Associations between testosterone and future PTSD symptoms among middle age and older UK residents.

IF 6.2 1区 医学 Q1 PSYCHIATRY
Hanyang Shen, Ciera Stafford, Joeri Meijsen, Lijin Zhang, Jacob Reiter, Rebecca B Lawn, Alicia K Smith, Mytilee Vermuri, Laramie E Duncan
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Abstract

Testosterone has been theorized to influence the development of post-traumatic stress disorder (PTSD). However, the relationship between testosterone level and PTSD is still not well understood. We evaluated the potential association between testosterone and subsequent development of PTSD symptoms using a large sample size, in a civilian context, inclusive of both males and females. Out of around 500,000 total UK Biobank participants, our sample had 130,471 participants who: had testosterone measures, completed the mental health questionnaire, and passed outlier exclusion. After adjusting for relevant covariates, we used linear regression to assess the relationship between testosterone level and future development of symptoms, in males and females separately (Nmales = 61,758, Nfemales = 67,053). In both males and females, small but significant nonlinear (and oftentimes U-shaped) relationships were observed between testosterone levels and PTSD symptoms. When grouping participants into deciles of testosterone for both sexes, the strongest associations between testosterone levels and PTSD symptoms were observed in the central deciles. For example, for total testosterone, compared to decile 1: individuals in decile 7 had the lowest PTSD symptom scores in both males (beta = -0.16, p = 1.58 × 10-3) and females (beta = -0.23, p = 3.04 × 10-5). We also found that body mass index (BMI) moderated the relationship between testosterone and PTSD symptoms, such that the relationship was considerably stronger among individuals with higher BMI. Results were similar for depression and anxiety measures. Analyses using calculated free testosterone (cFT) and the free androgen index (FAI) were generally consistent with total testosterone (TT) results. These findings suggest that mid-range testosterone levels are associated with the lowest risk of PTSD symptoms in both sexes, and future work should seek to examine if this relationship is causal.

英国中老年居民中睾酮与未来PTSD症状的关系
从理论上讲,睾丸激素会影响创伤后应激障碍(PTSD)的发展。然而,睾酮水平与创伤后应激障碍之间的关系仍未得到很好的理解。我们评估了睾酮与PTSD症状后续发展之间的潜在关联,使用了大量的样本,在平民背景下,包括男性和女性。在英国生物银行大约50万名参与者中,我们的样本中有130,471名参与者:进行了睾丸激素测量,完成了心理健康问卷,并通过了异常值排除。在调整相关协变量后,我们分别在男性和女性中使用线性回归来评估睾酮水平与未来症状发展之间的关系(nmale = 61,758, nfemale = 67,053)。在男性和女性中,在睾酮水平和PTSD症状之间观察到微小但显著的非线性(通常是u形)关系。当将参与者分为男女的睾丸激素十分位数时,在中心十分位数观察到睾丸激素水平与创伤后应激障碍症状之间最强的关联。例如,对于总睾酮,与十分位数1相比:十分位数7的个体在男性(β = -0.16, p = 1.58 × 10-3)和女性(β = -0.23, p = 3.04 × 10-5)中均具有最低的PTSD症状得分。我们还发现,身体质量指数(BMI)缓和了睾丸激素和PTSD症状之间的关系,因此这种关系在BMI较高的个体中相当强。抑郁和焦虑测试的结果相似。计算游离睾酮(cFT)和游离雄激素指数(FAI)与总睾酮(TT)结果基本一致。这些发现表明,中等水平的睾丸激素水平与男女患创伤后应激障碍症状的最低风险相关,未来的工作应该寻求检验这种关系是否存在因果关系。
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来源期刊
CiteScore
11.50
自引率
2.90%
发文量
484
审稿时长
23 weeks
期刊介绍: Psychiatry has suffered tremendously by the limited translational pipeline. Nobel laureate Julius Axelrod''s discovery in 1961 of monoamine reuptake by pre-synaptic neurons still forms the basis of contemporary antidepressant treatment. There is a grievous gap between the explosion of knowledge in neuroscience and conceptually novel treatments for our patients. Translational Psychiatry bridges this gap by fostering and highlighting the pathway from discovery to clinical applications, healthcare and global health. We view translation broadly as the full spectrum of work that marks the pathway from discovery to global health, inclusive. The steps of translation that are within the scope of Translational Psychiatry include (i) fundamental discovery, (ii) bench to bedside, (iii) bedside to clinical applications (clinical trials), (iv) translation to policy and health care guidelines, (v) assessment of health policy and usage, and (vi) global health. All areas of medical research, including — but not restricted to — molecular biology, genetics, pharmacology, imaging and epidemiology are welcome as they contribute to enhance the field of translational psychiatry.
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