Relationship Between Serum Dheas and Cortisol Levels and Psychogenic Stress Scales With Disease Severity in Patients Diagnosed With Alopeia Areata
Abstract
Amaç: Alopesi Areata (AA), nedeni tam olarak bilinmeyen; ancak genetik özellikler, otoimmünite, emosyonel stres ve atopi gibi çeşitli nedenlere bağlı olarak ortaya çıktığı düşünülmektedir. Biz de çalışmamızda AA'nın etyolojisinde önemli yer tutan, psikojenik stresin göstergesi olan Beck depresyon testi ve serum kortizol ile Dehidroepiandrosteron Sülfat (DHEAS) seviyelerinin ölçümlerini yaparak psikojenik stresin AA'daki hastalık şiddeti üzerine etkisini araştırmayı amaçladık. Metod: Çalışmamızda Van Yüzüncü Yıl Üniversitesi Hastanesi Dermatoloji Anabilim Dalı'na, 2023 Kasım ve 2024 Mart ayları arasında başvuran 18-65 yaş arası 50 AA tanılı hasta ve hayatının hiçbir döneminde AA tanısı almamış 18-65 yaş arası 50 kişiden oluşan kontrol grubu yer almaktadır. Tüm katılımcıların serum DHEAS ve kortizol seviyeleri ölçülüp, psikojenik stres durumlarını değerlendirmek için Beck depresyon testi uygulandı ve çıkan sonuçlar kaydedildi. Ayrıca hasta grubundaki bireylerin Severity of Alopecia Toll (SALT) skorları klinik değerlendirmeyle belirlenerek kaydedildi. Elde edilen veriler kendi aralarında ve hasta ile kontrol grubu arasında istatiksel olarak karşılaştırıldı. Bulgular: Çalışmamıza katılan 100 gönüllünün 42'si (%42) kadın, 58'i (%58) erkektir. Katılımcıların büyük çoğunluğu %72'si 18-34 yaş aralığındaydı. Katılımcıların %96'sı Van yerleşik yaşamaktadır. Katılımcılardan sadece 1'inde (%1) serum kortizol değeri normalin üzerinde gelmiş olup ve hasta grubunda yer almaktadır. Serum DHEAS seviyesi ise tüm katılımcıların 7'sinde (%7) normalin üzerinde gelmiş olup; %42,8'i hasta grubunda yer almaktadır. Tüm katılımcıların 37'sinde minimal depresyon olup, %54,1'i hasta grubunda yer almaktadır. Hafif depresyon hasta ve kontrol grubunda eşit sayıda görülmüş olup toplamda 30 (%30) kişide hafif depresyon saptanmıştır. Orta depresyon toplam 28 (%28) kişide görülmüş olup %42,9'u hasta grubunda yer almaktadır. Şiddetli depresyon ise toplamda 5 (%5) kişide görülmüş olup %60'ı hasta grubunda yer almaktadır. Hasta grubunun SALT skor analizleri incelendiğinde ise %68 oran ile hastaların büyük çoğunluğu < %25 kıl kaybının olduğu grupta, yer almaktadır. Sonuç: Elde ettiğimiz verilere göre istatiksel olarak hem DHEAS ile psikojenik stres, hem de SALT skoru arasında anlamlı bir ilişki bulunmamakla birlikte DHEAS düzeyi yüksek olan bireylerde; hafif ve şiddetli depresyonun görülme oranı DHEAS düzeyi normal olanlara göre daha yüksek seyretme eğiliminde olduğu görülmüştür. Benzer şekilde Beck depresyon testi sonucundaki depresyon şiddeti ile hastalık şiddeti arasında anlamlı bir ilişki saptanmamıştır. Elde ettiğimiz veriler istatiksel olarak anlamlı gelmese de, minimal ve şiddetli depresyonun hasta grubunda görülme oranı kontrol grubuna göre daha yüksek bulunmuştur. Stresin AA etyolojisindeki rolü inkar edilemese de daha anlamlı sonuçlar elde edebilmek için daha büyük örneklem kümelerine ihtiyaç vardır.
