Cortisol awakening response and subsequent depression: prospective longitudinal study.
Cortisol awakening response and subsequent depression: prospective longitudinal study.
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DOI：
10.1192/bjp.bp.113.126250
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发表时间：
2014-02
期刊：
影响因子：
--
通讯作者：
Lewis G
中科院分区：
文献类型：
--
作者：
Carnegie R;Araya R;Ben-Shlomo Y;Glover V;O'Connor TG;O'Donnell KJ;Pearson R;Lewis G
一些研究发现皮质醇升高与随后的抑郁症之间存在关联，但结果不一致。皮质醇觉醒反应可能是下丘脑-垂体-肾上腺功能和潜在应激反应的更稳定的测量方法。目的探讨唾液皮质醇，特别是皮质醇觉醒反应，是否与随后的抑郁症在一个大的人群队列。方法雅芳家长和儿童纵向研究（ALSPAC）的年轻人（年龄15岁，n = 841）收集唾液皮质醇在4个时间点为3个上学日。Logistic回归分析用于计算18岁时发生符合ICD-10标准的抑郁症的比值比。结果我们没有发现唾液皮质醇与随后的抑郁症之间存在关联的证据。皮质醇觉醒反应的比值比为1.24/标准差（95%CI 0.93-1.66，P = 0.14），调整混杂因素后为1.12（95%CI 0.73-1.72，P = 0.61）。没有证据表明其他皮质醇测量，包括每个时间点的皮质醇，昼夜下降和曲线下面积，与随后的抑郁症有关。结论我们的研究结果不支持唾液皮质醇升高会增加随后抑郁症的短期风险的假设。结果表明，如果确实存在关联，则关联很小，不太可能具有临床意义。
Background Some studies have found an association between elevated cortisol and subsequent depression, but findings are inconsistent. The cortisol awakening response may be a more stable measure of hypothalamic-pituitary-adrenal function and potentially of stress reactivity. Aims To investigate whether salivary cortisol, particularly the cortisol awakening response, is associated with subsequent depression in a large population cohort. Method Young people (aged 15 years, n = 841) from the Avon Longitudinal Study of Parents and Children (ALSPAC) collected salivary cortisol at four time points for 3 school days. Logistic regression was used to calculate odds ratios for developing depression meeting ICD-10 criteria at 18 years. Results We found no evidence for an association between salivary cortisol and subsequent depression. Odds ratios for the cortisol awakening response were 1.24 per standard deviation (95% CI 0.93-1.66, P = 0.14) before and 1.12 (95% CI 0.73-1.72, P = 0.61) after adjustment for confounding factors. There was no evidence that the other cortisol measures, including cortisol at each time point, diurnal drop and area under the curve, were associated with subsequent depression. Conclusions Our findings do not support the hypothesis that elevated salivary cortisol increases the short-term risk of subsequent depressive illness. The results suggest that if an association does exist, it is small and unlikely to be of clinical significance.
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