ESPE2021 ePoster Category 2 Pituitary, neuroendocrinology and puberty (48 abstracts)
Size Matters: CAG Repeat Length of the Androgen Receptor Gene, Testosterone, and Male Adolescent Depression Severity
Raphael Hirtz 1 , Lars Libuda 2 , Anke Hinney 3 , Manuel Föcker 4 , Judith Bühlmeier 3 , Jochen Antel 3 , Paul-Martin Holterhus 5 , Alexandra Kulle 5 , Cordula Kiewert 1 , Johannes Hebebrand 3 & Corinna Grasemann 6
1Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; 2Department of Exercise and Health, Institute of Nutrition, Consumption and Health, University Paderborn, Paderborn, Germany; 3Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; 4Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany; 5Department of Paediatrics I, Paediatric Endocrinology and Diabetes, University Hospital of Schleswig-Holstein, UKSH, Campus Kiel, and Christian-Albrechts-University, Kiel, Germany; 6Department of Pediatrics, Division of Rare Diseases, St Josef-Hospital, and CeSER, Ruhr-University Bochum, Bochum, Germany
Background: There is a distinct increase in the prevalence of depression with the onset of puberty. The role of peripubertal testosterone levels in boys in this context is insufficiently understood. Moreover, the number of CAG repeats of the androgen receptor gene (AR) and the depression status (subclinical vs. overt depression) may modulate the role of testosterone, but this has not yet been studied in a clinical sample.
Methods: Cross-sectional data from 118 boys treated as in- or daycare patients at a single psychiatric hospital were subjected to higher-order moderation analysis in the multiple regression framework, accounting for multiple confounders of testosterone levels.
Results: There was a constant relationship between free testosterone and the severity of depressive symptoms irrespective of the number of CAG repeats in adolescents with subclinical depression (Beck Depression Inventory-II (BDI-II) score ≤ 13; n = 45). In adolescents with at least mild overt depression (BDI-II score > 13; n = 73), however, there was a significant negative relationship between free testosterone and the BDI-II score in patients with less than 19 CAG repeats and a significant positive relationship in those with more than 28 CAG repeats.
Conclusions: These results suggest that the effects of testosterone on mood in male adolescents with depression depend on the genetic make-up of the AR as well as on depression status. This complex relationship should be considered by future studies addressing mental health issues against an endocrine background and may, moreover, contribute to tailored treatment concepts in psychiatric medicine, especially in adults.
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