Steroid
metabolism altered in depressed patients
Psychiatric matters.MD
Altered steroid metabolism has been identified in patients
with unipolar recurrent major depression, which investigators say may
be the cause as well as a consequence of the disorder.
The 24-h urinary steroid metabolites provide an overview of the alterations
of steroid metabolism, reflecting hypothalamic-pituitary-adrenal axis
(HPA) activity. Viktória Poór (University of Pécs,
Hungary) and colleagues measured these steroid metabolites in 20 patients
with major depression and in 29 mentally healthy control individuals
in order to determine the role of steroid metabolism in depression.
The results, published in the Journal of Affective Disorders, showed
that levels of etiocholanolone (E), and -cortolone ( -CL) were significantly
decreased in women with depression, at 2.39 mol/24 h for patients, compared
with 4.20 mol/24 h for controls.
In contrast, free cortisol (F) and allo-tetrahydrocorticosterone (aTHB)
concentrations were significantly increased in depressed women, compared
with controls, at 0.98 mol/24 h versus 0.46 mol/24 h and 2.51 mol/24
h versus 1.49 mol/24 h, respectively.
Among the male participants, depressed patients, compared with controls,
had significantly reduced levels of dehydroepiandrosterone (DHEA; 0.73
vs 0.25 mol/24 h), tetrahydrocorticosterone (THB; 10.96 vs 12.75 mol/24
h), -CL (2.22 vs 5.26 mol/24 h), and aTHB (2.98 vs 7.99 mol/24 h).
The index of 11 -hydroxysteroid dehydrogenase activity was significantly
decreased in patients from both genders, indicating that depressed individuals
convert peripheral cortisone to cortisol more readily than do controls.
The degree of the decline was significantly greater in depressed men.
"In this study... we could detect dysregulated HPA axis function
via the altered steroid metabolism in unipolar recurrent major depression,"
the researchers write.
They note that "higher F in depressed women and lower DHEA in depressed
men suggest different types of adrenal hormone dysregulation within
and between the sexes."
Also, the increased level of F and the stress marker aTHB in the women
"may be an indication of their higher stress sensibility,"
the team reports.
J Affect Disord 2004; 81: 55-59
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