1007/s00787-022-02009-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Hanna Kische
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Catharina Voss
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Robin Haring
- Faculty of Applied Public Health, European University of Applied Sciences, Rostock, Germany
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Theresa Magdalena Ollmann
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Ernst J, Rückert F, Ollmann TM, Voss C, Kische H, Knappe S, Beesdo-Baum K. Social Interactions in Everyday Life of Socially Anxious Adolescents: Effects on Mental State, Anxiety, and Depression. Res Child Adolesc Psychopathol 2024; 52:207-222. [PMID: 37768440 PMCID: PMC10834615 DOI: 10.1007/s10802-023-01121-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
Abstract
Unfavorable interpersonal behavior in social anxiety disorder (SAD) contributes to the maintenance of the disorder and may also be related to the development of secondary depression. Since there is limited research on daily life behavior in SAD, this study aimed to describe social interaction behavior and analyze the effect of positive interactions on depression, anxiety, and mental state. Data were obtained from the Behavior and Mind Health study (11/2015-12/2016), an epidemiological cohort study of adolescents and young adults (n = 1,180, aged 14-21 years) from Dresden, Germany. Interpersonal behavior, current mental state, anxiety, and depression were assessed eight times per day over four days using smartphone-based ecological momentary assessments. The analyzed subsample consisted of n = 723 participants, comparing 12-month SAD (n = 60) and healthy controls (HC; n = 663). The interaction behavior of participants with SAD did not differ substantially from that of HC in terms of frequency of social interactions, type of interaction partner, and time spent communicating, although they reported fewer real-life interaction partners (SAD: M = 2.49, SD = 4.78; HC: M = 3.18, SD = 6.43; F(17,044) = 23.92, p < 0.001). When comparing mental state, anxiety, and depression after interactions with familiar people to no interaction, no differences were found between SAD and HC. However, interactions with unfamiliar people negatively affected depressive symptoms in individuals with SAD (b = 0.53; SE = 0.25; 95%CI: 0.04-1.03; p = 0.036). In adolescents with SAD, social situations with unfamiliar people seem to be processed in a dysfunctional way, contributing to increased depressive mood in everyday life. This is particularly interesting given the high rate of secondary depression in SAD.
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Affiliation(s)
- Julia Ernst
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany.
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Susanne Knappe
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
- Evangelische Hochschule Dresden (ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
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Wendler-Bödicker C, Kische H, Voss C, Beesdo-Baum K. The Association Between Childhood Maltreatment and Body (dis)satisfaction in Adolescents and Young Adults from the General Population. J Trauma Dissociation 2024; 25:113-128. [PMID: 37403492 DOI: 10.1080/15299732.2023.2231927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/04/2023] [Indexed: 07/06/2023]
Abstract
Adolescents with a history of childhood maltreatment are vulnerable to body dissatisfaction and associated psychopathology such as eating disorders. The aim of this study was to expand the understanding of the association between childhood maltreatment and body dissatisfaction in adolescents and young adults. In an epidemiological cohort study, N = 1,001 participants aged 14-21 years from Dresden, Germany, completed self-report measures on childhood maltreatment, body image, and self-esteem. Lifetime mental disorders were assessed in standardized clinical interviews. Data analyses included multiple regression and mediation analyses. More than one-third of the participants reported experiences of childhood maltreatment (37.4%), in which emotional neglect and abuse were the most frequent subtypes. Individuals with a history of childhood maltreatment showed significantly less satisfaction with their physical appearance than participants without such adverse experiences. In a single mediator model, self-esteem emerged as potential mediator in the association between child maltreatment and body (dis)satisfaction. Experiences of childhood maltreatment may be considered as risk factor for the development of body dissatisfaction in adolescents, and the role of potential mediator variables such as self-esteem warrants further prospective research.
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Affiliation(s)
- Christine Wendler-Bödicker
- Institute of Clinical Psychology and Psychotherapy Behavioral Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Institute of Clinical Psychology and Psychotherapy Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Institute of Clinical Psychology and Psychotherapy Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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Kische H, Voss C, Haring R, Ollmann TM, Pieper L, Kirschbaum C, Beesdo-Baum K. Hair androgen concentrations and depressive disorders in adolescents from the general population. Eur Child Adolesc Psychiatry 2023; 32:1375-1389. [PMID: 35112167 PMCID: PMC10326161 DOI: 10.1007/s00787-021-01929-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/12/2021] [Indexed: 11/26/2022]
Abstract
Although the link between androgens and depression is well established in adults, the effects of cofactors on this association are less clearly understood, particularly in youth. Epidemiological cohort study of adolescents in Dresden, Germany. Analyses comprised data of 985 individuals assessed at baseline and of 512 individuals at 1-year follow-up. We investigated multivariable regression models for cross-sectional and longitudinal associations of hair testosterone, dehydroepiandrosterone (DHEA), and their cortisol ratios with 12-month diagnoses of major depressive disorder (MDD) and MDD without any anxiety disorder assessed with standardized diagnostic interview (DIA-X-5), and with dimensional depression scores (PHQ-9, PROMIS), separately for males and females. The potential moderating effect of social support was determined. Cross-sectional analyses yielded inverse associations of testosterone and DHEA with MDD and MDD without any anxiety disorders in males. In cross-sectional and longitudinal analyses, baseline ratio cortisol/DHEA was significantly, inversely associated to PROMIS-depression in males. Only cross-sectional associations for ratio cortisol/DHEA and PROMIS-depression remained significant after Bonferroni-Holm correction. No robust associations were observed in female participants. Social support exerted no consistent moderating effect on the investigated association. The present observational cohort study showed no consistent association of hair androgen concentrations with depressive disorders in adolescents. However, findings provide some support for the association between the cortisol/DHEA ratio and depression in males. Longitudinal research designs in large samples are needed to understand the interplay between androgens, depression, and developmental and social factors in youth.
