Τίτλος:
Psychological vulnerability to stress in carriers of congenital adrenal hyperplasia due to 21-hydroxylase deficiency
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective: 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 corticotropin-releasing hormone (CRH) secretion. Both cortisol and CRH have behavioral effects, and hypothalamic CRH hypersecretion has been associated with chronic states of anxiety and depression. We performed an endocrinologic and psychological evaluation in carriers of 21-OHD and matched control subjects. Design: We recruited 29 parents of children with classic CAH (14 males, 15 females; age (mean±SD): 41.8±5.7 yr), and hence 21-OHD carriers, and 13 normal subjects (5 males, 8 females; age: 43.8±6.1 yr). 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 24-hour urinary free cortisol (UFC) excretion. Psychometric assessment was performed by administering the State-Anxiety (STAI 1) and Trait-Anxiety (STAI 2) Inventory, 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 STAI 1 (47.6±5.6 vs. 43.3±5.4, P=0.023) scores than control subjects. Mean 24-hour UFC concentrations were positively correlated with paranoid (r=0.435; P=0.023) and psychoticism (r=0.454; P=0.017). Stepwise multiple linear regression analysis revealed that the single independent predictor of STAI 1 was peak stimulated 17-OHP concentrations (β: 0.055, SE: 0.023, R2: 0.290, P=0.031). Conclusions: Carriers of 21-OHD may be predisposed to the development of anxiety disorders. © 2017, Hellenic Endocrine Society. All rights reserved.
Συγγραφείς:
Kyritsi, E.-M.
Koltsida, G.
Farakla, I.
Papanikolaou, A.
Critselis, E.
Mantzou, E.
Zoumakis, E.
Kolaitis, G.
Chrousos, G.P.
Charmandari, E.
Περιοδικό:
Vitamins and Hormones
Εκδότης:
Hellenic Endocrine Society
Λέξεις-κλειδιά:
androstenedione; corticotropin; estradiol; glucose; hydrocortisone; hydroxyprogesterone; insulin; liothyronine; prasterone sulfate; prolactin; testosterone; thyrotropin; thyroxine; androstenedione; corticotropin; hydrocortisone; hydroxyprogesterone, adult; anxiety; Article; Beck Depression Inventory; blood sampling; chronic disease; clinical article; congenital adrenal hyperplasia; controlled study; corticotropin test; depression; female; genetic predisposition; genotype; heterozygote detection; hostility; human; hydrocortisone release; hypothyroidism; male; obsessive compulsive disorder; paranoia; parent; prediction; psychological well-being; psychometry; psychosis; questionnaire; social status; somatization; State Trait Anxiety Inventory; steroid 21 monooxygenase deficiency; stress; suicidal ideation; Symptom Checklist 90; Temperament and Character Inventory; Turner syndrome; anxiety; blood; case control study; congenital adrenal hyperplasia; genetics; middle aged; paranoid psychosis; psychology; urine, 17-alpha-Hydroxyprogesterone; Adrenal Hyperplasia, Congenital; Adrenocorticotropic Hormone; Adult; Androstenedione; Anxiety; Case-Control Studies; Female; Humans; Hydrocortisone; Male; Middle Aged; Paranoid Disorders; Psychometrics; Psychotic Disorders
DOI:
10.14310/horm.2002.1718
