Advertisement

Association Between Cortisol to DHEA-s Ratio and Sickness Absence in Japanese Male Workers

  • Kumi Hirokawa
  • Yasuhito Fujii
  • Toshiyo Taniguchi
  • Jiro Takaki
  • Akizumi Tsutsumi
Article

Abstract

Purpose

This study aimed to investigate the association between serum levels of cortisol and dehydroepiandrosterone sulfate (DHEA-s) and sickness absence over 2 years in Japanese male workers.

Method

A baseline survey including questions about health behavior, along with blood sampling for cortisol and DHEA-s, was conducted in 2009. In total, 429 men (mean ± SD age, 52.9 ± 8.6 years) from whom blood samples were collected at baseline were followed until December 31, 2011. The hazard ratios (HR) and 95% confidence intervals (CI) for sickness absence were calculated using a Cox proportional hazard model, adjusted for potential confounders.

Results

Among 35 workers who took sickness absences, 31 had physical illness. A high cortisol to DHEA-s ratio increased the risk of sickness absence (crude HR = 2.68, 95% CI 1.12–6.41; adjusted HR = 3.33, 95% CI 1.35–8.20). The cortisol to DHEA-s ratio was linearly associated with an increased risk of sickness absence (p for trend < .050). Single effects of cortisol and DHEA-s levels were not associated with sickness absences. This trend did not change when limited to absences resulting from physical illness.

Conclusion

Hormonal conditions related to the hypothalamus–pituitary–adrenocortical axis and adrenal function should be considered when predicting sickness absence. The cortisol to DHEA-s ratio may be more informative than single effects of cortisol and DHEA-s levels.

Keywords

Cortisol DHEA-s Sickness absence Prospective study Japanese male workers 

Notes

Acknowledgments

This study was supported by the Japan Society for the Promotion of Science KAKENHI (grant number: 21700681) to Kumi Hirokawa.