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Affiliation(s)
- Hanna Kische
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Catharina Voss
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Robin Haring
- Faculty of Applied Public Health, European University of Applied Sciences, Rostock, Germany
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Theresa Magdalena Ollmann
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Peschel SKV, Fürtjes S, Voss C, Sigrist C, Berwanger J, Ollmann TM, Kische H, Rückert F, Koenig J, Beesdo-Baum K. Temporal associations between experiential avoidance and disordered eating behaviors in adolescents and young adults: findings from an epidemiological cohort study with ecological momentary assessment. Eat Weight Disord 2023; 28:58. [PMID: 37405497 DOI: 10.1007/s40519-023-01584-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023] Open
Abstract
PURPOSE Previous studies linking experiential avoidance (EA) and eating pathology have largely relied on single measurements based on traditional retrospective questionnaires. Taking advantage of available repeated assessments of EA and disordered eating behaviors (DEBs) in the everyday lives of young people from an epidemiological cohort, we aimed to investigate ecologically valid temporal associations between these constructs. METHODS A random population sample of N = 1180 14-21-year-olds from Dresden, Germany, participated at baseline (2015/2016). As part of smartphone-based ecological momentary assessment (EMA), participants reported on engagement in EA and four DEBs (skipping eating, eating large amounts of food, loss-of-control eating, and restrained eating) up to eight times per day for four days. Multilevel modeling of concurrent and time-lagged associations between EA and DEBs, was conducted among those with at least 50% EMA-compliance (n = 1069). RESULTS EA was associated with higher concurrent levels of all four types of concurrent DEBs. In addition, EA significantly predicted subsequent levels of restrained eating. Only loss-of-control eating significantly predicted subsequent EA, and this effect depended on the timespan between consecutive assessments. When this timespan was short, higher Loss-of-control eating predicted lower subsequent EA, while it predicted higher subsequent EA when the timespan was longer. CONCLUSION The present findings suggest that EA is temporally closely linked to greater engagement in DEBs, supporting theoretical assumptions that DEBs may serve an attempted avoidance function in the context of unpleasant inner experiences. Future studies may benefit from examining samples with more pronounced eating pathology. LEVEL OF EVIDENCE Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.
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Affiliation(s)
- Stephanie K V Peschel
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Sophia Fürtjes
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christine Sigrist
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Johanna Berwanger
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Theresa M Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Asselmann E, Zenker M, Rückert F, Kische H, Pieper L, Beesdo-Baum K. Ecological momentary assessment and applied relaxation: Results of a randomized indicated preventive trial in individuals at increased risk for mental disorders. PLoS One 2023; 18:e0286750. [PMID: 37289760 PMCID: PMC10249886 DOI: 10.1371/journal.pone.0286750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/19/2023] [Indexed: 06/10/2023] Open
Abstract
Applied Relaxation (AR) is an established behavioral mental health intervention, but its efficacy in real life contexts remains unclear. Using randomized controlled trial data, we examined whether AR can effectively reduce mental health problems in daily life. A sample of 277 adults with increased psychopathological symptoms but without 12-month DSM-5 mental disorders at study entry was randomly assigned to an intervention group receiving AR training (n = 139) and an assessment-only control group (n = 138). Ecological momentary assessments were used to assess psychological outcomes in daily life over a period of seven days at baseline, post, and 12-month follow-up, respectively. Multilevel analyses indicated that all psychopathological symptoms decreased more in the intervention group than in the control group from baseline to post (range β = -0.31 for DASS-depression to β = -0.06 for PROMIS-anger). However, from post to follow-up, psychopathological symptoms decreased more in the control group than in the intervention group, so that only the intervention effects for PROMIS-depression (β = -0.10) and PROMIS-anger (β = -0.09) remained until follow-up. Moreover, positive affect (β = 0.19), internal control beliefs (β = 0.15), favorable coping (β = 0.60), and unfavorable coping (β = -0.41) improved more in the intervention group than in the control group, and these effects were mostly maintained in the long term. Some effects were stronger among women, older individuals, and individuals with higher initial symptoms. These findings suggest that AR can effectively reduce mental health problems in daily life. Trial registration. The trial has been registered at ClinicalTrials.gov (NCT03311529).
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Affiliation(s)
- Eva Asselmann
- Department of Psychology, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Potsdam, Germany
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Monique Zenker
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Frank Rückert
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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Kische H, Voss C, Pieper L, Beesdo-Baum K. ODP029 Associations between Objective and Subjective Indicators of Stress and Sleep Disturbance in Adolescents and Young Adults from the General Population. J Endocr Soc 2022. [DOI: 10.1210/jendso/bvac150.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Sleep is a complex and dynamic vital state, occupying one third of human's lifetime. Disturbed sleep can be a symptom of and a risk factor for a wide range of mental disorders and somatic diseases. One pathway through which sleep problems may lead to health problems is by dysregulation of the body's physiological stress response system as indicated by aberrant cortisol. Previous findings showed that poor sleep quality and sleep disruption were associated with elevated cortisol levels in adults. Regarding adolescents, there is evidence that sleep problems are linked to hyper-reactivity to stress with effects being stronger in girls than boys. In addition, adolescence itself was associated with decreased sleep quality and an increase in perceived stress dependent on age. However, little evidence is available for the association between objective and subjective stress markers and sleep in the daily life of adolescents from the general population. The aim of this study was to examine the association between 1) cortisol and 2) subjective stress with sleep in adolescents and young adults.
Methods
We used baseline data (11/2015–12/2016) of the Behavior and Mind Health(BeMIND) study, an epidemiological study based on a random community sample of individuals aged 14 to 21 years (Dresden, Germany, N = 1,180). We assessed sleep disturbance with the short form of the PROMIS Sleep-Disturbance questionnaire (8 items) via Ecological Momentary Assessment, conducted on four days directly after awakening, calculated mean. Cortisol was measured in hair (pg/mg) and saliva (nmol/l). Cortisol awakening response and total cortisol were calculated. Subjective stress was assessed via 1) the Perceived Stress Scale (PSS), 2) the Trier Inventory of the Assessment of Chronic Stress-Screening (TICS), and 3) two items for time urgency (subjective stress in school/at work/university and leisure, self-developed). Weighted linear regressions with robust standard errors were performed after exclusions (n = 1132, 48.4% female). Models were adjusted for sex, age, pubertal development and rerun in sex-specific analyses.
Results
Mean age was 17.83 (SD 0. 07). Neither hair, nor saliva cortisol was associated with PROMIS Sleep (hair cortisol: unstandardized β-coefficient: -0. 002, 95% confidence interval (CI): -0. 012; 0. 007). All analyzed subjective stress variables were associated with PROMIS Sleep. We found positive associations between PSS (β-coefficient: 0.151, 95% CI: 0.117; 0.183), TICS (β-coefficient: 0. 056, 95% CI: 0. 045; 0. 066), and time urgency (β-coefficient: 0.114, 95% CI: 0. 061; 0.166) with sleep. There was no evidence for sex-specific effects.
Conclusion
Results confirmed the association between perceived stress and sleep in a population-based study with adolescents and young adults, that was previously shown mainly in adults. No evidence for a link between cortisol and sleep was found. Further analyses would benefit from a longitudinal perspective and consideration of mediating/moderation variables to elucidate the complex interplay between stress and sleep.
Presentation: No date and time listed
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Beesdo-Baum K, Zenker M, Rückert F, Kische H, Pieper L, Asselmann E. Efficacy of Applied Relaxation as indicated preventive intervention in individuals at increased risk for mental disorders: A randomized controlled trial. Behav Res Ther 2022; 157:104162. [DOI: 10.1016/j.brat.2022.104162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/07/2022] [Accepted: 07/08/2022] [Indexed: 11/02/2022]
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Kische H, Ollmann TM, Voss C, Hoyer J, Rückert F, Pieper L, Kirschbaum C, Beesdo-Baum K. Corrigendum to "Associations of saliva cortisol and hair cortisol with generalized anxiety, social anxiety, and major depressive disorder: An epidemiological cohort study in adolescents and young adults" [Psychoneuroendocrinology 126 (2021)]. Psychoneuroendocrinology 2022; 141:105797. [PMID: 35595616 DOI: 10.1016/j.psyneuen.2022.105797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany.
