Table 2.
Hypothalamic-pituitary-adrenal axis measurements in women with perimenopausal depression (n = 20) and control women (n = 20)
| Asymptomatic controls (n = 20) | Perimenopausal depression (n = 20) | ||||
|---|---|---|---|---|---|
| Median (IQR) | Mean (SD) | Median (IQR) | Mean (SD) | P | |
| Cortisol, mcg/dL | |||||
| –15 min | 1.1 (0.9-1.5) | 1.3 (0.8) | 1.1 (0.9-1.5) | 1.1 (0.4) | .63 |
| –5 min | 1.0 (1.0-1.6) | 1.3 (0.8) | 1.1 (0.9-1.5) | 1.1 (0.4) | .72 |
| Baseline AVG | 1.1 (0.9-1.6) | 1.3 (0.8) | 1.1 (0.9-1.5) | 1.1 (0.4) | .59 |
| 15 min | 1.9 (1.1-2.3) | 2.4 (2.4) | 1.7 (1.0-3.6) | 2.3 (1.6) | .96 |
| 30 min | 7.3 (3.7-9.3) | 7.5 (5.4) | 7.2 (1.4-15.3) | 8.1 (6.6) | .98 |
| 45 min | 10.1 (3.8-12.8) | 10.0 (7.0) | 9.5 (2.0-16.7) | 10.8 (8.8) | .91 |
| 60 min | 13.2 (7.0-17.2) | 12.9 (8.5) | 11.9 (3.1-20.3) | 12.9 (9.9) | .83 |
| 75 min | 14.1 (7.9-18.5) | 14.4 (8.5) | 14.7 (4.6-24.0) | 15.3 (10.6) | .90 |
| AUC | 503.5 (219.8-686.2) | 510.6 (366.2) | 489.9 (95.9-907.7) | 549.4 (466.0) | .94 |
| Delta max | 13.5 (7.7-17.2) | 13.3 (8.4) | 13.2 (3.9-23.5) | 14.5 (11.1) | .94 |
| ACTH, pg/mL | |||||
| –15 min | 6.9 (4.7-7.8) | 7.1 (2.9) | 5.7 (5.0-7.2) | 6.4 (2.2) | .50 |
| –5 min | 6.4 (5.3-8.1) | 6.6 (2.0) | 5.7 (5.0-6.2) | 5.9 (1.2) | .27 |
| Baseline avg | 6.4 (5.4-7.6) | 6.8 (2.2) | 5.9 (5.2-7.5) | 6.1 (1.4) | .41 |
| 15 min | 16.6 (12.2-22.7) | 20.0 (11.6) | 18.8 (10.4-29.8) | 23.7 (20.3) | .87 |
| 30 min | 22.1 (16.0-26.7) | 30.2 (24.9) | 19.5 (12.4-42.4) | 26.7 (18.6) | .45 |
| 45 min | 24.7 (16.9-32.9) | 34.9 (31.0) | 21.4 (15.5-52.0) | 33.0 (24.7) | .73 |
| 60 min | 27.8 (19.4-39.0) | 37.4 (33.5) | 23.9 (19.2-50.5) | 35.3 (26.1) | .68 |
| 75 min | 28.7 (22.7-40.2) | 38.4 (28.7) | 26.5 (19.3-45.5) | 34.8 (23.4) | .58 |
| AUC | 1106.3 (643.4-1612.3) | 1657.0 (1555.4) | 1039.7 (652.7-2726.0) | 1627.4 (1339.7) | .87 |
| Delta max | 23.9 (16.9-30.5) | 35.5 (33.5) | 20.4 (14.4-51.5) | 34.0 (27.9) | .65 |
| Dexamethasone, mcg/dL | 108.0 (85.2-218.0) | 155.8 (97.2) | 129.5 (106.7-183.7) | 152.9 (87.2) | .76 |
| CBG, mcg/mL | 51.2 (48.4-60.5) | 55.6 (9.8) | 64.2 (54.2-70.2) | 62.8 (11.8) | .06 |
| UFC, mcg/24 h | 12.4 (10.6-17.5) | 16.0 (10.2) | 14.0 (9.7-19.4) | 15.5 (8.0) | .96 |
| Urine creatinine, mg/d | 58.0 (40.5-73.0) | 68.3 (49.2) | 66.0 (43.5-91.5) | 69.7 (31.4) | .47 |
Values of cortisol and ACTH listed in table are nontransformed. Wilcoxon rank sum test was used for the continuous variables.
No significant differences were observed between women with perimenopausal depression (PMD) and control women in any measure of hypothalamic-pituitary-adrenal axis function including individual time points in cortisol and ACTH, AUCs, and delta max of cortisol and ACTH after corticotropin-releasing hormone administration, as well as baseline measures of 24-hour UFCs, CBG, and plasma dexamethasone levels.
Estradiol (conversion to SI pmol/L—3.671); progesterone (conversion to SI nmol/liter 3.18); ACTH (conversion to SI pmol/L—0.22); cortisol (conversion to SI nmol/L—27.59), UFC (conversion to SI nmol/d—2.76), CBG (conversion to SI nmol/L—17.18).
Abbreviations: ACTH, adrenocorticotropin; AUC, area under the curve; avg, average; CBG, cortisol-binding globulin; Delta max, difference between maximum stimulated and baseline values; IQR, interquartile range; UFC, 24-hour urinary free cortisol.