Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Εμμανουήλ Ζουμάκης, Επίκουρος Καθηγητής, Iατρική Σχολή, ΕΚΠΑ
Γεώργιος Χρούσος, Ομότιμος Καθηγητής, Iατρική Σχολή, ΕΚΠΑ
Θεοκλής Ζαούτης, Καθηγητής, Iατρική Σχολή ΕΚΠΑ
Αθανάσιος Καδίτης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αντώνιος Καττάμης, Καθηγητής, Iατρική Σχολή, ΕΚΠΑ
Maria Roser Pons, Καθηγήτρια, Iατρική Σχολή, ΕΚΠΑ
Λάμπρος Φώτης, Επίκουρος Καθηγητής, Iατρική Σχολή, ΕΚΠΑ
Original Title:
Ενδροκρινολογική και ψυχολογική αξιολόγηση των φορέων της ανεπάρκειας της 21-υδροξυλάσης. Διερεύνηση ύπαρξης σωματικής και ψυχολογικής ευαισθησίας στο στρες
Translated title:
Endrocrinologic and psychologic evaluation of carries of 21- hydroxylase deficiency. Evidence for physical and psychological vulnerability to stress
Summary:
Background: Carriers of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) demonstrate increased secretion of cortisol precursors following ACTH stimulation, suggestive of impaired cortisol production and compensatory increases in hypothalamic CRH secretion. Both cortisol and CRH have behavioral effects, and hypothalamic CRH hypersecretion has been associated with chronic states of anxiety and depression.
Objective: To perform endocrinologic and psychologic evaluation in carriers of 21-OHD and matched control subjects.
Patients and Methods: Twenty-nine parents of children with classic CAH (14 males, 15 females; age (mean ± SEM): 41.76 ± 1.07 yr), and hence obligate 21-OHD carriers, and 13 normal subjects (5 males, 8 females; age: 43.77 ± 1.69 yr) were recruited to participate in the study. All subjects underwent a formal ovine (o) CRH stimulation test with measurement of ACTH, cortisol, 17-hydroxyprogesterone (17-OHP), and androstenedione concentrations, which was preceded by determination of urinary free cortisol excretion. Psychometric assessment was performed by administering the State-Anxiety Inventory (STAI), Beck Depression Inventory, Symptom Checklist-90R, and Temperament and Character Inventory.
Results: Carriers of 21-OHD had significantly higher 17-OHP concentrations following oCRH stimulation and higher STAI1 (47.6 ± 1.1 vs 43.3 ± 1.5, P=0.023) scores compared with control subjects. Mean 24-hour UFC concentrations were positively correlated with paranoid ideation (r=0.435; P=0.023) and psychotism (r=0.454; P=0.017). Stepwise multiple linear regression analysis revealed that the single independent predictor of state anxiety STAI1 was peak stimulated 17-OHP concentrations (β: 0.055, SE: 0.023, R2: 0.290, P=0.031).
Conclusions: Carrier state of 21-OHD may predispose subjects the development of anxiety disorde
Main subject category:
Health Sciences
Keywords:
Adrenal glands, Stress, 17- hydroxyprogesterone, Pituitary,
Number of references:
100