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany
| | - Jana Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany; Centre for Obesity, St¨adtisches Klinikum Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universit¨at Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universit¨at Dresden, Dresden, Germany
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Ollmann TM, Seidl E, Venz J, Pieper L, Voss C, Hoyer J, Kische H, Poppenhäger SR, Schiele MA, Domschke K, Beesdo-Baum K. 5-HTT genotype and inertia of negative affect in adolescents and young adults from the general population. J Neural Transm (Vienna) 2022; 129:343-351. [PMID: 35246765 PMCID: PMC8930868 DOI: 10.1007/s00702-022-02459-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/03/2022] [Indexed: 11/28/2022]
Abstract
The study aims to replicate the previous found association of 5-HTTLPR and inertia of negative affect in daily life of adolescents and young adults. Data of 877 adolescents (aged 14–21 years) of the Behavior and Mind Health (BeMIND) study (epidemiological cohort study, Dresden, Germany) were genotyped for 5-HTTLPR/rs25531, grouped into SS/SLG/SLA/LGLA/LGLG vs. LALA, and provided ratings on negative affect items, depression and anxiety (Patient-Reported Outcomes Measurement Information System) eight times a day over 4 days. Multilevel regression models did not reveal an association of 5-HTTLPR genotype and inertia of negative affect, nor associations with inertia of anxiety or depression. Inertia of negative affect seems not to be a psychological mechanism through which 5-HTTLPR acts on psychopathology.
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Affiliation(s)
- T. M. Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - E. Seidl
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - J. Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - L. Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - C. Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - J. Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - H. Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - S. R. Poppenhäger
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - M. A. Schiele
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - K. Domschke
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Basics in NeuroModulation, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - K. Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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12
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Kische H, Zenker M, Pieper L, Beesdo-Baum K, Asselmann E. Applied relaxation and cortisol secretion: findings from a randomized controlled indicated prevention trial in adults with stress, anxiety, or depressive symptoms. Stress 2022; 25:122-133. [PMID: 35285766 DOI: 10.1080/10253890.2022.2045939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Previous research has shown that relaxation interventions can reduce distress, anxiety, and depression. The exact mechanisms that underlie the efficacy of relaxation interventions remain unresolved. This study aimed to investigate whether applied relaxation (AR) leads to changes in cortisol secretion and whether these effects mediate fewer symptoms due to AR. Data come from a randomized controlled preventive interventional trial (N = 277) with elevated tension/distress, anxiety, or depressive symptomatology. Participants were randomized to an intervention group (IG; n = 139, received AR training), or a non-interventional control group (CG, n = 138). Psychopathological symptoms were assessed with DASS-21 and diagnoses of mental disorders via DIA-X-5. Cortisol was measured as short-term index in saliva (six times/d for 2 d at pre-, post-, and follow-up [FU] assessment) and long-term index in hair samples (once at pre-assessment and FU, respectively). Data were analyzed as pre-specified secondary analyses of the randomized controlled trial (RCT) on completer basis (n = 134 CG, n = 102 IG), using multivariable-adjusted linear regression models and mediation analyses (the DASS-21 change in the IG vs. CG with cortisol (area under the curve [AUC]) as mediator). From pre- to post-assessment, total daily salivary cortisol (AUC) decreased more strongly in the IG vs. CG (β-coefficient: -13.83, 95% confidence interval [CI]: -26.85 to -0.81), but was rendered non-significant when adjusting for pre-assessment AUC. This effect was not found for the cortisol awakening response (CAR) or hair cortisol. There was no evidence for a mediation of cortisol (AUC). These findings provide little support for the idea that cortisol reductions explain the beneficial effects of AR on mental health.
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Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Monique Zenker
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Eva Asselmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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Kische H, Hannemann A, Voss C, Nauck M, Völzke H, Pieper L, Beesdo-Baum K, Arnold A. Lack of Significant Association between Sex Hormone Concentrations and Atopic Dermatitis in Adolescents and Adults in Two Population-Based Studies. J Invest Dermatol 2021; 142:486-489.e4. [PMID: 34314741 DOI: 10.1016/j.jid.2021.07.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/21/2021] [Accepted: 07/13/2021] [Indexed: 01/30/2023]
Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, University of Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, University of Greifswald, Greifswald, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, University of Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, University of Greifswald, Greifswald, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, University of Greifswald, Greifswald, Germany; Institute for Community Medicine, University Medicine Greifswald, University of Greifswald, Greifswald, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Andreas Arnold
- Clinic of Dermatology, University Medicine Greifswald, University of Greifswald, Greifswald, Germany
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14
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Kische H, Ollmann TM, Voss C, Hoyer J, Rückert F, Pieper L, Kirschbaum C, Beesdo-Baum K. Associations of saliva cortisol and hair cortisol with generalized anxiety, social anxiety, and major depressive disorder: An epidemiological cohort study in adolescents and young adults. Psychoneuroendocrinology 2021; 126:105167. [PMID: 33592366 DOI: 10.1016/j.psyneuen.2021.105167] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Most of the observed associations of generalized anxiety disorder (GAD), social anxiety disorder (SAD) and major depressive disorder (MDD) with cortisol concentrations came from clinical and adult study samples, with inconsistent findings, partly due to method variance. We examined cross-sectional and longitudinal associations between GAD, SAD and MDD with saliva and hair cortisol as well as hair cortisol change in a population-based sample of adolescents and young adults, considering relevant co-factors. DESIGN Epidemiological cohort study in Dresden, Germany. Data of 1050 individuals (mean age: 17.2 years) assessed at baseline (11/2015-12/2016) and of 605 individuals assessed at 1-year follow-up (FU1) are used. METHODS Multivariable regression models were implemented to assess cross-sectional and longitudinal associations of DSM-5 defined 12-month diagnoses of GAD, SAD, and MDD, with short-term (saliva cortisol: cortisol awakening response (CAR) and area under the curve (AUC) as total cortisol) and long-term (hair cortisol) cortisol indices. Multivariable models were adjusted for age or "tanner" stage, waist circumference, tobacco and alcohol consumption, physical inactivity, and hair cortisol dependent confounder. Sex-specific analyses were additionally conducted. RESULTS Cross-sectional analyses revealed positive associations between SAD and baseline saliva cortisol in multivariable models (CAR: β-coefficient: 0.12; 95% CI: 0.01; 0.23) but could not be confirmed after adjusting for "tanner" stage or comorbid depression. Cross-sectional analyses concerning GAD and MDD in the full baseline sample yielded no significant associations. Sex-specific linear models revealed a significant inverse cross-sectional association between MDD (β-coefficient: - 2.21; 95% CI: - 3.64; - 0.79) as well as SAD (β-coefficient: - 2.21; 95% CI: - 4.03; - 0.38) with baseline hair cortisol in males, but not in females. In longitudinal analyses, no significant associations were found in the fully adjusted model, except for a positive association between hair cortisol change between baseline and FU1 and FU1-SAD (OR: 1.07; 95% CI: 1.02; 1.12). CONCLUSIONS Results confirmed sex-specificity and the role of pubertal development in the association between cortisol with SAD and MDD, while no association emerged regarding cortisol and GAD. Future research in adolescents focusing on the role of cortisol in the pathogenesis of anxiety and depressive disorders would benefit from considering factors like sex-specificity and puberty development as well as comorbidity.
