title: Cortisol, platelet serotonin content, and platelet activity in patients with major depression and type 2 diabetes: an exploratory investigation.
abstract: OBJECTIVE
  Hypothalamic-pituitary-adrenal system dysfunction, serotonergic system alterations, and enhanced platelet activity may contribute to the increased cardiac risk in depression. This exploratory study examined associations between cortisol parameters, platelet serotonin (5-HT) content, and platelet activity markers in patients with newly diagnosed major depression (MD) and/or Type 2 diabetes (T2DM) compared with healthy controls.
  
  
  METHODS
  We compared cortisol awakening response (CAR), diurnal decrease in salivary cortisol concentrations (slope), platelet 5-HT, and platelet markers (CD40, CD40 ligand [CD40L], soluble CD40L, CD62P, β-thromboglobulin, and platelet factor-4) in 22 T2DM patients, 20 MD patients, 18 T2DM patients with MD, and 24 healthy controls.
  
  
  RESULTS
  Platelet markers were elevated in MD (F(6,60) = 11.14, p < .001) and T2DM (F(6,60) = 13.07, p < .001). Subgroups did not differ in 5-HT or cortisol slope, whereas T2DM patients without depression had significantly lower CAR than did healthy controls (F(1,61) = 7.46, p = .008). In healthy controls, cortisol slope correlated with platelet activity for CD40 (r = -0.43, p = .048) and 5-HT was correlated with CD40L (r = 0.53, p = .007). In patients with both T2DM and MD, 5-HT and CD62P were correlated (r = 0.52, p = .033).
  
  
  CONCLUSIONS
  Increased platelet activity in T2DM and MD may play a role in the association between diabetes, depression, and coronary artery disease. The present data suggest that group differences in cortisol or 5-HT as well as group-specific associations of cortisol or 5-HT with platelet markers might be of limited importance in the shared pathways of T2DM and depression in the pathophysiology of coronary artery disease.
authors: From the Department of Health Psychology (Zahn), Institute of Psychology, Johannes Gutenberg University Mainz, Germany; Departments of Psychosomatic Medicine and Psychotherapy (Petrak, Hägele, Herpertz) and Psychiatry, Psychotherapy, and Preventive Medicine (Juckel, Norra, Uhl), LWL University Hospital Bochum, Ruhr University Bochum, Germany; Department of Psychiatry and Psychotherapy (Franke), Charité-Universitätsmedizin Berlin, Germany; Central Institute of Mental Health (Lederbogen), Medical Faculty, University of Heidelberg, Mannheim, Germany; and Cardiovascular Centre (Neubauer), St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
authors: Daniela
authors: D
authors: Zahn
authors: Frank
authors: F
authors: Petrak
authors: Leonora
authors: L
authors: Franke
authors: Anna-Karolina
authors: AK
authors: Hägele
authors: Georg
authors: G
authors: Juckel
authors: Florian
authors: F
authors: Lederbogen
authors: Horst
authors: H
authors: Neubauer
authors: Christine
authors: C
authors: Norra
authors: Idun
authors: I
authors: Uhl
authors: Stephan
authors: S
authors: Herpertz
mesh_terms: D001792:Blood Platelets / Q000737:chemistry*; D019013:CD40 Antigens / Q000097:blood; D023201:CD40 Ligand / Q000097:blood; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D010978:Platelet Factor 4 / Q000097:blood; D012463:Saliva / Q000737:chemistry; D012701:Serotonin / Q000097:blood*; D001620:beta-Thromboglobulin / Q000032:analysis
chemical_list: D019013:CD40 Antigens; D019007:P-Selectin; D001620:beta-Thromboglobulin; D023201:CD40 Ligand; D012701:Serotonin; D010978:Platelet Factor 4; D006854:Hydrocortisone