ABSTRACT
Objective:To explore the relationship between seizure cluster of temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) and cortisol (COR) rhythm, and understand its mechanism from the perspective of neuroendocrine.Methods:Fifty-seven patients with unilateral TLE-HS were recruited from the Qinghai Provincial People′s Hospital from May 1st 2012 to December 31st 2020. According to the history of seizure clusters one month before admission, 27 patients were enrolled in seizure clusters group (SC group), 30 patients were included in without seizures cluster group (NSC group). The clinical characteristics were systematically analyzed and compared between the SC and NSC groups. Plasma COR levels were measured at 8:00, 16:00 and 24:00 (COR8, COR16 and COR0) on the same day, and bilateral magnetic resonance spectroscopy (MRS) diagnosis was performed in two groups. Independent sample t test, chi-square test, repeated analysis of variance, covariance analysis, and multivariate Logistic regression were used for statistical analysis. Results:Time effect, grouping effect and the interaction effect of the time and grouping in the level of COR were statistically significant. Covariance analysis excluded age as an influential factor, COR16, COR0 and the slope of COR8-16 in the SC group [(126.22±19.98) μg/L, (51.63±21.43) μg/L, -7.78±4.54] were higher than the NSC group [(97.70±18.55) μg/L, (31.90±10.73) μg/L, -12.40±4.16], and the difference was statistically significant ( F=5.587, 4.320, 4.013, all P<0.05). The slope of COR0-8 in the SC group (17.11±6.32) was lower than that in the NSC group (20.62±6.54), and the difference was statistically significant ( F=-2.065, P<0.05). There was no significant difference in lateralization of hippocampal sclerosis between the two groups, and there was no significant difference in the ratio of N-acetyl aspartic acid(NAA)/[choline(Cho)+creatinine(Cr)] in the unilateral hippocampal sclerosis zone of the two groups, but the NAA/(Cho±Cr) ratio of the contralateral hippocampus in the SC group (0.71±0.03) was lower than that in the NSC group (0.76±0.06),and the difference was statistically significant ( t=4.999, P=0.029). Multivariate Logistic regression analysis showed that COR16 ( OR=1.328, 95% CI 1.073-1.642, P=0.009), COR8-16 ( OR=3.657, 95% CI 1.404-9.525, P=0.008) were independent risk factors of seizure clusters in TLE-HS. Conclusion:COR rhythm disturbance may be the neuroendocrine basis of seizure clusters in patients with TLE-HS.
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Objective To explore the relationship between anxious depression and cortisol rhythm disorder and influencing factors of immune metabolism. And to look for biological markers that can be used for clinical diagnosis and treatment of anxious depression. Methods Totally 43 patients with anxious depres-sion(A-MDD group) and 44 patients with non-anxious depression matched by sex,age and years of education (NA-MDD group)were recruited. Electrochemiluminescence was used to detect the plasma levels of adreno-corticotropic hormone(ACTH),cortisol(COR),c-reactive protein(CRP) and IL-6. Automatic biochemical a-nalysis was used to detect plasma total TC,TG,HDL and LDL. Using logistic regression analysis to discuss the influencing factors of anxiety depression. Results The comparison between the two group showed that the age of first onset,BMI and SBP in the A-MDD group((35. 15±11. 56),(24. 11±3. 03)kg/m2,(130. 09 ±13. 33)mmHg) were significantly higher than those in the NA-MDD group((31. 34± 14. 08),( 22. 70± 3. 19)kg/m2,( 121. 89±12. 49)mmHg)(t=2. 631,2. 009,2. 964,all P<0. 05). The HAMD score and the factor scores of cognitive impairment,change of day and night,delay,sleep disorder and feeling of despair in the A-MDD group((31. 81±5. 39),(8. 03±3. 00),(1. 17±0. 70),(6. 88±1. 93),(4. 44±1. 44),(4. 67± 2. 37)) were significantly higher than those in the NA-MDD group((25. 25±5. 017),(3. 87±3. 12),(0. 79 ±0. 78),(4. 64±2. 22),(3. 34±1. 54),(3. 61±2. 02))(t=2. 297,6. 524,2. 505,5. 210,3. 452,2. 421,all P<0. 05). The plasma TG,CRP and IL-6 levels in the A-MDD group((1. 63±1. 11)mmol/L,(1. 20±0. 77) mg/L,(3. 54±1. 90) pg/L) were significantly higher than those in the NA-MDD group (( 1. 19 ± 0. 66) mmol/L,(0. 933±0. 89)mg/L,(2. 65±1. 34)pg/L) (t=2. 254,2. 250,2. 352,all P<0. 05). The incidence of cortisol disturbance was 72% in the A-MDD group,and 48% in the NA-MDD group,and the difference was statistically significant (χ2=5. 369 P=0. 020). Multivariate Logistic regression found that sleep disorder (β=0. 729,OR=2. 072,95%CI=1. 018-3. 119),IL-6(β=0. 583,OR=1. 792,95%CI=1. 168-2. 748),cog-nitive impairment (β=0. 099,OR=1. 104,95% CI=1. 022-1. 193),cortisol rhythm disorders(β=0. 075, OR=1. 078,95%CI=1. 014-1. 146) were the risk factors for anxious depression. Conclusion Anxious de-pression has a high incidence of cortisol rhythm disorder. The COR and IL-6 may be mediators of cortisol rhythm disorder. IL-6 and cortisol rhythm disorder together with sleep disorder and negative cognition consti-tute maybe high risk factors for anxious depression.
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PURPOSE: The present study was carried out to determine day-to-day differences in cortisol levels and the molar cortisol-to-dehydroepiandrosterone (DHEA) ratio (molar C/D ratio) in working subjects. MATERIALS AND METHODS: The cortisol and DHEA levels were measured from saliva samples collected 30 minutes after awakening for 7 consecutive days in full-time working subjects that worked Monday through Saturday. To determine the day-to-day differences within subjects, the collected data was analyzed using variance (ANOVA) for a randomized complete block design (RCBD). RESULTS: The cortisol levels from samples collected 30 minutes after awakening on workdays were similar to each other, but were significantly different from the cortisol levels on Sunday. The DHEA levels were not significantly different between the days of week. The DHEA levels on Monday and Tuesday were relatively lower than the levels on the other weekdays. The DHEA levels on Thursday and Friday were relatively higher than the other days. The molar C/D ratios on Sunday were significantly lower than those on workdays. The molar C/D ratios on Monday and Tuesday were significantly higher than those on Wednesday or other workdays. CONCLUSION: The cortisol levels and the molar C/D ratios demonstrate differences in adrenocortical activities between workdays and non-workdays, but the molar C/D ratio additionally represents differences in adrenocortical status between the first two workdays and other workdays. Thus, it is possible that the day-to-day differences in the cortisol levels and the molar C/D ratio represent the adrenal response to upcoming work-related stress.