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Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jana Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Centre for Obesity, Städtisches Klinikum Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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15
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Walther A, Wehrli S, Kische H, Penz M, Wekenborg M, Gao W, Rothe N, Beesdo-Baum K, Kirschbaum C. Depressive symptoms are not associated with long-term integrated testosterone concentrations in hair. World J Biol Psychiatry 2021; 22:288-300. [PMID: 32657193 DOI: 10.1080/15622975.2020.1795253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The association between depressive symptomatology and endogenous testosterone levels is inconclusive. Large inter- and intra-individual testosterone differences suggest point measurements from saliva or serum to be inadequate to map basal testosterone concentrations highlighting the potential for long-term integrated testosterone levels from hair. METHODS Using data from a prospective cohort study, a total of 578 participants (74% female) provided complete data on depressive symptomatology, clinical features, and hair samples for quantification of testosterone concentrations at baseline. Available data of three annual follow-up examinations were used for longitudinal analyses. RESULTS Correlation analysis showed in both, men and women, hair testosterone across all the four time points not to be significantly related to depressive symptoms. Examined clinical features were not associated with testosterone levels, except for having a current diagnosis of a psychological disorder, which was associated with reduced testosterone levels in men, but not in women. Acceptable model fit for an autoregressive cross-lagged panel analysis emerged only for the female subsample suggesting inverse cross-relations for the prediction of testosterone by depressive symptomatology and vice versa. CONCLUSIONS Findings from this study add to the literature by showing no association between long-term integrated testosterone in hair and depressive symptomatology in men and women.
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Affiliation(s)
- A Walther
- Department of Biopsychology, TU Dresden, Dresden, Germany.,Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - S Wehrli
- Department of Biopsychology, TU Dresden, Dresden, Germany.,Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - H Kische
- Department of Behavioral Epidemiology, TU Dresden, Dresden, Germany
| | - M Penz
- University Hospital Dresden Clinic and Polyclinic for Psychotherapy and Psychosomatics, Dresden, Germany
| | - M Wekenborg
- Department of Biopsychology, TU Dresden, Dresden, Germany
| | - W Gao
- Department of Biopsychology, TU Dresden, Dresden, Germany
| | - N Rothe
- Department of Biopsychology, TU Dresden, Dresden, Germany
| | - K Beesdo-Baum
- Department of Behavioral Epidemiology, TU Dresden, Dresden, Germany
| | - C Kirschbaum
- Department of Biopsychology, TU Dresden, Dresden, Germany
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Ollmann TM, Voss C, Venz J, Seidl E, Hoyer J, Kische H, Pieper L, Schiele MA, Domschke K, Beesdo-Baum K. The interaction of 5-HTT variation, recent stress, and resilience on current anxiety levels in adolescents and young adults from the general population. Depress Anxiety 2021; 38:318-327. [PMID: 33058370 DOI: 10.1002/da.23101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/11/2020] [Accepted: 09/09/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous work on gene-environment (GxE) interplay concerning anxiety has focused on the interaction of 5-HTTLPR with childhood adversities or traumatic events whereas the impact of recent stressors is understudied, as is the integration of resilience. The current study aimed to investigate the interactive effect of 5-HTTLPR and recent stress on anxiety in adolescents considering resilience as buffer of a GxE risk constellation. METHOD In a random population-based sample of 14-21 years old from Dresden, Germany, (N = 1180; genotyped = 942) recent stress (Daily Hassles [DH] Scale, Perceived Stress Scale, Screening Scale of the Trier Inventory for the Assessment of Chronic Stress), resilience (Connor-Davidson resilience scale) and anxiety (Patient Reported Outcome Measurement Information System Anxiety Short Form) were assessed via questionnaire in 2015 or 2016. RESULTS Fractional regression models revealed that resilience interacted with recent stress in form of DH as well as recent chronic stress and 5-HTTLPR regarding anxiety. Participants carrying the more active LA LA genotype reported consistently higher levels of anxiety when experiencing more DH or more recent chronic stress and having low levels of resilience. When the resilience scores were high, LA LA carriers reported the lowest anxiety scores despite DH or recent chronic stress. CONCLUSION Findings revealed an interactive relationship between 5-HTTLPR genotype and recent stress suggesting resilience to function as an additional dimension buffering the impact of a GxE risk constellation. Early interventions to build resilience may be useful to prevent an escalation of distress and associated unfavorable health outcomes.
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Affiliation(s)
- Theresa M Ollmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - John Venz
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute of Clinical Psychology and Psychotherapy, Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - Esther Seidl
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jana Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute of Clinical Psychology and Psychotherapy, Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, Center for Basics in NeuroModulation, University of Freiburg, Freiburg, Germany
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute of Clinical Psychology and Psychotherapy, Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
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Beesdo‐Baum K, Voss C, Venz J, Hoyer J, Berwanger J, Kische H, Ollmann TM, Pieper L. The Behavior and Mind Health (BeMIND) study: Methods, design and baseline sample characteristics of a cohort study among adolescents and young adults. Int J Methods Psychiatr Res 2020; 29:e1804. [PMID: 31808242 PMCID: PMC7051848 DOI: 10.1002/mpr.1804] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 04/14/2019] [Accepted: 08/16/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES The Behavior and Mind Health (BeMIND) study is a population-based cohort study of adolescents and young adults from Dresden, Germany. The aim is to investigate psychological and behavioral factors linked to a range of mental disorders and health behaviors and their interaction with social-environmental and genetic/biologic factors. METHODS A random sample of 14-21 year olds was drawn from the population registry in 2015. The baseline investigation was completed 11/2015-12/2016 (N = 1,180). Assessments include standardized diagnostic interview, cognitive-affective tasks, questionnaires, biosamples, and ecologic momentary assessment in real life with combined actigraphic/geographic monitoring. In the family study component, parents completed similar assessments and provided information on child's early development. RESULTS The participation rate (minimum response proportion) was 21.7%; the cooperation rate was 43.4%. Acceptance and completion of study components were high. General health data indicate that more than 80% reported no or only mild impairment due to mental or somatic health problems in the past year; about 20% ever sought treatment for mental health problems or chronic somatic illnesses, respectively. CONCLUSIONS Data from BeMIND baseline and follow-up investigations will provide novel insights into contributors to health and disease as adolescents grow into adulthood.
