Associations of hair cortisol concentrations with paediatric appendicitis

Abstract The pathogenesis of paediatric appendicitis is still an enigma. In recent years, it has become more evident that our inherent immunological responses affect the trajectory of the disease course. Long-term stress has an impact on our immune system; however, it is practically and ethically ch...

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Autores principales:	Johanna Gudjonsdottir, Michaela Runnäs, Lars Hagander, Elvar Theodorsson, Martin Salö
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fb432edccae747a4829da2f91e9ec79d
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spelling	oai:doaj.org-article:fb432edccae747a4829da2f91e9ec79d2021-12-02T16:31:52ZAssociations of hair cortisol concentrations with paediatric appendicitis10.1038/s41598-021-94828-82045-2322https://doaj.org/article/fb432edccae747a4829da2f91e9ec79d2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94828-8https://doaj.org/toc/2045-2322Abstract The pathogenesis of paediatric appendicitis is still an enigma. In recent years, it has become more evident that our inherent immunological responses affect the trajectory of the disease course. Long-term stress has an impact on our immune system; however, it is practically and ethically challenging to prospectively track blood measurements of cortisol-levels in asymptomatic children should an acute appendicitis episode develop. The aim of this case–control study was therefore to evaluate the effect of increased stress measured as historical imprints in hair (hair cortisol concentrations [HCC]), on the risk of developing appendicitis and complicated appendicitis. 51 children (aged < 15 years) with appendicitis (34 with complicated appendicitis), were compared to 86 healthy controls. HCC reflecting the activity of the HPA-axis 0–3 and 4–6 months prior to sampling was evaluated and compared between groups as well as between the two measurements of each study subject. In the univariate analysis with both cases and controls, an increase in HCC between the measurement timepoints was associated with a substantial increase in risk of appendicitis (OR 7.52 [95% CI 2.49–22.67], p = 0.001). This increased risk remained in the multivariate analysis after adjustment for age, sex and season (aOR OR 10.76 [95%CI 2.50–46.28], p = 0.001). When comparing the cases of uncomplicated and complicated appendicitis through a multivariate analysis, adjusted for age and sex, the children with an increased HCC prior to appendicitis had a substantial and statistically significant increase in risk of complicated appendicitis (aOR 7.86 [95% CI 1.20–51.63], p = 0.03). Biological stress, measured as an increase in HCC, seems to be associated with an increased risk of paediatric appendicitis and a more complicated disease course.Johanna GudjonsdottirMichaela RunnäsLars HaganderElvar TheodorssonMartin SalöNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Johanna Gudjonsdottir Michaela Runnäs Lars Hagander Elvar Theodorsson Martin Salö Associations of hair cortisol concentrations with paediatric appendicitis
description	Abstract The pathogenesis of paediatric appendicitis is still an enigma. In recent years, it has become more evident that our inherent immunological responses affect the trajectory of the disease course. Long-term stress has an impact on our immune system; however, it is practically and ethically challenging to prospectively track blood measurements of cortisol-levels in asymptomatic children should an acute appendicitis episode develop. The aim of this case–control study was therefore to evaluate the effect of increased stress measured as historical imprints in hair (hair cortisol concentrations [HCC]), on the risk of developing appendicitis and complicated appendicitis. 51 children (aged < 15 years) with appendicitis (34 with complicated appendicitis), were compared to 86 healthy controls. HCC reflecting the activity of the HPA-axis 0–3 and 4–6 months prior to sampling was evaluated and compared between groups as well as between the two measurements of each study subject. In the univariate analysis with both cases and controls, an increase in HCC between the measurement timepoints was associated with a substantial increase in risk of appendicitis (OR 7.52 [95% CI 2.49–22.67], p = 0.001). This increased risk remained in the multivariate analysis after adjustment for age, sex and season (aOR OR 10.76 [95%CI 2.50–46.28], p = 0.001). When comparing the cases of uncomplicated and complicated appendicitis through a multivariate analysis, adjusted for age and sex, the children with an increased HCC prior to appendicitis had a substantial and statistically significant increase in risk of complicated appendicitis (aOR 7.86 [95% CI 1.20–51.63], p = 0.03). Biological stress, measured as an increase in HCC, seems to be associated with an increased risk of paediatric appendicitis and a more complicated disease course.
format	article
author	Johanna Gudjonsdottir Michaela Runnäs Lars Hagander Elvar Theodorsson Martin Salö
author_facet	Johanna Gudjonsdottir Michaela Runnäs Lars Hagander Elvar Theodorsson Martin Salö
author_sort	Johanna Gudjonsdottir
title	Associations of hair cortisol concentrations with paediatric appendicitis
title_short	Associations of hair cortisol concentrations with paediatric appendicitis
title_full	Associations of hair cortisol concentrations with paediatric appendicitis
title_fullStr	Associations of hair cortisol concentrations with paediatric appendicitis
title_full_unstemmed	Associations of hair cortisol concentrations with paediatric appendicitis
title_sort	associations of hair cortisol concentrations with paediatric appendicitis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/fb432edccae747a4829da2f91e9ec79d
work_keys_str_mv	AT johannagudjonsdottir associationsofhaircortisolconcentrationswithpaediatricappendicitis AT michaelarunnas associationsofhaircortisolconcentrationswithpaediatricappendicitis AT larshagander associationsofhaircortisolconcentrationswithpaediatricappendicitis AT elvartheodorsson associationsofhaircortisolconcentrationswithpaediatricappendicitis AT martinsalo associationsofhaircortisolconcentrationswithpaediatricappendicitis
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Associations of hair cortisol concentrations with paediatric appendicitis

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