Aim: Alopecia Areata (AA) is a condition whose exact cause is not fully understood; however, it is believed to arise from various factors such as genetic traits, autoimmunity, emotional stress, and atopy. In our study, we aimed to investigate the effect of psychological stress on the severity of AA by measuring the Beck Depression Inventory and serum cortisol and Dehydroepiandrosterone Sulfate (DHEAS) levels, which are indicators of psychological stress that play a significant role in the etiology of AA. Method: Our study included 50 patients diagnosed with AA aged 18-65 who presented to the Dermatology Department of Van Yüzüncü Yıl University Hospital between November 2023 and March 2024, along with a control group of 50 individuals aged 18-65 who had never been diagnosed with AA at any point in their lives. Serum DHEAS and cortisol levels were measured for all participants, and the Beck Depression Inventory was administered to assess psychological stress, with the results recorded. Additionally, the Severity of Alopecia Tool (SALT) scores of individuals in the patient group were determined through clinical evaluation and recorded. The obtained data were statistically compared both within the groups and between the patient and control groups. Results: Among the 100 volunteers participating in our study, 42 (42%) were female and 58 (58%) were male. The vast majority of participants (72%) were aged between 18-34 years. The majority of participants (%96) were residing in Van. Only 1 participant (1%) had a serum cortisol level above normal, and this individual was in the patient group. The serum DHEAS level was above normal in 7 participants (7%), with 42.8% of these in the patient group. A total of 37 participants (37%) exhibited minimal depression, with 54.1% being from the patient group. Mild depression was observed in the same number of individuals in both the patient and control groups, totaling 30 (30) individuals. Moderate depression was seen in 28 participants (28%), with 42.9% from the patient group. Severe depression was identified in 5 participants (5%), 60% of whom were in the patient group. When analyzing the SALT scores of the patient group, it was found that the majority of patients (68%) were in the group with <25% hair loss. Conclusion: According to our findings, there was no statistically significant relationship between both DHEAS and psychological stress, as well as between the SALT score and disease severity. However, it was observed that individuals with elevated DHEAS levels tended to have a higher prevalence of mild and severe depression compared to those with normal DHEAS levels. Similarly, no significant relationship was found between the severity of depression from the Beck Depression Inventory and disease severity. Although our data were not statistically significant, the prevalence of minimal and severe depression was found to be higher in the patient group compared to the control group. While the role of stress in the etiology of AA cannot be denied, larger sample sizes are needed to achieve more significant results. Keywords: alopecia areata, stress, cortisol, DHEAS
Aim: Alopecia Areata (AA) is a condition whose exact cause is not fully understood; however, it is believed to arise from various factors such as genetic traits, autoimmunity, emotional stress, and atopy. In our study, we aimed to investigate the effect of psychological stress on the severity of AA by measuring the Beck Depression Inventory and serum cortisol and Dehydroepiandrosterone Sulfate (DHEAS) levels, which are indicators of psychological stress that play a significant role in the etiology of AA. Method: Our study included 50 patients diagnosed with AA aged 18-65 who presented to the Dermatology Department of Van Yüzüncü Yıl University Hospital between November 2023 and March 2024, along with a control group of 50 individuals aged 18-65 who had never been diagnosed with AA at any point in their lives. Serum DHEAS and cortisol levels were measured for all participants, and the Beck Depression Inventory was administered to assess psychological stress, with the results recorded. Additionally, the Severity of Alopecia Tool (SALT) scores of individuals in the patient group were determined through clinical evaluation and recorded. The obtained data were statistically compared both within the groups and between the patient and control groups. Results: Among the 100 volunteers participating in our study, 42 (42%) were female and 58 (58%) were male. The vast majority of participants (72%) were aged between 18-34 years. The majority of participants (%96) were residing in Van. Only 1 participant (1%) had a serum cortisol level above normal, and this individual was in the patient group. The serum DHEAS level was above normal in 7 participants (7%), with 42.8% of these in the patient group. A total of 37 participants (37%) exhibited minimal depression, with 54.1% being from the patient group. Mild depression was observed in the same number of individuals in both the patient and control groups, totaling 30 (30) individuals. Moderate depression was seen in 28 participants (28%), with 42.9% from the patient group. Severe depression was identified in 5 participants (5%), 60% of whom were in the patient group. When analyzing the SALT scores of the patient group, it was found that the majority of patients (68%) were in the group with <25% hair loss. Conclusion: According to our findings, there was no statistically significant relationship between both DHEAS and psychological stress, as well as between the SALT score and disease severity. However, it was observed that individuals with elevated DHEAS levels tended to have a higher prevalence of mild and severe depression compared to those with normal DHEAS levels. Similarly, no significant relationship was found between the severity of depression from the Beck Depression Inventory and disease severity. Although our data were not statistically significant, the prevalence of minimal and severe depression was found to be higher in the patient group compared to the control group. While the role of stress in the etiology of AA cannot be denied, larger sample sizes are needed to achieve more significant results. Keywords: alopecia areata, stress, cortisol, DHEAS
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Dermatoloji, Dermatology
Turkish CoHE Thesis Center URL
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