Abstract：Objective To study the changes in serum cortisol levels in adolescents with type 1 diabetes (T1DM) and elevated depressive symptoms. Methods Twenty-eight adolescents with T1DM and 31 healthy peers were assessed for depressive symptoms using a depression self-rating scale developed by the Epidemiological Survey Center. Selected subjects were classified into four groups:T1DM with elevated depressive symptoms group (n=15), T1DM without elevated depressive symptoms group (n=13), elevated depressive symptoms without T1DM group (n=15), and normal control group (n=16). Fasting blood samples were collected in the morning, and the levels of serum cortisol were compared among the four groups. The correlations of serum levels of cortisol and glycosylated hemoglobin A1c (HbA1c) with the score of depression self-rating scale were evaluated by Pearson correlation analysis. Results The fasting serum cortisol levels in the 28 T1DM patients were significantly higher than in the 31 healthy peers (PPr=0.481, P=0.010). Conclusions The fasting serum cortisol levels in adolescents with T1DM and elevated depressive symptoms are significantly increased, suggesting that the patients with comorbidity of T1DM and depression develop dysfunction of the corticotropin-releasing hormone-adrenocorticotropic hormone-cortisol axis. The elevated depressive symptoms may be associated with a poor control of glucose metabolism.
WEN Yi-Jiang,GUO Jia,ZHOU Zhi-Guang et al. Changes in fasting serum cortisol levels in adolescents with type 1 diabetes and elevated depressive symptoms[J]. CJCP, 2015, 17(10): 1098-1102.
Li XH, Li TL, Yang Z, et al. A nine-year prospective study on the incidence of childhood type 1 diabetes mellitus in China[J]. Biom Environ Sci, 2000, 13(4):263-270.
[3]
American Diabetes Association. American Diabetes Association Practice Guidelines[J]. Diabetes Care, 2009, 32(Suppl 1):3-12.
Jaser S, Whittemore R, Ambrosino J, et al. Mediators of depressive symptoms in children with type1 diabetes and their mothers[J]. J Pediatr Psychol, 2008(33):509-519.
Nemeroff CB, Vale WW. The neurobiology of depression:inroads to treatment and new drug discovery[J]. J Clin Psych, 2005, 66(Supp7):5-13.
[15]
Guo J, Whittemore R, Grey M, et al. Diabetes self-management, depressive symptoms, metabolic control, and quality of life in youths with type 1 diabetes in China:a cross-sectional descriptive study[J]. J Clin Nurs, 2013, 22(1-2):69-79.
Moussa MMA, Alsaeid M, Abdella N, et al. Social and psychological characteristics of Kuwaiti children and adolescents with type 1diabetes[J]. Soc Sci Med, 2005, 60(8):1835-1844.
