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The Very Low-Dose Dexamethasone Suppression Test in the General Population: A Cross-Sectional Study
Determinants of the hypothalamic-pituitary-adrenal (HPA) axis functioning are increasingly explored in population-based studies. However, functional tests measuring the negative feedback of the HPA axis cannot easily be implemented into large observational studies. Furthermore, high doses of dexamet...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063373/ https://www.ncbi.nlm.nih.gov/pubmed/27736954 http://dx.doi.org/10.1371/journal.pone.0164348 |
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author | Direk, Nese Dekker, Marieke J. H. J. Luik, Annemarie I. Kirschbaum, Clemens de Rijke, Yolanda B. Hofman, Albert Hoogendijk, Witte J. G. Tiemeier, Henning |
author_facet | Direk, Nese Dekker, Marieke J. H. J. Luik, Annemarie I. Kirschbaum, Clemens de Rijke, Yolanda B. Hofman, Albert Hoogendijk, Witte J. G. Tiemeier, Henning |
author_sort | Direk, Nese |
collection | PubMed |
description | Determinants of the hypothalamic-pituitary-adrenal (HPA) axis functioning are increasingly explored in population-based studies. However, functional tests measuring the negative feedback of the HPA axis cannot easily be implemented into large observational studies. Furthermore, high doses of dexamethasone often completely suppress the HPA axis in healthy persons. This study aimed to detect the effects of the health, lifestyle and sociodemographic factors, psychiatric problems and cognitive functions on the negative feedback of the HPA axis using a very low-dose (0.25 mg) dexamethasone suppression test (DST).We evaluated the associations of several determinants with the saliva cortisol concentrations after dexamethasone intake in a confounder-adjusted model also corrected for baseline saliva cortisol concentrations in the Rotterdam Study, a large population-based study (N = 1822). We found that female sex, low income, lack of exercise, instrumental disability and smoking were all independently associated with stronger suppression of the HPA axis. Even though there were no linear associations between psychiatric measures and cortisol suppression, we found that depressive symptoms and anxiety disorders were more common in persons with non-suppression of cortisol. Conversely, psychotropic medication use was related to enhanced suppression of cortisol after DST. In this large study, we found that female gender, low socioeconomic status and poor health were all related to suppression of the HPA axis. Non-linear associations were detected between the suppression of the HPA axis and common psychiatric disorders in community-dwelling persons. |
format | Online Article Text |
id | pubmed-5063373 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-50633732016-11-04 The Very Low-Dose Dexamethasone Suppression Test in the General Population: A Cross-Sectional Study Direk, Nese Dekker, Marieke J. H. J. Luik, Annemarie I. Kirschbaum, Clemens de Rijke, Yolanda B. Hofman, Albert Hoogendijk, Witte J. G. Tiemeier, Henning PLoS One Research Article Determinants of the hypothalamic-pituitary-adrenal (HPA) axis functioning are increasingly explored in population-based studies. However, functional tests measuring the negative feedback of the HPA axis cannot easily be implemented into large observational studies. Furthermore, high doses of dexamethasone often completely suppress the HPA axis in healthy persons. This study aimed to detect the effects of the health, lifestyle and sociodemographic factors, psychiatric problems and cognitive functions on the negative feedback of the HPA axis using a very low-dose (0.25 mg) dexamethasone suppression test (DST).We evaluated the associations of several determinants with the saliva cortisol concentrations after dexamethasone intake in a confounder-adjusted model also corrected for baseline saliva cortisol concentrations in the Rotterdam Study, a large population-based study (N = 1822). We found that female sex, low income, lack of exercise, instrumental disability and smoking were all independently associated with stronger suppression of the HPA axis. Even though there were no linear associations between psychiatric measures and cortisol suppression, we found that depressive symptoms and anxiety disorders were more common in persons with non-suppression of cortisol. Conversely, psychotropic medication use was related to enhanced suppression of cortisol after DST. In this large study, we found that female gender, low socioeconomic status and poor health were all related to suppression of the HPA axis. Non-linear associations were detected between the suppression of the HPA axis and common psychiatric disorders in community-dwelling persons. Public Library of Science 2016-10-13 /pmc/articles/PMC5063373/ /pubmed/27736954 http://dx.doi.org/10.1371/journal.pone.0164348 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication. |
spellingShingle | Research Article Direk, Nese Dekker, Marieke J. H. J. Luik, Annemarie I. Kirschbaum, Clemens de Rijke, Yolanda B. Hofman, Albert Hoogendijk, Witte J. G. Tiemeier, Henning The Very Low-Dose Dexamethasone Suppression Test in the General Population: A Cross-Sectional Study |
title | The Very Low-Dose Dexamethasone Suppression Test in the General Population: A Cross-Sectional Study |
title_full | The Very Low-Dose Dexamethasone Suppression Test in the General Population: A Cross-Sectional Study |
title_fullStr | The Very Low-Dose Dexamethasone Suppression Test in the General Population: A Cross-Sectional Study |
title_full_unstemmed | The Very Low-Dose Dexamethasone Suppression Test in the General Population: A Cross-Sectional Study |
title_short | The Very Low-Dose Dexamethasone Suppression Test in the General Population: A Cross-Sectional Study |
title_sort | very low-dose dexamethasone suppression test in the general population: a cross-sectional study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063373/ https://www.ncbi.nlm.nih.gov/pubmed/27736954 http://dx.doi.org/10.1371/journal.pone.0164348 |
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