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Autoren: Schmalbach, Ileana
Herhaus, Benedict
Pässler, Sebastian
Runst, Sarah
Berth, Hendrik
Wolff-Stephan, Silvia
Petrowski, Katja
Titel: Cortisol reactivity in patients with anorexia nervosa after stress induction
Online-Publikationsdatum: 23-Apr-2021
Sprache des Dokuments: Englisch
Zusammenfassung/Abstract: There is a need of experimental studies on biomarkers in patients with anorexia nervosa (PAN), especially in the context of stress, in order to foster understanding in illness maintenance. To this end, the cortisol response to an acute stressor was investigated in n = 26 PAN (BMI: 19.3 ± 3.4 kg/m2), age, and gender matched to n = 26 healthy controls (HC; BMI: 23.08 ± 3.3 kg/m2). For this purpose, salivary cortisol parameters were assessed in two experimental conditions: (1) rest/no intervention and (2) stress intervention (TSST; Trier Social Stress Test). In addition, psychological indicators of stress were assessed (Primary Appraisal Secondary Appraisal, Visual Analogue Scale, and Trier Inventory for the assessment of Chronic Stress), as well as psychological distress, depression, and eating disorder (ED) symptoms. A 2 × 2 × 8 ANOVA demonstrated elevated cortisol levels in PAN in the resting condition. In the stress intervention no significant group effect in terms of cortisol (F (1, 50) = 0.69; p = 0.410; η2p=0.014). A significant condition (F (1, 50) = 20.50; p = 0.000; η2p=0.291) and time effect (F(2.71, 135.44) = 11.27; p = 0.000; η2p=0.20) were revealed, as well as two significant interaction effects. First: Condition × group (F (1, 50) = 4.17, p = 0.046; η2p=0.077) and second: Condition × time (F (2.71, 135.44) = 16.07, p = 0.000, η2p=0.24.). In terms of AUCG, no significant differences between both groups were exhibited. Regardless, significant results were evinced in terms of an increase (AUCi: F(1, 50) = 20.66, p = 0.015, η2p=0.113), baseline to peak (+20 min post-TSST: t5 = 16.51 (9.02), p = 0.029) and reactivity (MPAN = 0.73 vs. MHC = 4.25, p = 0.036). In addition, a significant correlation between AUCG and BMI: r (24) = −0.42, p = 0.027 was demonstrated, but not between AUCi and BMI (r (24) = −0.26, p = 0.20). Psychological indices suggested higher levels of chronic and perceived stress in PAN relative to HC. However, stress perception in the stress condition (VAS) was comparable. Additional analyses demonstrated that ED-symptoms are highly correlated with psychological distress and depression, but not with BMI. In addition, it could be demonstrated that reactivity is rather related to ED-symptoms and psychological burden than to BMI. In conclusion, PAN showed elevated basal cortisol levels at rest and exhibited a blunted cortisol reactivity to the TSST as evinced by salivary cortisol parameters. Further, it was shown that weight recovery influences reversibility of hypercortisolemia, i.e., cortisol levels normalize with weight gain. However, HPAA (hypothalamus–pituitary–adrenal axis) irregularities in terms of reactivity persist even at a BMI ≤ 19.3 (±3.4). Our data suggest that pronounced psychological burden in PAN, have a greater impact on the HPAA functionality (secondary to the ED) than BMI itself.
DDC-Sachgruppe: 610 Medizin
610 Medical sciences
Veröffentlichende Institution: Johannes Gutenberg-Universität Mainz
Organisationseinheit: FB 04 Medizin
Veröffentlichungsort: Mainz
ROR: https://ror.org/023b0x485
DOI: http://doi.org/10.25358/openscience-5790
Version: Published version
Publikationstyp: Zeitschriftenaufsatz
Nutzungsrechte: CC BY
Informationen zu den Nutzungsrechten: https://creativecommons.org/licenses/by/4.0/
Zeitschrift: Translational Psychiatry
10
Seitenzahl oder Artikelnummer: 275
Verlag: Nature Publishing Group
Verlagsort: London
Erscheinungsdatum: 2020
ISSN: 2158-3188
URL der Originalveröffentlichung: https://doi.org/10.1038/s41398-020-00955-7
DOI der Originalveröffentlichung: 10.1038/s41398-020-00955-7
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