Testosterone, estradiol, DHEA and cortisol in relation to anxiety and depression scores in adolescents

Briana NC Chronister; Eduardo Gonzalez; Dolores Lopez-Paredes; Jose Suarez-Torres; Sheila Gahagan; Danilo Martinez; Janeth Barros; David R. Jacobs; Harvey Checkoway; Jose R. Suarez-Lopez

doi:10.1016/j.jad.2021.07.026

Testosterone, estradiol, DHEA and cortisol in relation to anxiety and depression scores in adolescents

Briana NC Chronister, Eduardo Gonzalez, Dolores Lopez-Paredes, Jose Suarez-Torres, Sheila Gahagan, Danilo Martinez, Janeth Barros, David R. Jacobs, Harvey Checkoway, Jose R. Suarez-Lopez

Epidemiology & Community Health

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Background Adrenal and sex hormone dysregulation have been independently associated with increased depression and anxiety. Cortisol can modify production of sex hormones and hormone-mood associations. This study evaluated associations and interplay of sex and adrenal hormones with depression and anxiety. Methods We assessed 545 Ecuadorian adolescents (11–17y, 50.4% female, ESPINA) for depression and anxiety symptoms using standardized scales. Testosterone, cortisol, dehydroepiandrosterone (DHEA), and estradiol (boys only) were measured in saliva. We performed logistic regression modeling to calculate odds ratios (OR) of elevated depression or anxiety (scores ≥60) comparing participants with low (<10th percentile) and elevated hormones (≥90th percentile) to normal concentrations (10th–90th percentile). Effect modification by cortisol and testosterone was assessed. Models adjusted for demographic, anthropometric, and circadian measures. Results In all participants, elevated testosterone (OR [95%CI:]=1.78 [0.98, 3.23]) and cortisol (OR=1.69 [0.95, 2.99]) were marginally associated with elevated anxiety scores. In boys, elevated estradiol was associated with elevated depression (OR=4.75 [1.95, 11.56]) and anxiety scores (OR=2.43 [1.01, 5.84]). In linear regression, estradiol was positively associated with depression (difference/10% hormone increase (β=0.45 [0.15, 0.75]) and anxiety scores (β=0.42 [0.13, 0.72]). Higher cortisol levels strengthened the depression association with estradiol in boys (β=0.54 [0.12, 0.96]), and with testosterone (β= -0.19 [-0.35, -0.03]) and DHEA (β= -0.12 [-0.22, -0.02]) in girls. Testosterone also modified associations. Limitations This was a cross-sectional analysis. Discussion Elevated testosterone, cortisol, and estradiol (≥90th percentile) were associated with altered mood. Cortisol and testosterone were considerable effect modifiers to the associations of most hormones with depression and anxiety.

Original language	English (US)
Pages (from-to)	838-846
Number of pages	9
Journal	Journal of Affective Disorders
Volume	294
DOIs	https://doi.org/10.1016/j.jad.2021.07.026
State	Published - Nov 1 2021

Bibliographical note

Funding Information:
The ESPINA study received funding from the National Institute of Occupational Safety and Health ( 1R36OH009402 ) and the National Institute of Environmental Health Sciences ( R01ES025792 , R21ES026084, R01ES030378 ). Briana Chronister was funded by the National Institute of Mental Health (5T32MH122376).

Publisher Copyright:
© 2021

Keywords

Adolescents
Adrenal hormones
Anxiety
Depression
Ecuador
Gonadal hormones

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1016/j.jad.2021.07.026

Find It

Find It at U of M Libraries

Cite this

@article{d2bd83f46de9458895e7f7bfc305ec06,

title = "Testosterone, estradiol, DHEA and cortisol in relation to anxiety and depression scores in adolescents",

