Cortisol, dehydroepiandrosterone sulfate, fatty acids, and their relation in recurrent depression

Journal article (2019)

Authors

D. M. ter Horst Universiteit van Amsterdam
Aart H. Schene Universiteit van Amsterdam, Radboud University Medical Center
C.A. Figueroa Universiteit van Amsterdam, Radboud Universiteit Nijmegen
Johanna Assies Universiteit van Amsterdam
Anja Lok Universiteit van Amsterdam
Claudi L.H. Bockting Universiteit van Amsterdam
Henricus G. Ruhe Radboud University Medical Center, Universiteit van Amsterdam
Roel J.T. Mocking Universiteit van Amsterdam
Affiliation
External organisation
Fatty acids Recurrence Cortisol Major depressive disorder Dehydroepiandrosterone sulfate Hypothalamic–pituitary–adrenal (HPA) axis
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Published Date

2019

Language

English

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Abstract

Background: Alterations in hypothalamic–pituitary–adrenal (HPA)-axis activity, fatty acid metabolism, and their relation have been associated with (recurrent) major depressive disorder (MDD), although conflicting findings exist. Aims: To determine whether alterations in HPA-axis activity and fatty acids in recurrent MDD remain during remission (i.e. reflect a potential trait factor). Furthermore, to test the association between HPA-axis activity and fatty acids in patients versus controls. Methods: We cross-sectionally compared 73 remitted unmedicated recurrent MDD patients with 46 matched never-depressed controls. Measurements included salivary cortisol and dehydroepiandrosterone sulfate (DHEAS) (awakening, evening, and after sad mood induction) and erythrocyte fatty acid parameters: (I) three main fatty acids [omega-3 docosahexaenoic acid (DHA), and the omega-3 eicosapentaenoic acid/omega-6 arachidonic acid (EPA/AA)-ratio], and (II) structural fatty acid indices [chain length, unsaturation and peroxidation]. Results: Patients showed higher cortisol awakening responses (p = 0.006) and lower evening cortisol/DHEAS ratios (p = 0.044) compared to matched controls. Fatty acids did not differ between patients and controls, but HPA-axis indicators were significantly associated with fatty acid parameters in both groups (0.001 ≤ p ≤ 0.043). Patients and controls significantly differed in the relations between awakening DHEAS or cortisol/DHEAS ratios and fatty acid parameters, including unsaturation and peroxidation indices (0.001≤ p ≤ 0.034). Significance remained after correction for confounders. Conclusions: Our results further support alterations in HPA-axis activity, i.e. a lower baseline, but higher responsiveness of awakening cortisol, in remitted medication-free recurrent MDD patients. Furthermore, the relationship between HPA-axis and fatty acids showed significant differences in recurrent MDD patients versus controls. Prospective research is needed to determine the predictive value of this relationship for MDD recurrence.