Aldosterone concentrations in saliva reflect the duration and severity of depressive episode in a sex dependent manner

Segeda, V.; Izáková, Lubomira; Hlavacova, Natasa; Bednarova, Aneta; Ježová, Daniela

doi:10.1016/j.jpsychires.2017.04.011

Cited by 34 publications

(28 citation statements)

References 30 publications

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“…However, these studies have consistently found increased aldosterone levels in depressed patients compared with healthy individuals 30,57 . Furthermore, salivary aldosterone was associated with depression severity 58 and predicted treatment response to standard antidepressants 59,60 . In turn, patients with primary aldosteronism exhibit more depressive symptoms compared with the general population 61,62 .…”

Section: Discussionmentioning

confidence: 99%

Steroid hormone secretion after stimulation of mineralocorticoid and NMDA receptors and cardiovascular risk in patients with depression

et al. 2020

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Major depressive disorder (MDD) is associated with altered mineralocorticoid receptor (MR) and glucocorticoid receptor function, and disturbed glutamatergic signaling. Both systems are closely intertwined and likely contribute not only to the pathophysiology of MDD, but also to the increased cardiovascular risk in MDD patients. Less is known about other steroid hormones, such as aldosterone and DHEA-S, and how they affect the glutamatergic system and cardiovascular disease risk in MDD. We examined salivary cortisol, aldosterone, and DHEA-S secretion after stimulation of MR and glutamatergic NMDA receptors in 116 unmedicated depressed patients, and 116 age-and sex-matched healthy controls. Patients (mean age = 34.7 years, SD = ±13.3; 78% women) and controls were randomized to four conditions: (a) control condition (placebo), (b) MR stimulation (0.4 mg fludrocortisone), (c) NMDA stimulation (250 mg D-cycloserine (DCS)), and (d) combined MR/NMDA stimulation (fludrocortisone + DCS). We additionally determined the cardiovascular risk profile in both groups. DCS had no effect on steroid hormone secretion, while cortisol secretion decreased in both fludrocortisone conditions across groups. Independent of condition, MDD patients showed (1) increased cortisol, increased aldosterone, and decreased DHEA-S concentrations, and (2) increased glucose levels and decreased high-density lipoprotein cholesterol levels compared with controls. Depressed patients show profound alterations in several steroid hormone systems that are associated both with MDD pathophysiology and increased cardiovascular risk. Prospective studies should examine whether modulating steroid hormone levels might reduce psychopathology and cardiovascular risk in depressed patients.

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Section: Discussionmentioning

confidence: 99%

Steroid hormone secretion after stimulation of mineralocorticoid and NMDA receptors and cardiovascular risk in patients with depression

et al. 2020

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“…An a priori power analysis was performed to estimate the appropriate sample size for the study using G*Power version 3.1 [25]. This analysis was conducted based on previous data collected by our group [14] in order to estimate the optimal sample size to test the hypothesis that aldosterone and cortisol show different dynamic changes in the course of clinical depression. We calculated the optimal sample size for a repeated measures analysis of variance (ANOVA) with within-between interaction for an α-level of 0.05, a power of 80%, 2 groups, and 2 measurement time points (morning vs. evening).…”

Section: Subjectsmentioning

confidence: 99%

Salivary Aldosterone, Cortisol, and Their Morning to Evening Slopes in Patients with Depressive Disorder and Healthy Subjects: Acute Episode and Follow-Up 6 Months after Reaching Remission

et al. 2020

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Background/Objective: Cortisol is thought to be involved in the pathophysiology of affective disorders. Less attention has been given to other neuroendocrine factors. The aim of the present study was to test the hypothesis that adrenocortical steroids aldosterone and cortisol show different dynamic changes in the course of clinical depression with the assumption that aldosterone is a state marker of depression. Methods: A total of 78 adult subjects (39 patients with depressive disorder and 39 healthy controls) participated in a prospective non-interventional clinical study. Patients were investigated at the time of an acute episode and 6 months after reaching remission. The clinical and personal characteristics, and morning and evening salivary concentrations of aldosterone and cortisol were evaluated. Results: Patients with an acute depressive episode exhibited higher evening aldosterone and lower morning cortisol concentrations compared to healthy subjects. In these patients, both hormone concentrations showed flatter morning to evening slopes. Salivary aldosterone, but not cortisol concentrations, were lower in patients 6 months after reaching remission compared to those in the acute state. Similarly, 6 months of remission resulted in a steeper morning to evening slope of salivary aldosterone compared to the acute state. The cortisol rhythm remained dysregulated. A significant negative correlation between trait anxiety scores and morning cortisol concentrations in patients at 6 months of clinical remission was observed. Conclusion: Diurnal changes in salivary aldosterone concentrations appear to be a state marker, whilst those of cortisol a trait marker of depression.

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“…The most complete results so far have been obtained by examining 60 patients with major depressive disorder in a study performed in collaboration with clinical psychiatrists, particularly the Department of Psychiatry, Faculty of Medicine, Comenius University and University Hospital Bratislava, Slovakia [43]. The sample consisted of 37 postmenopausal women and 23 men suffering from major depressive disorder.…”

Section: Translation Of Experimental Data To Clinical Researchmentioning

confidence: 99%

“…It is well known that aldosterone secretion shows a daily rhythm [35,44,45] with the highest values in the morning and the lowest at evening. The patients with depression failed to exert known daily rhythmicity of aldosterone release [43]. An intriguing finding was the observation of the relationship between morning aldosterone concentrations and the duration of the current depressive episode.…”

Section: Translation Of Experimental Data To Clinical Researchmentioning

confidence: 99%

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Hlavacova¹,

Jezová²

2019

Aldosterone-Mineralocorticoid Receptor - Cell Biology to Translational Medicine

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The mineralocorticoid hormone aldosterone has been investigated almost exclusively with respect to cardiovascular function, as the main effects of aldosterone are related to water-electrolyte balance and the control of the blood pressure. This overview is focused on less traditional and long-time neglected effects of aldosterone on the brain and behavior. Preclinical studies by our research group brought evidence on causal relationships between aldosterone and anxiety as well as aldosterone and depression-like behavior. Aldosterone was found to be anxiogenic and depressogenic in a rat model. Preclinical studies also indicate that aldosterone may be an early marker of depression onset. Aldosterone is known to be an important component of the stress response, and we have shown that its role is particularly important during early postnatal period in pups. Studies in patients with major depressive disorder revealed that an unfavorable therapy outcome is predicted by a higher salivary aldosterone/cortisol ratio. Our clinical studies showed that salivary aldosterone concentrations reflect the severity, duration of the depressive episode, and treatment outcome in patients with major depressive disorder. Moreover, the patients with depression fail to exert known daily rhythmicity of aldosterone release.

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Aldosterone concentrations in saliva reflect the duration and severity of depressive episode in a sex dependent manner

Cited by 34 publications

References 30 publications

Steroid hormone secretion after stimulation of mineralocorticoid and NMDA receptors and cardiovascular risk in patients with depression

Steroid hormone secretion after stimulation of mineralocorticoid and NMDA receptors and cardiovascular risk in patients with depression

Salivary Aldosterone, Cortisol, and Their Morning to Evening Slopes in Patients with Depressive Disorder and Healthy Subjects: Acute Episode and Follow-Up 6 Months after Reaching Remission

View on Aldosterone and the Brain Revisited

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