abstract = "Background Adrenal and sex hormone dysregulation have been independently associated with increased depression and anxiety. Cortisol can modify production of sex hormones and hormone-mood associations. This study evaluated associations and interplay of sex and adrenal hormones with depression and anxiety. Methods We assessed 545 Ecuadorian adolescents (11–17y, 50.4% female, ESPINA) for depression and anxiety symptoms using standardized scales. Testosterone, cortisol, dehydroepiandrosterone (DHEA), and estradiol (boys only) were measured in saliva. We performed logistic regression modeling to calculate odds ratios (OR) of elevated depression or anxiety (scores ≥60) comparing participants with low (<10th percentile) and elevated hormones (≥90th percentile) to normal concentrations (10th–90th percentile). Effect modification by cortisol and testosterone was assessed. Models adjusted for demographic, anthropometric, and circadian measures. Results In all participants, elevated testosterone (OR [95%CI:]=1.78 [0.98, 3.23]) and cortisol (OR=1.69 [0.95, 2.99]) were marginally associated with elevated anxiety scores. In boys, elevated estradiol was associated with elevated depression (OR=4.75 [1.95, 11.56]) and anxiety scores (OR=2.43 [1.01, 5.84]). In linear regression, estradiol was positively associated with depression (difference/10% hormone increase (β=0.45 [0.15, 0.75]) and anxiety scores (β=0.42 [0.13, 0.72]). Higher cortisol levels strengthened the depression association with estradiol in boys (β=0.54 [0.12, 0.96]), and with testosterone (β= -0.19 [-0.35, -0.03]) and DHEA (β= -0.12 [-0.22, -0.02]) in girls. Testosterone also modified associations. Limitations This was a cross-sectional analysis. Discussion Elevated testosterone, cortisol, and estradiol (≥90th percentile) were associated with altered mood. Cortisol and testosterone were considerable effect modifiers to the associations of most hormones with depression and anxiety.",

keywords = "Adolescents, Adrenal hormones, Anxiety, Depression, Ecuador, Gonadal hormones",

author = "Chronister, {Briana NC} and Eduardo Gonzalez and Dolores Lopez-Paredes and Jose Suarez-Torres and Sheila Gahagan and Danilo Martinez and Janeth Barros and Jacobs, {David R.} and Harvey Checkoway and Suarez-Lopez, {Jose R.}",

note = "Funding Information: The ESPINA study received funding from the National Institute of Occupational Safety and Health ( 1R36OH009402 ) and the National Institute of Environmental Health Sciences ( R01ES025792 , R21ES026084, R01ES030378 ). Briana Chronister was funded by the National Institute of Mental Health (5T32MH122376). Publisher Copyright: {\textcopyright} 2021",

year = "2021",

month = nov,

day = "1",

doi = "10.1016/j.jad.2021.07.026",

language = "English (US)",

volume = "294",

pages = "838--846",

journal = "Journal of Affective Disorders",

issn = "0165-0327",

publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Testosterone, estradiol, DHEA and cortisol in relation to anxiety and depression scores in adolescents

AU - Chronister, Briana NC

AU - Gonzalez, Eduardo

AU - Lopez-Paredes, Dolores

AU - Suarez-Torres, Jose

AU - Gahagan, Sheila

AU - Martinez, Danilo

AU - Barros, Janeth

AU - Jacobs, David R.

AU - Checkoway, Harvey

AU - Suarez-Lopez, Jose R.

N1 - Funding Information: The ESPINA study received funding from the National Institute of Occupational Safety and Health ( 1R36OH009402 ) and the National Institute of Environmental Health Sciences ( R01ES025792 , R21ES026084, R01ES030378 ). Briana Chronister was funded by the National Institute of Mental Health (5T32MH122376). Publisher Copyright: © 2021