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Affiliation(s)
- Katja Beesdo‐Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - John Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Jana Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Johanna Berwanger
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
- Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and PsychotherapyTechnische Universität DresdenDresdenGermany
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18
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Asselmann E, Kische H, Haring R, Hertel J, Schmidt CO, Nauck M, Beesdo-Baum K, Grabe HJ, Pané-Farré CA. Prospective associations of androgens and sex hormone-binding globulin with 12-month, lifetime and incident anxiety and depressive disorders in men and women from the general population. J Affect Disord 2019; 245:905-911. [PMID: 30699875 DOI: 10.1016/j.jad.2018.11.052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/05/2018] [Accepted: 11/03/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Findings on associations of androgens and sex hormone-binding globulin (SHBG) with anxiety and depressive disorders in the general population remain inconclusive. METHODS We used data of n = 993 men and n = 980 women from the Study of Health in Pomerania (SHIP, a prospective-longitudinal general population study from northeastern Germany). Immunoassay-measured serum concentrations of total testosterone, androstenedione and SHBG were assessed when participants were aged 20-80. 12-month, lifetime and incident DSM-IV anxiety and depressive disorders were assessed with the DIA-X/M-CIDI at 10-year follow-up, when participants were aged 29-89. Logistic regressions were adjusted for age, smoking, alcohol consumption, physical activity, waist circumference, hypertension and oral contraceptive use (women only) at baseline and follow-up interval. RESULTS In men and women, androgens and SHBG were not associated significantly with incident anxiety and depressive disorders. In men, higher total testosterone predicted any 12-month (OR = 1.46) and lifetime (OR = 1.34) anxiety disorder, lifetime social phobia (OR = 2.15), and 12-month (OR = 1.48) and lifetime (OR = 1.39) specific phobia, but neither 12-month nor lifetime depression. Moreover, androstenedione in men interacted with age in predicting lifetime anxiety disorders (OR = 0.98): Higher androstenedione more strongly predicted lifetime anxiety in younger vs. older men. These findings, however, did not survive correction for multiple testing. In women, androgens and SHBG were not associated significantly with 12-month and lifetime anxiety and depressive disorders. LIMITATIONS The follow-up period was relatively long and other factors might have affected the examined associations. CONCLUSIONS Higher serum total testosterone in men and androstenedione in younger men may relate to an increased risk of anxiety disorders.
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Affiliation(s)
- Eva Asselmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany; Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Johannes Hertel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | | | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research, Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Christiane A Pané-Farré
- Department of Physiological and Clinical Psychology, University of Greifswald, Greifswald, Germany
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19
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Kische H, Arnold A, Gross S, Wallaschofski H, Völzke H, Nauck M, Haring R. Sex Hormones and Hair Loss in Men From the General Population of Northeastern Germany. JAMA Dermatol 2019; 153:935-937. [PMID: 28403384 DOI: 10.1001/jamadermatol.2017.0297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Hanna Kische
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.,Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
| | - Andreas Arnold
- Clinic of Dermatology, University Medicine Greifswald, Germany
| | - Stefan Gross
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany.,Department of Cardiology, University Medicine Greifswald, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany.,Institute for Community Medicine, University Medicine Greifswald, Germany.,German Centre for Diabetes Research (DZD), partner site Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Germany
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.,European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Kische H, Hoyer J, Pieper L, Venz J, Klotsche J, März W, Koch-Gromus U, Pittrow D, Lehnert H, Silber S, Stalla GK, Zeiher AM, Wittchen HU, Haring R. Testosterone is not associated with traits of optimism or pessimism: Observational evidence from the prospective DETECT study. PLoS One 2018; 13:e0207870. [PMID: 30496216 PMCID: PMC6264867 DOI: 10.1371/journal.pone.0207870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/06/2018] [Indexed: 11/18/2022] Open
Abstract
Background Previous experimental research on testosterone (T) and psychological traits is inconclusive. Thus, we performed the first large-scale observational study of the association between T and dispositional optimism / pessimism. Methods We used prospective data from 6,493 primary-care patients (3,840 women) of the DETECT study (Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment), including repeated immunoassay-based measurement of serum T and optimism / pessimism assessed by the revised Life-Orientation Test (LOT-R). Cross-sectional and longitudinal associations of baseline T and one-year change in T with optimism and pessimism were investigated using age- and multivariable-adjusted regression models. Results Cross-sectional analyses showed no association of T with optimism or pessimism in both sexes. Longitudinal analyses also showed no association of baseline T with optimism or pessimism at four-year follow-up. Multivariable analyses of total LOT-R score yielded similarly non-significant results (β-coefficient per unit change in T for men: -0.01 (95% CI: -0.24–0.22), women: 0.08 (-0.03–0.20)). Furthermore, change in T was not related to optimism or pessimism at four-year follow-up. Conclusions The present observational study of a large-scale prospective sample showed no association of T with optimism or pessimism. Integrating further experimental and interventional evidence from alternative methodological approaches would strengthen this conclusion and establish stronger evidence about the potential hormonal basis of psychological traits.
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Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Jürgen Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - John Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Jens Klotsche
- German Rheumatism Research Centre Berlin, Berlin, Germany
| | - Winfried März
- Medical Clinic V, Medical Faculty Mannheim at Heidelberg University, Heidelberg, Germany
| | - Uwe Koch-Gromus
- Department of Medical Psychology, University Medical Center Eppendorf, Hamburg, Germany
| | - David Pittrow
- Institute of Clinical Pharmacology, Medical Faculty, Technical University of Dresden, Dresden, Germany
| | - Hendrik Lehnert
- Department of Medicine I, University of Schleswig-Holstein, Lübeck, Germany
| | | | | | - Andreas M. Zeiher
- Department of Medicine III Cardiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Robin Haring
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- * E-mail:
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Kische H, Pieper L, Venz J, Klotsche J, März W, Koch-Gromus U, Pittrow D, Lehnert H, Silber S, Stalla GK, Zeiher AM, Wittchen HU, Haring R. Longitudinal change instead of baseline testosterone predicts depressive symptoms. Psychoneuroendocrinology 2018; 89:7-12. [PMID: 29306775 DOI: 10.1016/j.psyneuen.2017.12.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/16/2017] [Accepted: 12/20/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND The association between total testosterone (T) and depression mostly relies on single sex hormone assessment and remains inconclusive. Thus, we investigated the comparative predictive performance of baseline T and change in T with development of depressive symptoms and incident depressive episodes. METHODS We used data from 6493 primary care patients (2653 men and 3840 women) of the DETECT study (Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment), including four-year follow-up, repeated immunoassay-based measurement of serum T and depressive symptoms assessed by the Depression Screening Questionnaire (DSQ). Cross-sectional and longitudinal associations of baseline T and one-year change in T with prevalent and incident depression were investigated using age- and multivariable-adjusted regression models. RESULTS Baseline T showed no association with prevalent or incident depressive symptoms and episodes in both sexes. In men, a positive change in T (higher T at one-year follow-up compared to baseline) was associated with a lower burden of depressive symptoms (β-coefficient per unit change in T: -0.17; 95% CI: -0.31 to -0.04) and lower risk of incident depressive symptoms (odds ratio per unit change in T: 0.84; 95% CI: 0.72-0.98) at four-year follow-up. In women, the association of T change with incident depressive episodes was rendered non-significant after multivariable adjustment. DISCUSSION The present study observed a sex-specific inverse association of T change, but not baseline T, with increased depressive symptom burden in men. Future studies should assess longitudinal changes in sex hormone status as predictor of adverse health outcomes related to low T.
