title: The relation between hypothalamic-pituitary-adrenal (HPA) axis activity and age of onset of alcohol use.
abstract: OBJECTIVE
  Hypothalamic-pituitary-adrenal (HPA) axis activity may prove a viable biomarker for identifying those susceptible to alcohol use disorders. The purpose of this study was to examine the relation of the age at which adolescents begin drinking with diurnal and stress cortisol.
  
  
  METHODS
  Adolescents' diurnal cortisol levels on a normal day and cortisol levels during a stress procedure were examined in relation to the age of onset of alcohol use.
  
  
  METHODS
  All adolescents (aged 14-20 years) were part of a general population study in the Netherlands (n = 2286).
  
  
  METHODS
  Ten assessments of salivary cortisol taken on a normal day (diurnal cortisol), as well as during a social stress procedure (stress cortisol) were used as indicators of HPA axis activity.
  
  
  RESULTS
  The age at which the first alcoholic drink was consumed varied as a function of cortisol levels at the onset of as well as during the stress procedure. Those who began drinking at an earlier age showed lower cortisol levels at the onset of the stressful tasks (r(2) = 0.14, P < 0.001) and during the stressful tasks (r(2) = 0.10, P < 0.05), although not after the tasks (cortisol recovery). Effects were strongest for anticipatory pre-task cortisol levels. Differences in diurnal cortisol levels did not explain variance in the age at which adolescents had begun drinking.
  
  
  CONCLUSIONS
  Lessened activity of the hypothalamic-pituitary-adrenal axis at the onset of and during a stress procedure is present in adolescents who begin drinking at an early age.
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center/Sophia Children's Hospital, Rotterdam, the Netherlands.
authors.forename: Brittany E
authors.initials: BE
authors.lastname: Evans
authors.forename: Kirstin
authors.initials: K
authors.lastname: Greaves-Lord
authors.forename: Anja S
authors.initials: AS
authors.lastname: Euser
authors.forename: Ingmar H A
authors.initials: IH
authors.lastname: Franken
authors.forename: Anja C
authors.initials: AC
authors.lastname: Huizink
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000428:Alcohol Drinking / Q000503:physiopathology*; D019540:Area Under Curve; D015415:Biomarkers / Q000378:metabolism; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D008297:Male; D009426:Netherlands; D010913:Pituitary-Adrenal System / Q000502:physiology*; D012463:Saliva / Q000737:chemistry; D012650:Self Disclosure; D013315:Stress, Psychological / Q000503:physiopathology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006854:Hydrocortisone