PY - 2021/11/1

Y1 - 2021/11/1

N2 - Background Adrenal and sex hormone dysregulation have been independently associated with increased depression and anxiety. Cortisol can modify production of sex hormones and hormone-mood associations. This study evaluated associations and interplay of sex and adrenal hormones with depression and anxiety. Methods We assessed 545 Ecuadorian adolescents (11–17y, 50.4% female, ESPINA) for depression and anxiety symptoms using standardized scales. Testosterone, cortisol, dehydroepiandrosterone (DHEA), and estradiol (boys only) were measured in saliva. We performed logistic regression modeling to calculate odds ratios (OR) of elevated depression or anxiety (scores ≥60) comparing participants with low (<10th percentile) and elevated hormones (≥90th percentile) to normal concentrations (10th–90th percentile). Effect modification by cortisol and testosterone was assessed. Models adjusted for demographic, anthropometric, and circadian measures. Results In all participants, elevated testosterone (OR [95%CI:]=1.78 [0.98, 3.23]) and cortisol (OR=1.69 [0.95, 2.99]) were marginally associated with elevated anxiety scores. In boys, elevated estradiol was associated with elevated depression (OR=4.75 [1.95, 11.56]) and anxiety scores (OR=2.43 [1.01, 5.84]). In linear regression, estradiol was positively associated with depression (difference/10% hormone increase (β=0.45 [0.15, 0.75]) and anxiety scores (β=0.42 [0.13, 0.72]). Higher cortisol levels strengthened the depression association with estradiol in boys (β=0.54 [0.12, 0.96]), and with testosterone (β= -0.19 [-0.35, -0.03]) and DHEA (β= -0.12 [-0.22, -0.02]) in girls. Testosterone also modified associations. Limitations This was a cross-sectional analysis. Discussion Elevated testosterone, cortisol, and estradiol (≥90th percentile) were associated with altered mood. Cortisol and testosterone were considerable effect modifiers to the associations of most hormones with depression and anxiety.

AB - Background Adrenal and sex hormone dysregulation have been independently associated with increased depression and anxiety. Cortisol can modify production of sex hormones and hormone-mood associations. This study evaluated associations and interplay of sex and adrenal hormones with depression and anxiety. Methods We assessed 545 Ecuadorian adolescents (11–17y, 50.4% female, ESPINA) for depression and anxiety symptoms using standardized scales. Testosterone, cortisol, dehydroepiandrosterone (DHEA), and estradiol (boys only) were measured in saliva. We performed logistic regression modeling to calculate odds ratios (OR) of elevated depression or anxiety (scores ≥60) comparing participants with low (<10th percentile) and elevated hormones (≥90th percentile) to normal concentrations (10th–90th percentile). Effect modification by cortisol and testosterone was assessed. Models adjusted for demographic, anthropometric, and circadian measures. Results In all participants, elevated testosterone (OR [95%CI:]=1.78 [0.98, 3.23]) and cortisol (OR=1.69 [0.95, 2.99]) were marginally associated with elevated anxiety scores. In boys, elevated estradiol was associated with elevated depression (OR=4.75 [1.95, 11.56]) and anxiety scores (OR=2.43 [1.01, 5.84]). In linear regression, estradiol was positively associated with depression (difference/10% hormone increase (β=0.45 [0.15, 0.75]) and anxiety scores (β=0.42 [0.13, 0.72]). Higher cortisol levels strengthened the depression association with estradiol in boys (β=0.54 [0.12, 0.96]), and with testosterone (β= -0.19 [-0.35, -0.03]) and DHEA (β= -0.12 [-0.22, -0.02]) in girls. Testosterone also modified associations. Limitations This was a cross-sectional analysis. Discussion Elevated testosterone, cortisol, and estradiol (≥90th percentile) were associated with altered mood. Cortisol and testosterone were considerable effect modifiers to the associations of most hormones with depression and anxiety.

KW - Adolescents

KW - Adrenal hormones

KW - Anxiety

KW - Depression

KW - Ecuador

KW - Gonadal hormones

UR - http://www.scopus.com/inward/record.url?scp=85111877319&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85111877319&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2021.07.026

DO - 10.1016/j.jad.2021.07.026

M3 - Article

C2 - 34375211

AN - SCOPUS:85111877319

SN - 0165-0327

VL - 294

SP - 838

EP - 846

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Testosterone, estradiol, DHEA and cortisol in relation to anxiety and depression scores in adolescents

Abstract

Bibliographical note

Keywords

UN SDGs

Publisher link

Find It

Other files and links

Fingerprint

Cite this