The role of stress-induced cortisol in the relationship between depression and decreased bone mineral density

被引:39
作者
Furlan, PM
Ten Have, T
Cary, M
Zemel, B
Wehrli, F
Katz, IR
Gettes, DR
Evans, DL
机构
[1] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA
[2] Univ Penn, Dept Epidemiol & Biostat, Philadelphia, PA 19104 USA
[3] Univ Penn, Dept Med, Philadelphia, PA 19104 USA
[4] Univ Penn, Dept Neurosci, Philadelphia, PA 19104 USA
[5] Univ Penn, Childrens Hosp Philadelphia, Sch Med, Div Gastroenterol & Nutr, Philadelphia, PA 19104 USA
[6] Univ Penn, Med Ctr, Hosp Univ Penn, Dept Radiol,Lab Struct NMR Imaging, Philadelphia, PA 19104 USA
[7] Philadelphia Vet Adm Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA
关键词
depression; bone density; cortisol; stress; mediator; postmenopausal;
D O I
10.1016/j.biopsych.2004.12.033
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: This study was designed to test the hypothesis that cortisol mediates the relationship between bone density and depression in postmenopausal women. Methods. Nineteen women aged 52-79 who bad been assessed for bone mineral density by dual-energy x-ray absorptiometer (DEXA) were evaluated for depression and anxiety. Diurnal and stress-induced measures of salivary cortisol were obtained during the following week and at a laboratory session involving a speech task. Results. Nine volunteers reported depression while 10 were never depressed. Ever depressed women bad significantly lower total lumbar and right femur DEAA Z scores than never depressed (t(17) = 2.5, p = .019 and t(17) = 2.06, p = .05, respectively). Ever depressed women demonstrated a significant increase in salivary cortisol (area under the curve (AUC) 27.83, SD = 37.64) compared to never depressed women (AUC= -13.34, SD = 19.55) (t(17) = -3.041, p = .007) during a psychological challenge. There were significant inverse relationships between salivary cortisol AUC values and bone density Z scores at every measured bone site. Mediation analyses suggest that 51-67% of the association between depression and bone density could be attributed to stress-induced changes in cortisol. Conclusions. Cortisol hypesecretion in response to stress may, in pail, explain the impact of depression on bone density in post-menopausal women.
引用
收藏
页码:911 / 917
页数:7
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