Association of serum cortisol and dehydroepiandrosterone sulfate (DHEAS) levels with psychological stress in patients with vitiligo

Background/aim: Vitiligo is a depigmentation disorder that leads to serious psychological burden in patients, who are frequentlyreported to have depression and anxiety. The aim of this study was to investigate the association between stress-related hormone levelsand psychological stress in vitiligo.Materials and methods: In this study 46 vitiligo patients and 46 controls were enrolled; their cortisol, dehydroepiandrosterone sulfate(DHEAS), and cortisol/DHEAS levels were measured. Psychological burden was assessed by the Beck Depression Inventory andPerceived Stress Scale.Results: Patients and controls did not differ in terms of cortisol, DHEAS, or cortisol/DHEAS. Patients had higher perceived stress thancontrols but did not differ in terms of depression scores. Correlation analyses revealed that cortisol/DHEAS correlated positively withperceived stress (P = 0.009, r = 0.272). The correlation between cortisol/DHEAS and perceived stress was stronger in the patient group(P = 0.013, r = 0.363) and close to zero among controls. In regression analyses, lower depression and higher perceived stress were shownto predict cortisol/DHEAS values.Conclusion: Vitiligo patients significantly differed from the healthy population in terms of hormones and psychological distress. Therewas also an association between perceived stress and cortisol/DHEAS ratio in vitiligo. Abnormality of hormonal response to distresslowers DHEAS, which is known for its antioxidant properties, a possible mechanism for vitiligo development. Another importantfinding is the significance of using the composite variable cortisol/DHEAS, which seems to be more sensitive to distress than each of itscomponents. We suggest its use in future studies on psychological distress–hormone relationships.

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