Estradiol variability, stressful life events, and the emergence of depressive symptomatology during the menopausal transition.
Estradiol variability, stressful life events, and the emergence of depressive symptomatology during the menopausal transition.
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DOI：
10.1097/gme.0000000000000528
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发表时间：
2016-03
期刊：
影响因子：
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通讯作者：
Girdler SS
中科院分区：
文献类型：
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作者：
Gordon JL;Rubinow DR;Eisenlohr-Moul TA;Leserman J;Girdler SS
研究雌二醇波动在绝经过渡期引发抑郁症状中的作用，并评估近期非常紧张的生活事件（VSLEs）作为这种关系的调节因素的作用。52名处于绝经过渡期或绝经早期（年龄45-60岁）的正常女性被分配到激素治疗的随机对照试验的安慰剂组，为本报告提供了数据。在招募时，评估了女性近期VSLE、抑郁症状、血清雌二醇和孕酮的经历。在第1个月、第8个月和第14个月，对抑郁症状和激素进行了重新评估，参与者接受了包括演讲和心算任务的压力刺激电池。参与者对他们的焦虑、恐惧、愤怒和拒绝的感觉进行评分。雌二醇的标准差提供了整个14个月内激素变异性的指数。14个月内雌二醇变异性越大，预测第14个月时抑郁症状越严重，但仅在基线时报告更多VSLE的女性中（39%的女性报告≤1起近期事件）。更大的雌二醇变异性也预测了在第8个月和第14个月时对实验室压力源的更大的排斥感。此外，在基线时报告VSLE较高的女性中，在第8个月对实验室压力源的拒绝感预测了第14个月的抑郁症状。这些数据表明，雌二醇的变化可能会增加情绪敏感性的心理社会压力，特别是敏感性的社会排斥。结合接近绝经过渡期的VSLE，这种敏感性的增加可能有助于抑郁情绪的发展。
To examine the role of estradiol fluctuation in triggering depressive symptoms in the menopause transition and assess the role of recent very stressful life events (VSLEs) as a moderating factor in this relationship. 52 euthymic women in the menopause transition or early postmenopause (age 45–60) who were assigned to the placebo arm of a randomized controlled trial of hormone therapy provided the data for this report. At enrollment, women’s experience of recent VSLEs, depressive symptoms, serum estradiol and progesterone were assessed. At months 1, 8 and 14, depressive symptoms and hormones were re-assessed and participants underwent a stressor battery involving a speech and a mental arithmetic task. Participants rated their feelings of anxiety, fear, anger and rejection. The standard deviation of estradiol provided an index of hormone variability over the entire 14 months. Greater estradiol variability across the 14 months predicted greater depressive symptoms at month 14, though only in women reporting a higher number of VSLEs at baseline (39% of women reported ≤1 recent event). Greater estradiol variability also predicted greater feelings of rejection to the laboratory stressor at months 8 and 14. Furthermore, among women reporting higher VSLEs at baseline, feelings of rejection in response to the laboratory stressor at month 8 predicted depressive symptoms at month 14. These data suggest estradiol variability may enhance emotional sensitivity to psychosocial stress, particularly sensitivity to social rejection. Combined with VSLEs proximate to the menopause transition, this increased sensitivity may contribute to the development of depressed mood.