The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms
The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms
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DOI：
10.1016/j.psyneuen.2014.04.001
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发表时间：
2014-07-01
影响因子：
3.7
通讯作者：
Olff, Miranda
中科院分区：
文献类型：
--
作者：
Mouthaan, Joanne;Sijbrandij, Marit;Olff, Miranda
背景资料：下丘脑-垂体-肾上腺（HPA）轴对应激反应的激活减少被怀疑是创伤后应激障碍（PTSD）的易感因素。先前的研究表明，关于皮质醇在预测创伤后应激障碍中的作用的研究结果不一致。此外，还没有前瞻性研究探讨脱氢表雄酮（DHEA）或其硫酸盐形式DHEAS以及皮质醇与DHEA（S）比率在预测创伤后应激障碍中的作用。在这项研究中，我们测试是否急性血浆皮质醇，脱氢表雄酮和皮质醇-脱氢表雄酮比率预测PTSD症状在6周和6个月posttraumatic.Methods：血液样本的397个成人1级创伤中心的病人，在创伤复苏室数小时内受伤后，进行了分析皮质醇和脱氢表雄酮水平。PTSD症状进行了评估，在6周和6个月后的创伤与临床医生管理PTSDScale.Results：多元线性回归分析表明，较低的皮质醇预测PTSD症状在6周和6个月，控制年龄，性别，采血时间，损伤，创伤史，入院重症监护。更高的DHEAS和一个较小的皮质醇DHEAS比率预测PTSD症状在6周，但不是在控制相同的变量，而不是在6 months.Conclusions：我们的研究提供了重要的新证据的关键作用的HPA轴在响应创伤显示，急性皮质醇和DHEAS水平预测PTSD症状的幸存者最近的创伤。(c)2014爱思唯尔有限公司版权所有。
Background: Decreased activation of the hypothalamus pituitary adrenal (HPA) axis in response to stress is suspected to be a vulnerability factor for posttraumatic stress disorder (PTSD). Previous studies showed inconsistent findings regarding the role of cortisol in predicting PTSD. In addition, no prospective studies have examined the role of dehydroepiandrosterone (DHEA), or its sulfate form DHEAS, and the cortisol-to-DHEA(S) ratio in predicting PTSD. In this study, we tested whether acute plasma cortisol, DHEAS and the cortisol-to-DHEAS ratio predicted PTSD symptoms at 6 weeks and 6 months post-trauma.Methods: Blood samples of 397 adult level-1 trauma center patients, taken at the trauma resuscitation room within hours after the injury, were analyzed for cortisol and DHEAS levels. PTSD symptoms were assessed at 6 weeks and 6 months post-trauma with the Clinician Administered PTSD Scale.Results: Multivariate linear regression analyses showed that lower cortisol predicted PTSD symptoms at both 6 weeks and 6 months, controlling for age, gender, time of blood sampling, injury, trauma history, and admission to intensive care. Higher DHEAS and a smaller cortisol-toDHEAS ratio predicted PTSD symptoms at 6 weeks, but not after controlling for the same variables, and not at 6 months.Conclusions: Our study provides important new evidence on the crucial role of the HPA-axis in response to trauma by showing that acute cortisol and DHEAS levels predict PTSD symptoms in survivors of recent trauma. (c) 2014 Elsevier Ltd. All rights reserved.