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Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany.
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany
| | - John Venz
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany
| | | | - Winfried März
- Medical Clinic V, Medical Faculty Mannheim of Heidelberg University, Germany
| | - Uwe Koch-Gromus
- Department of Medical Psychology, University Medical Center Eppendorf, Hamburg, Germany
| | - David Pittrow
- Institute of Clinical Pharmacology, Medical Faculty, Technical University Carl Gustav Carus, Dresden, Germany
| | - Hendrik Lehnert
- Department of Medicine I, University of Schleswig-Holstein, Lübeck, Germany
| | | | - G K Stalla
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Andreas M Zeiher
- Department of Medicine III Cardiology, Goethe-University Frankfurt, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany
| | - Robin Haring
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Seyfart T, Friedrich N, Kische H, Bülow R, Wallaschofski H, Völzke H, Nauck M, Keevil BG, Haring R. Association of sex hormones with physical, laboratory, and imaging markers of anthropometry in men and women from the general population. PLoS One 2018; 13:e0189042. [PMID: 29324787 PMCID: PMC5764233 DOI: 10.1371/journal.pone.0189042] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/19/2017] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the association of sex hormones with anthropometry in a large population-based cohort, with liquid chromatography-mass spectrometry (LCMS)-based sex hormone measurements and imaging markers. STUDY DESIGN/MAIN OUTCOME MEASURES Cross-sectional data from 957 men and women from the population-based Study of Health in Pomerania (SHIP) were used. Associations of a comprehensive panel of LCMS-measured sex hormones with anthropometric parameters, laboratory, and imaging markers were analyzed in multivariable regression models for the full sample and stratified by sex. Sex hormone measures included total testosterone (TT), free testosterone (fT), estrone and estradiol, androstenedione (ASD), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG). Domains of anthropometry included physical measures (body-mass-index (BMI), waist circumference, waist-to-height-ratio, waist-to-hip-ratio, and hip circumference), laboratory measures of adipokines (leptin and vaspin), and magnet resonance imaging-based measures (visceral and subcutaneous adipose tissue). RESULTS In men, inverse associations between all considered anthropometric parameters with TT were found: BMI (β-coefficient, standard error (SE): -0.159, 0.037), waist-circumference (β-coefficient, SE: -0.892, 0.292), subcutaneous adipose tissue (β-coefficient, SE: -0.156, 0.023), and leptin (β-coefficient, SE: -0.046, 0.009). In women TT (β-coefficient, SE: 1.356, 0.615) and estrone (β-coefficient, SE: 0.014, 0.005) were positively associated with BMI. In analyses of variance, BMI and leptin were inversely associated with TT, ASD, and DHEAS in men, but positively associated with estrone. In women, BMI and leptin were positively associated with all sex hormones. CONCLUSION The present population-based study confirmed and extended previously reported sex-specific associations between sex hormones and various anthropometric markers of overweight and obesity.
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Affiliation(s)
- Tom Seyfart
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hanna Kische
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- * E-mail:
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), University Medicine Greifswald, Greifswald, Germany
| | - Brian G. Keevil
- Department of Clinical Chemistry, University Hospital South Manchester, Manchester, United Kingdom
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
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Pätzug K, Friedrich N, Kische H, Hannemann A, Völzke H, Nauck M, Keevil BG, Haring R. Sex hormones and quantitative ultrasound parameters at the heel in men and women from the general population. Bone Rep 2017; 7:51-56. [PMID: 28875157 PMCID: PMC5574814 DOI: 10.1016/j.bonr.2017.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 08/15/2017] [Accepted: 08/17/2017] [Indexed: 11/28/2022] Open
Abstract
Purpose/introduction The present study investigates potential associations between liquid chromatography-mass spectrometry (LC-MS) measured sex hormones, dehydroepiandrosterone sulphate, sex hormone-binding globulin (SHBG) and bone ultrasound parameters at the heel in men and women from the general population. Methods Data from 502 women and 425 men from the population-based Study of Health in Pomerania (SHIP-TREND) were used. Cross-sectional associations of sex hormones including testosterone (TT), calculated free testosterone (FT), dehydroepiandrosterone sulphate (DHEAS), androstenedione (ASD), estrone (E1) and SHBG with quantitative ultrasound (QUS) parameters at the heel, including broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (SI) were examined by analysis of variance (ANOVA) and multivariable quantile regression models. Results Multivariable regression analysis showed a sex-specific inverse association of DHEAS with SI in men (Beta per SI unit = − 3.08, standard error (SE) = 0.88), but not in women (Beta = − 0.01, SE = 2.09). Furthermore, FT was positively associated with BUA in men (Beta per BUA unit = 29.0, SE = 10.1). None of the other sex hormones (ASD, E1) or SHBG was associated with QUS parameters after multivariable adjustment. Conclusions This cross-sectional population-based study revealed independent associations of DHEAS and FT with QUS parameters in men, suggesting a potential influence on male bone metabolism. The predictive role of DHEAS and FT as a marker for osteoporosis in men warrants further investigation in clinical trials and large-scale observational studies. Population-based data of healthy men and women from the general population Sex hormone panel measured by liquid chromatography-mass spectrometry (LC-MS) Associations of dehydroepiandrosterone sulphate and free testosterone with bone ultrasound parameters in men Estrone, androstenedione and SHBG were not associated with bone ultrasound parameters in both sexes.
