Impact of psychological health on peripheral endothelial function and the HPA-axis activity in healthy adolescents

Atherosclerosis. 2017 Jun:261:131-137. doi: 10.1016/j.atherosclerosis.2017.03.012. Epub 2017 Mar 9.


Background and aims: The development of adolescence psychological health over a 3-year period and its relationship to peripheral endothelial function and the hypothalamic-pituitary-adrenal (HPA)-axis activity were examined in a cohort of healthy adolescents in a longitudinal study.

Methods: A total of 162 adolescents (94 females) participated in both baseline (mean age 14.5 ± 1 years) and three-year follow-up studies. Psychological health was evaluated by self-report using the Beck Youth Inventories of Emotional and Social Impairment and the psychosomatic problem scale. Peripheral endothelial function was assessed using a peripheral artery tonometry device. The HPA-axis activity measured as cortisol awakening response (CAR) was assessed only at follow-up by collecting two saliva samples, immediately after awakening and 15 min later. Physical activity, smoking and parental education were assessed by questionnaires.

Results: Adolescents reported increased depression and decreased anger over three years, while only females reported increased psychosomatic complaints. Reduced peripheral endothelial function was associated with high level of anger (β = -0.332, p = 0.018) and disruptive behaviour (β = -0.390, p = 0.006) over three years in males, but not in females, after adjusting for covariates. Blunted cortisol awakening response was associated with high level of anxiety (β = -0.235, p = 0.017), depression (β = -0.203, p = 0.038), anger (β = -0.185, p = 0.048), and low level of self-concept (β = 0.289, p = 0.002) after adjusting for covariates.

Conclusions: High level of negative emotions during adolescence may have adverse effects on peripheral endothelial function and the regulation of the HPA-axis activity, while high level of self-concept might be protective.

Keywords: Adolescence; Cortisol awakening response; Negative emotional status; Peripheral endothelial function; Self-concept.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Age Factors
  • Biomarkers / metabolism
  • Educational Status
  • Emotions*
  • Endothelium, Vascular / physiology*
  • Exercise
  • Female
  • Fingers / blood supply*
  • Follow-Up Studies
  • Healthy Volunteers
  • Hemodynamics*
  • Humans
  • Hydrocortisone / metabolism
  • Hypothalamo-Hypophyseal System / metabolism
  • Hypothalamo-Hypophyseal System / physiology*
  • Longitudinal Studies
  • Male
  • Manometry
  • Mental Health*
  • Parents / psychology
  • Pituitary-Adrenal System / metabolism
  • Pituitary-Adrenal System / physiology*
  • Saliva / metabolism
  • Self Concept*
  • Self Report
  • Smoking / psychology


  • Biomarkers
  • Hydrocortisone