Associations between hair cortisol, cortisone and DHEA levels and COVID-19-related stressors among family members

• In Event: The biological signatures of exposure to COVID-19 lockdown during the first 1000 days of life.

Abstract

IIntroduction. Associations between stressors related to the COVID-19 pandemic and elevated hair cortisol concentrations among mother-child pairs has been reported (Perry et al., 2021). In Finland, a state of emergency due to the pandemic took place from mid-March 2020 until mid-June 2020 when the first wave of COVID outbreak had weakened. During this time, we investigated whether parent-reported pandemic-related stressful events were associated with hair cortisol, cortisone and DHEA concentrations, possible markers for chronic activation of the stress regulation system during the early pandemic, among family members (mothers, fathers and children aged 5–8 years).

Hypotheses. COVID-19-related stressful events associate with biological long-term stress hormone responses among all family members. Especially, parental stressful experiences associate with the stress physiology of the child.

Study population. This study consisted of 150 mothers, 25 fathers and 165 children (44 % girls) with the hair sample and the complete questionnaire data. Families were drawn from a large Finnish cohort.

Methods. Proximal 3 cm hair samples utilized to define cortisol, cortisone and DHEA concentrations were collected at home by parents, or when requested by a parent, by a research staff at university facilities, in June 2020. Hair samples covered the cumulative hormone output from last three months (March–May 2020). Parents reported pandemic-related stressors (e.g. lifestyle restrictions, economic difficulties, health events related to self and others) by an online questionnaire which was a modified from a questionnaire concerning SARS-related stressors (Main et al. 2011). Parents self-reported depressive and anxiety symptoms using online Edinburgh Postnatal Depression Scale and Symptom Checklist-90 anxiety scale. Hair hormone concentrations (HHC) were analyzed using LC-MS/MS at Technical University of Dresden, Germany. Regression analyses with ln-transformed HHC as an outcome were used to analyze the association between each hormone and experienced stressor category separately among mothers, fathers and children.

Results. We found increased hair cortisone concentrations among girls (β = 0.66, 95% CI = 0.21–1.11, p = .005), whose mothers reported more health events related to self, adjusted for child age, ponderal index, maternal depressive and anxiety symptoms and education. Among fathers, hair cortisone concentrations associated with health events related to self (β = 0.56, 95% CI = 0.02–1.11 p = .043) when adjusted for their depressive (p = .007) and anxiety symptoms, age and education. We found no other bivariate associations between HHC and pandemic-related stressors. Finding concerning cortisone could point to the possible role of altered cortisol metabolism in the biological response to pandemic. It is also suggested that hair cortisone could be a more stable marker for changes in free serum cortisol than hair cortisol in some individuals (Stalder et al., 2013). Cortisone may be less sensitive to unexplained variation seen in cortisol levels, which would be incorporated into the hair after local inactivation to cortisone by hair follicle 11β-HSD2. Our results support the idea that parental stressful experiences might have an impact on the stress physiology of their children, and that broader focus on different HHC is needed.

Authors

• Susanna Kortesluoma, University of Turku
  Presenting Author

• Paula Mustonen, University of Turku and Turku University Hospital

• Max Karukivi, University of Turku

• Linnea Karlsson, University of Turku

• Hasse Karlsson, Turku University Hospital and University of Turku

• Saara Nolvi, University of Turku