Psoriasis severity and hypothalamic-pituitary-adrenal axis function: results from the CALIPSO study.
Psoriasis is a chronic inflammatory disease that significantly impacts life quality, being associated with stress and mental disorders. We investigated whether the activity of the hypothalamic-pituitary-adrenal (HPA) axis was associated with psoriasis severity, daily life stress and anxiety, and depressive symptoms. In this ancillary study, which was part of the CALIPSO (coronary artery calcium in psoriasis) study, saliva was collected from 102 patients with psoriasis immediately upon awakening, 30, and 60 min after awakening, at 2:00 pm and at bedtime (five time points) to determine salivary cortisol levels. We used Pearson's correlation coefficient to evaluate the association of clinical and psychopathological variables with HPA activity. We found a direct correlation between bedtime cortisol and psoriasis severity evaluated by the psoriasis area severity index (PASI; r=0.39, P<0.001). No correlations between other clinical and psychopathological variables or with other cortisol assessments were observed. The findings indicated that HPA dysfunction may be present in psoriasis, as bedtime cortisol was correlated with psoriasis severity. Our study is limited by the lack of a control group; therefore, we were not able to explore whether these cortisol values were different compared with a concurrent, healthy sample.
Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.
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Brunoni
Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.
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Santos
Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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Sabbag
Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.
P A
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Lotufo
Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil.
I M
IM
Benseñor
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D001007:Anxiety / Q000523:psychology; D002986:Clinical Trials as Topic; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology*; D007256:Information Systems; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000473:pathology* / Q000503:physiopathology*; D011565:Psoriasis / Q000378:metabolism / Q000503:physiopathology* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012463:Saliva / Q000737:chemistry; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology
D006854:Hydrocortisone