Funding

This study was funded by the Japan Society for the Promotion of Science KAKENHI (grant number: 21700681).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Mommersteeg PM, Heijnen CJ, Kavelaars A, van Doornen LJ. Immune and endocrine function in burnout syndrome. Psychosom Med. 2006;68(6):879–86.  https://doi.org/10.1097/01.psy.0000239247.47581.0c.CrossRefPubMedGoogle Scholar
  2. 2.
    Sonnenschein M, Mommersteeg PM, Houtveen JH, Sorbi MJ, Schaufeli WB, van Doornen LJ. Exhaustion and endocrine functioning in clinical burnout: an in-depth study using the experience sampling method. Biol Psychol. 2007;75(2):176–84.  https://doi.org/10.1016/j.biopsycho.2007.02.001.CrossRefPubMedGoogle Scholar
  3. 3.
    Phillips AC, Carroll D, Gale CR, Lord JM, Arlt W, Batty GD. Cortisol, DHEA sulphate, their ratio, and all-cause and cause-specific mortality in the Vietnam Experience Study. Eur J Endocrinol. 2010;163(2):285–92.  https://doi.org/10.1530/EJE-10-0299.CrossRefPubMedGoogle Scholar
  4. 4.
    Chida Y, Steptoe A. Cortisol awakening response and psychosocial factors: a systematic review and meta-analysis. Biol Psychol. 2009;80(3):265–78.  https://doi.org/10.1016/j.biopsycho.2008.10.004.CrossRefPubMedGoogle Scholar
  5. 5.
    Zorn JV, Schür RR, Boks MP, Kahn RS, Joëls M, Vinkers CH. Cortisol stress reactivity across psychiatric disorders: a systematic review and meta-analysis. Psychoneuroendocrinology. 2017;77:25–36.  https://doi.org/10.1016/j.psyneuen.2016.11.036.CrossRefPubMedGoogle Scholar
  6. 6.
    Kamba A, Daimon M, Murakami H, Otaka H, Matsuki K, Sato E, et al. Association between higher serum cortisol levels and decreased insulin secretion in a general population. PLoS One. 2016;11(11):e0166077.  https://doi.org/10.1371/journal.pone.0166077.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Fabre B, Grosman H, Gonzalez D, Machulsky NF, Repetto EM, Mesch V, et al. Prostate cancer, high cortisol levels and complex hormonal interaction. Asian Pac J Cancer Prev. 2016;17(7):3167–71.PubMedGoogle Scholar
  8. 8.
    Lennartsson AK, Theorell T, Kushnir MM, Jonsdottir IH. Changes in DHEA-s levels during the first year of treatment in patients with clinical burnout are related to health development. Biol Psychol. 2016;120:28–34.  https://doi.org/10.1016/j.biopsycho.2016.08.003.CrossRefPubMedGoogle Scholar
  9. 9.
    Vermeulen A. Dehydroepiandrosterone sulfate and aging. Ann N Y Acad Sci. 1995;774(1 Dehydroepiand):121–7.  https://doi.org/10.1111/j.1749-6632.1995.tb17376.x.CrossRefPubMedGoogle Scholar
  10. 10.
    Wemm S, Koone T, Blough ER, Mewaldt S, Bardi M. The role of DHEA in relation to problem solving and academic performance. Biol Psychol. 2010;85(1):53–61.  https://doi.org/10.1016/j.biopsycho.2010.05.003.CrossRefPubMedGoogle Scholar
  11. 11.
    Veronese N, Trevisan C, De Rui M, Bolzetta F, Maggi S, Zambon S, et al. Serum dehydroepiandrosterone sulfate and risk for type 2 diabetes in older men and women: the Pro.V.A Study. Can J Diabetes. 2016;40(2):158–63.  https://doi.org/10.1016/j.jcjd.2015.09.013.CrossRefPubMedGoogle Scholar
  12. 12.
    Tivesten Å, Vandenput L, Carlzon D, Nilsson M, Karlsson MK, Ljunggren Ö, et al. Dehydroepiandrosterone and its sulfate predict the 5-year risk of coronary heart disease events in elderly men. J Am Coll Cardiol. 2014;64(17):1801–10.  https://doi.org/10.1016/j.jacc.2014.05.076.CrossRefPubMedGoogle Scholar
  13. 13.
    Ferrari E, Casarotti D, Muzzoni B, Albertelli N, Cravello L, Fioravanti M, et al. Age-related changes of the adrenal secretory pattern: possible role in pathological brain aging. Brain Res Brain Res Rev. 2001;37(1-3):294–300.  https://doi.org/10.1016/S0165-0173(01)00133-3.CrossRefPubMedGoogle Scholar
  14. 14.
    Sollberger S, Ehlert U. How to use and interpret hormone ratios. Psychoneuroendocrinology. 2016;63:385–97.  https://doi.org/10.1016/j.psyneuen.2015.09.031.CrossRefPubMedGoogle Scholar
  15. 15.
    Young AH, Gallagher P, Porter RJ. Elevation of the cortisol-dehydroepiandrosterone ratio in drug-free depressed patients. Am J Psychiatry. 2002;159(7):1237–9.  https://doi.org/10.1176/appi.ajp.159.7.1237.CrossRefPubMedGoogle Scholar
  16. 16.
    Radloff LS. The CES-D scale. A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.  https://doi.org/10.1177/014662167700100306.CrossRefGoogle Scholar
  17. 17.
    Shima S, Shikano T, Kitamura T, Asai M. New self-rating scale for depression. Seishin Igaku. 1985;27:717–23. [in Japanese]Google Scholar
  18. 18.
    Hänsel A, Hong S, Cámara RJ, von Känel R. Inflammation as a psychophysiological biomarker in chronic psychosocial stress. Neurosci Biobehav Rev. 2010;35(1):115–21.  https://doi.org/10.1016/j.neubiorev.2009.12.012. Review. CrossRefPubMedGoogle Scholar
  19. 19.
    Lennartsson AK, Kushnir MM, Bergquist J, Jonsdottir IH. DHEA and DHEA-S response to acute psychosocial stress in healthy men and women. Biol Psychol. 2012;90(2):143–9.  https://doi.org/10.1016/j.biopsycho.2012.03.003.CrossRefPubMedGoogle Scholar
  20. 20.
    Lennartsson AK, Theorell T, Kushnir MM, Bergquist J, Jonsdottir IH. Perceived stress at work is associated with attenuated DHEA-S response during acute psychosocial stress. Psychoneuroendocrinology. 2013;38(9):1650–7.  https://doi.org/10.1016/j.psyneuen.2013.01.010.CrossRefPubMedGoogle Scholar
  21. 21.
    Buford TW, Willoughby DS. Impact of DHEA(S) and cortisol on immune function in aging: a brief review. Appl Physiol Nutr Metab. 2008;33(3):429–33.  https://doi.org/10.1139/H08-013.CrossRefPubMedGoogle Scholar
  22. 22.
    Henderson M, Harvey SB, Overland S, Mykletun A, Hotopf M. Work and common psychiatric disorders. J R Soc Med. 2011;104(5):198–207.  https://doi.org/10.1258/jrsm.2011.100231.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Lee DY, Kim E, Choi MH. Technical and clinical aspects of cortisol as a biochemical marker of chronic stress. BMB Rep. 2015;48(4):209–16.  https://doi.org/10.5483/BMBRep.2015.48.4.275.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Lemmens SG, Born JM, Martens EA, Martens MJ, Westerterp-Plantenga MS. Influence of consumption of a high-protein vs. high-carbohydrate meal on the physiological cortisol and psychological mood response in men and women. PLoS One. 2011;6(2):e16826.  https://doi.org/10.1371/journal.pone.0016826.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Chrousos, Vgontzas AN, Kritikou I. HPA Axis and Sleep. In: De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. https://www.ncbi.nlm.nih.gov/books/NBK279071/ Accessed 18 Jan 2017.

Copyright information

© International Society of Behavioral Medicine 2017

Authors and Affiliations

  1. 1.Department of NursingBaika Women’s UniversityOsakaJapan
  2. 2.Department of Welfare System and Health ScienceOkayama Prefectural UniversityOkayamaJapan
  3. 3.Department of Public HealthSanyo Gakuen University Graduate School of NursingOkayamaJapan
  4. 4.Department of Public HealthKitasato University School of MedicineSagamiharaJapan

Personalised recommendations