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Key Words
- ANOVA, analysis of variance
- ASD, androstenedione
- BMD, bone mineral density
- BUA, broadband ultrasound attenuation
- Bone
- CI, confidence interval
- DHEAS
- DHEAS, dehydroepiandrosterone sulphate
- E1, estrone
- FT, free testosterone
- LC-MS, liquid chromatography-mass spectrometry
- QUS, quantitative ultrasound
- SE, standard error
- SHBG, sex hormone-binding globulin
- SHIP, Study of Health in Pomerania
- SI, stiffness index
- SOS, speed of sound
- Sex hormones
- Stiffness index
- TT, testosterone
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Affiliation(s)
- Konrad Pätzug
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Hanna Kische
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.,DZD (German Centre for Diabetes Research), Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Greifswald, Germany
| | - Brian G Keevil
- Department of Clinical Chemistry, University Hospital South Manchester, UK
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.,European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Kische H, Gross S, Wallaschofski H, Grabe HJ, Völzke H, Nauck M, Haring R. Associations of androgens with depressive symptoms and cognitive status in the general population. PLoS One 2017; 12:e0177272. [PMID: 28498873 PMCID: PMC5428943 DOI: 10.1371/journal.pone.0177272] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/25/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Associations between androgens and depressive symptoms were mostly reported from cross-sectional and patient-based studies. STUDY DESIGN/MAIN OUTCOME MEASURES Longitudinal data from 4,110 participants of the Study of Health in Pomerania were used to assess sex-specific associations of baseline total and free testosterone, androstenedione and sex hormone-binding globulin with incident depressive symptoms and cognitive status at 5- and 10-year follow-up. RESULTS Despite sex-specific differences in depressive symptoms prevalence at baseline (women: 17.4%, men: 8.1%), cross-sectional analyses showed no associations between sex hormones and depressive symptoms. In age-adjusted longitudinal analyses, total testosterone was associated with incident depressive symptoms (relative risk at 5-year follow-up: 0.73, 95% confidence interval: 0.58-0.92). Similarly, age-adjusted analyses showed a positive association between sex hormone-binding globulin and cognitive status in men (β-coefficient per standard deviation: 0.44, 95% confidence interval: 0.13-0.74). In women, age-adjusted associations of androstenedione with baseline depressive symptoms (relative risk: 0.88, 95% confidence interval: 0.77-0.99) were found. None of the observed associations remained after multivariable adjustment. CONCLUSIONS The present population-based, longitudinal study revealed inverse associations between sex hormones and depressive symptoms. However, the null finding after multivariable adjustment suggests, that the observed associations were not independent of relevant confounders including body mass index, smoking and physical inactivity. Furthermore, the low number of incident endpoints in our non-clinical population-based sample limited the statistical power and reduced the chance to detect a statistically significant effect.
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Affiliation(s)
- Hanna Kische
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- * E-mail:
| | - Stefan Gross
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
- Department of Cardiology, University Medicine Greifswald, Greifswald, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Kische H, Ewert R, Fietze I, Gross S, Wallaschofski H, Völzke H, Dörr M, Nauck M, Obst A, Stubbe B, Penzel T, Haring R. Sex Hormones and Sleep in Men and Women From the General Population: A Cross-Sectional Observational Study. J Clin Endocrinol Metab 2016; 101:3968-3977. [PMID: 27403929 DOI: 10.1210/jc.2016-1832] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT AND OBJECTIVES Associations between sex hormones and sleep habits originate mainly from small and selected patient-based samples. We examined data from a population-based sample with various sleep characteristics and the major part of sex hormones measured by mass spectrometry. DESIGN, SETTING, AND PARTICIPANTS We used data from 204 men and 213 women of the cross-sectional Study of Health in Pomerania-TREND. MAIN OUTCOME AND MEASURES Associations of total T (TT) and free T, androstenedione (ASD), estrone, estradiol (E2), dehydroepiandrosterone-sulphate, SHBG, and E2 to TT ratio with sleep measures (including total sleep time, sleep efficiency, wake after sleep onset, apnea-hypopnea index [AHI], Insomnia Severity Index, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index) were assessed by sex-specific multivariable regression models. RESULTS In men, age-adjusted associations of TT (odds ratio 0.62; 95% confidence interval (CI) 0.46-0.83), free T, and SHBG with AHI were rendered nonsignificant after multivariable adjustment. In multivariable analyses, ASD was associated with Epworth Sleepiness Scale (β-coefficient per SD increase in ASD: -0.71; 95% CI: -1.18 to -0.25). In women, multivariable analyses showed positive associations of dehydroepiandrosterone-sulphate with wake after sleep onset (β-coefficient: .16; 95% CI 0.03-0.28) and of E2 and E2 to TT ratio with Epworth Sleepiness Scale. Additionally, free T and SHBG were associated with AHI in multivariable models among premenopausal women. CONCLUSIONS The present cross-sectional, population-based study observed sex-specific associations of androgens, E2, and SHBG with sleep apnea and daytime sleepiness. However, multivariable-adjusted analyses confirmed the impact of body composition and health-related lifestyle on the association between sex hormones and sleep.
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Affiliation(s)
- Hanna Kische
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Ralf Ewert
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Ingo Fietze
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Stefan Gross
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Henry Völzke
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Marcus Dörr
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Anne Obst
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Beate Stubbe
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Thomas Penzel
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine (H.K., H.W., M.N., R.H.), Departments of Internal Medicine B (R.E., A.O., B.S.) and Cardiology (S.G., M.D.), and Institute for Community Medicine (H.V.), University Medicine Greifswald, D-17475 Greifswald, Germany; Interdisciplinary Sleep Center (I.F., T.P.), Charité, University Medicine, 10117 Berlin, Germany; German Centre for Cardiovascular Research (S.G., H.V., M.D., M.N.) and German Centre for Diabetes Research (H.V.), partner site Greifswald, 13092 Greifswald, Germany; and Faculty of Applied Public Health (R.H.), European University of Applied Sciences, 18051 Rostock, Germany
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Kische H, Gross S, Wallaschofski H, Völzke H, Dörr M, Nauck M, Haring R. Clinical correlates of sex hormones in women: The study of health in Pomerania. Metabolism 2016; 65:1286-96. [PMID: 27506736 DOI: 10.1016/j.metabol.2016.05.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/25/2016] [Accepted: 05/17/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite associations of sex hormones in women with increased cardiometabolic risk and mortality, the clinical correlates of altered sex hormone concentrations in women are less clearly understood. We investigated a broad range of clinical correlates of sex hormones in women from a large population-based sample. METHODS Data from 2560 women from two cohorts of the Study of Health in Pomerania were used. Stepwise multivariable regression models were implemented to investigate a broad range of behavioral, socio-demographic, and cardiometabolic clinical correlates related to total testosterone (TT), free testosterone (fT), androstenedione (ASD), dehydroepiandrosterone-sulfate (DHEAS), estrone (E1), estradiol (E2), and sex hormone-binding globulin (SHBG). RESULTS Waist circumference and BMI (β-coefficient: -0.03; 95% CI: -0.04; 0.03) were inversely related to SHBG, and BMI was positively related to TT (β-coefficient: 0.005; 95% CI: 0.001; 0.009), fT, E1, and E2. Smoking was positively related to TT (β-coefficient: 0.04; 95% CI: 0.01; 0.06), ASD, and fT. Systolic blood pressure (TT: β-coefficient: 0.002; 95% CI: 0.001; 0.003), hypertension (TT: β-coefficient: 0.05; 95% CI: 0.003; 0.11), low-density lipoprotein (LDL) cholesterol (TT: β-coefficient: 0.02; 95% CI: 0.01; 0.05), and total cholesterol (TT: β-coefficient: -0.03; 95% CI: 0.01; 0.05) were positively related to TT and ASD. Finally, type 2 diabetes mellitus (T2DM), and metabolic syndrome (MetS) were positively related to fT, but inversely related to SHBG. CONCLUSIONS Our population-based study, with sex hormone concentrations measured by liquid chromatography tandem mass spectrometry, revealed associations between clinical correlates including waist circumference, smoking, cohabitation, systolic blood pressure, cholesterol, and MetS with sex hormones. Thus, sex hormones and SHBG may play a role in the cardiovascular risk profile of women.
