Increased salivary chromogranin A in women with severe negative mood states in the premenstrual phase

Abstract

The present study investigated whether salivary chromogranin A (CgA), a psychological stress marker associated with sympathetic nervous system activity, changes during the menstrual cycle in women with different degrees of premenstrual psychoemotional symptoms. Forty-five women (28.6 ± 1.3 years) with regular menstrual cycles participated in this study. Salivary CgA and cortisol were measured during the follicular and late-luteal phases. The authors used the Profile of Mood State (POMS) to assess current mood states of subjects in each menstrual phase and divided the subjects into three groups depending on increase of total mood disturbance (TMD), a global measure of affective states of POMS from the follicular to the late-luteal phase: Low (4.1 ± 0.7%), Middle (18.7 ± 1.2%) and High (51.7 ± 7.4%). Results showed no intramenstrual cycle differences in salivary CgA in the Low and Middle groups. Women in the High group, in contrast, had a significantly higher level of salivary CgA in the late-luteal phase compared to that of the follicular phase. Additionally, salivary CgA level significantly and positively correlated with TMD and four emotional subscales: tension-anxiety, depression-dejection, anger-hostility and confusion in the late-luteal phase. No intergroup or menstrual-cycle difference occurred in the salivary cortisol. This study indicates a significant late-luteal increase in salivary CgA, reflecting an increase of sympathetic nerve activity in women who experience a substantial increase (>30%) in a cluster of negative psychoemotional symptoms premenstrually. Furthermore, salivary CgA, as opposed to salivary cortisol, could serve as a reliable noninvasive biomarker to more sensitively evaluate neuropsychophysiological fluctuations during the menstrual cycle.

Keywords::

• Premenstrual syndrome
• profile of mood states
• salivary chromogranin A
• salivary cortisol
• sympathetic nervous system activity

Acknowledgements

The authors wish to express their appreciation to all volunteers for their dedicated participation in this study.

Declaration of Interest: This work was supported by the Japan Society for the Promotion of Science, Grant-in-Aid for Scientific Research (C) 18590623 and 21500669.

Current knowledge on this subject

• A majority of reproductive-age women experience negative emotional mood states together with physical and behavioral symptoms premenstrually. Known as premenstrual syndrome (PMS), its etiopathogenesis remains unclear.

• Salivary chromogranins A (CgA) reflects sympathoadrenal activity in the stress response and changes more rapidly and more sensitively to psychological stressors than salivary cortisol.

• Scarce information exists as to whether the menstrual cyclicity of salivary CgA relates to a cluster of psychoemotional symptoms appearing in the late-luteal phase.

What this study adds

• To our knowledge, the present study represents the first one to indicate a significant late-luteal increase in salivary CgA in women who experience a substantial increase (>30%) in a cluster of negative psychoemotional symptoms premenstrually.

• We found no intramenstrual cycle differences in salivary CgA levels in women with mild to moderate premenstrual emotional symptoms, which rather signals impending normal menstruation categorized within the sphere of premenstrual molimina.

• Salivary CgA levels significantly and positively correlated with a total mood disturbance score and four emotional subscales: tension-anxiety, depression-dejection, anger-hostility and confusion in the premenstrual phase.

• Salivary CgA, as opposed to salivary cortisol, could serve as a reliable noninvasive biomarker to evaluate more sensitively the neuropsychophysiological fluctuations during the menstrual cycle.