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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...

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Autores principales: Direk, Nese, Dekker, Marieke J. H. J., Luik, Annemarie I., Kirschbaum, Clemens, de Rijke, Yolanda B., Hofman, Albert, Hoogendijk, Witte J. G., Tiemeier, Henning
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
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.
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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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