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Affiliation(s)
- Hanna Kische
- Institute of Clinical Chemistry and Laboratory Medicine.
| | - Stefan Gross
- German Centre for Cardiovascular Research (DZHK), site Greifswald; Department of Cardiology, University Medicine Greifswald, Germany
| | | | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), site Greifswald; Institute for Community Medicine
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), site Greifswald; Department of Cardiology, University Medicine Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine; German Centre for Cardiovascular Research (DZHK), site Greifswald
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine; European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
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Kische H, Gross S, Wallaschofski H, Völzke H, Dörr M, Nauck M, Felix SB, Haring R. Serum androgen concentrations and subclinical measures of cardiovascular disease in men and women. Atherosclerosis 2016; 247:193-200. [PMID: 26926599 DOI: 10.1016/j.atherosclerosis.2016.02.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/09/2016] [Accepted: 02/17/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Most of the observed associations of androgens and sex hormone-binding globulin (SHBG) with subclinical cardiovascular disease (CVD) stem from selected study samples with immunoassay-based hormone measurements. Thus, we used a large population-based sample with total testosterone (TT) and androstenedione (ASD) concentrations measured by liquid chromatography-tandem mass spectrometry. DESIGN Data of 2140 individuals (mean age: 60,8 years) from the cohort Study of Health in Pomerania were assessed at baseline and 5-year follow-up. METHODS Multivariable regression models were implemented to assess cross-sectional and longitudinal associations of TT, free testosterone (fT), ASD, SHBG and dehydroepiandrosterone-sulphate (DHEAS) with measures of subclinical CVD including intima media thickness (IMT), carotid plaques, left ventricular mass (LVM), fractional shortening (FS), relative wall thickness (RWT), and left ventricular geometry. RESULTS Cross-sectional analyses yielded an association of TT with IMT in women (β-coefficient per log unit increase: 0.02; 95% CI: 0.007; 0.45) and ASD with FS in both sexes (men: β-coefficient: -2.94; 95% CI: -4.75; -1.12; women: β-coefficient: 1.64; 95% CI: 0.55; 2.73). In longitudinal analyses, DHEAS was positively associated with FS change (β-coefficient: 2.34; 95% CI: -0.59; 4.08). In women, SHBG was positively associated with incident plaques (Q1 vs. Q3 (Ref.): β-coefficient: 1.35; 95% CI: 1.04; 1.74). In both sexes, longitudinal analyses showed no consistent association of TT with subclinical CVD. CONCLUSIONS Despite several sex-specific associations of androgens and SHBG with subclinical CVD, the present representative study for the age group ≥45 years among men and women from the general population detected no consistent associations in longitudinal analyses.
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Affiliation(s)
- Hanna Kische
- Institute of Clinical Chemistry and Laboratory Medicine, Germany.
| | - Stefan Gross
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany; Department of Cardiology, University Medicine Greifswald, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, Germany; German Centre for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany; Institute for Community Medicine, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany; Department of Cardiology, University Medicine Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, Germany; German Centre for Cardiovascular Research (DZHK), Greifswald, Germany
| | - Stephan B Felix
- German Centre for Cardiovascular Research (DZHK), Greifswald, Germany; Department of Cardiology, University Medicine Greifswald, Germany
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, Germany; European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
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Fenske B, Kische H, Gross S, Wallaschofski H, Völzke H, Dörr M, Nauck M, Keevil BG, Brabant G, Haring R. Endogenous Androgens and Sex Hormone-Binding Globulin in Women and Risk of Metabolic Syndrome and Type 2 Diabetes. J Clin Endocrinol Metab 2015; 100:4595-603. [PMID: 26445113 DOI: 10.1210/jc.2015-2546] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CONTEXT AND OBJECTIVES The association of endogenous androgens and sex hormone-binding globulin (SHBG) with metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) mostly 23562 refers to small and selected study samples with immunoassay-based measurements. Thus, we investigated the association of hormone levels with MetS and T2DM in women from a large population-based sample. DESIGN, SETTING, AND PARTICIPANTS A total of 2077 women from the Study of Health in Pomerania were assessed at baseline (N = 3160, 1997-2001) and 5-year follow-up (N = 1711, 2002-2006). MAIN OUTCOMES AND MEASURES We investigated associations of total testosterone (T) and androstenedione measured by liquid chromatography-tandem mass spectrometry, SHBG by immunoassay, and free T and free androgen index with MetS and T2DM. RESULTS Baseline prevalence of MetS and T2DM was 23.1% (N = 365) and 9.5% (N = 196), with an incidence of 17.7 and 7.0 per 1.000 person-years, respectively. Cross-sectional analyses yielded inverse associations of SHBG with MetS (relative risk [RR], 0.67; 95% confidence interval [CI], 0.60-0.74) and T2DM (RR, 0.61; 95% CI, 0.50-0.74) after multivariable adjustment. In longitudinal analyses, only age-adjusted models showed an inverse association of baseline SHBG with incident MetS (RR, 0.61; 95% CI, 0.51-0.73) and T2DM (RR, 0.58; 95% CI, 0.43-0.78). Multivariable-adjusted models stratified by menopausal status revealed an inverse association between SHBG and incident MetS risk in postmenopausal women (RR, 0.65; 95% CI, 0.51-0.81). CONCLUSIONS This longitudinal population-based study revealed independent inverse associations of SHBG with MetS and T2DM, suggesting low SHBG as a potential risk marker for cardiometabolic morbidity, especially among postmenopausal women.
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Affiliation(s)
- Benjamin Fenske
- Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057
| | - Hanna Kische
- Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057
| | - Stefan Gross
- Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057
| | - Henry Völzke
- Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057
| | - Marcus Dörr
- Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057
| | - Brian G Keevil
- Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057
| | - Georg Brabant
- Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057
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