Hair cortisol levels in posttraumatic stress disorder and metabolic syndrome
Hair cortisol levels in posttraumatic stress disorder and metabolic syndrome
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DOI：
10.1080/10253890.2020.1724949
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发表时间：
2020-02
期刊：
影响因子：
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通讯作者：
L. L. van den Heuvel-L.;T. Stalder;S. du Plessis;S. Suliman;C. Kirschbaum;S. Seedat
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文献类型：
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作者：
L. L. van den Heuvel-L.;T. Stalder;S. du Plessis;S. Suliman;C. Kirschbaum;S. Seedat
创伤后应激障碍（PTSD）患者代谢综合征（MetS）发生率增高，且PTSD和MetS均与下丘脑-垂体-肾上腺（HPA）轴功能改变相关。很少有研究调查了hpa轴功能障碍在PTSD和MetS共同发生中的可能作用。在一项病例对照研究中，我们旨在确定毛发皮质醇浓度（HCC）是否与(i) PTSD发病率和严重程度以及（ii） PTSD和MetS共发有关。我们使用DSM-5临床应用PTSD量表（CAPS-5）对216名年龄在20 - 79岁的混合血统女性进行PTSD诊断和严重程度评分（M = 43.8, SD =13.3）。毛发样本，代表三个月的皮质醇水平的回顾性窗口，获得并利用液相色谱-串联质谱分析。我们构建了多元线性回归模型来评估PTSD诊断、PTSD严重程度和MetS合并症是否与HCC相关，并控制潜在的混杂因素。PTSD患者（n = 110）的HCC发生率显著高于创伤暴露对照组（n = 106） （adj β = 0.154, p = 0.033; Cohen’s d = 0.44）， CAPS严重程度评分（adj β = 0.207, p = 0.005）与HCC显著相关。MetS与HCC无相关性，PTSD与MetS对HCC无显著相互作用。本研究为PTSD患者慢性神经内分泌失调介导的应激反应提供了证据，并具有明确的剂量-反应关系。然而，在这个样本中，HCC似乎对PTSD和MetS的合并症没有特异性。总结：我们发现，在南非患有创伤后应激障碍（PTSD）的女性头发样本中测量的应激激素皮质醇水平明显高于同样经历过创伤但没有创伤后应激障碍的女性。然而，在被研究的女性中，头发皮质醇水平与代谢综合征（心脏病的一系列危险因素）无关。因此，我们表明患有创伤后应激障碍的南非妇女长期应激激素水平升高，这种影响与创伤后应激障碍有关，而不仅仅是由于创伤暴露。
Abstract Individuals with post-traumatic stress disorder (PTSD) evidence increased rates of metabolic syndrome (MetS), and both PTSD and MetS are associated with alterations in hypothalamic–pituitary–adrenal (HPA) axis function. Few investigations have examined the possible role of HPA-axis dysfunction in the co-occurrence of PTSD and MetS. In a case-control study, we aimed to determine whether hair cortisol concentrations (HCC) were associated with (i) PTSD caseness and severity and (ii) PTSD and MetS co-occurrence. We used the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) to determine PTSD diagnoses and severity scores in 216 females of mixed ancestry aged between 20 and 79 years (M = 43.8, SD =13.3). Hair samples, representing a three-month retrospective window of cortisol levels, were obtained and analyzed utilizing liquid chromatography-tandem mass spectrometry. We constructed multivariate linear regression models to evaluate whether PTSD diagnosis, PTSD severity, and MetS comorbidity were associated with HCC, controlling for potential confounders. HCC were significantly higher (adj β = 0.154, p = .033; Cohen’s d = 0.44) in PTSD patients (n = 110) than trauma-exposed controls (n = 106) and CAPS severity scores (adj β = 0.207, p = .005) were significantly associated with HCC. MetS was not associated with HCC and there were no significant interactions between PTSD and MetS on HCC. This study provides evidence of a chronically dysregulated neuroendocrine mediated stress response in PTSD, with a clear dose-response relationship. HCC do not, however, appear to have specificity for the comorbidity of PTSD and MetS in this sample. LAY SUMMARY We found that levels of the stress hormone, cortisol, measured in hair samples were significantly higher in South African women with post-traumatic stress disorder (PTSD) than in women who had also experienced trauma but did not have PTSD. Hair cortisol levels were, however, not associated with metabolic syndrome, a cluster of risk factors for heart disease, in the women studied. We thus show that South African women with PTSD have elevated long-term stress hormone levels and that this effect is related to PTSD and not solely due to trauma exposure.