Elevated plasma cortisol concentrations: A link between low birth weight and the insulin resistance syndrome?
Elevated plasma cortisol concentrations: A link between low birth weight and the insulin resistance syndrome?
复制标题
DOI：
10.1210/jc.83.3.757
复制
发表时间：
1998-03-01
影响因子：
5.8
通讯作者：
Walker, BR
中科院分区：
文献类型：
--
作者：
Phillips, DIW;Barker, DJP;Walker, BR
最近的研究表明，胎儿生长迟缓与成年后胰岛素抵抗综合征的发生有关。其机制尚不清楚。然而，下丘脑-垂体-肾上腺轴（HPAA）的活性增加可能是这种关联的基础;已知该轴在动物中因胎儿生长迟缓而重置，并且在人类中有证据表明HPAA活性升高与胰岛素抵抗综合征之间存在关联。因此，我们研究了健康男性样本中出生时的大小，血浆皮质醇浓度和胰岛素抵抗综合征成分之间的关系。我们测量了0900 h空腹血浆皮质醇和皮质类固醇结合球蛋白水平的370名男子谁出生在英国赫特福德郡，1920-1930年之间，其出生体重记录。空腹血浆皮质醇浓度范围为112-702 nmol/L，与收缩压（P = 0.02）、空腹和口服葡萄糖耐量试验后2小时血糖浓度（P = 0.0002和P = 0.04）、血浆甘油三酯水平（P = 0.009）和胰岛素抵抗（P = 0.006）相关。血浆皮质醇浓度逐渐下降（P = 0.007），从408 nmol/L的男性，出生体重为5.5磅（2.50公斤）或以下的309 nmol/L的那些谁出生时体重9.5磅（4.31公斤）或以上，一个趋势独立于年龄和体重指数。这些发现表明，血浆皮质醇浓度在正常范围内可能对血压和葡萄糖耐量有重要影响。此外，这项研究提供了第一个证据表明，宫内编程的HPAA可能是一种机制之间的关联低出生体重和胰岛素抵抗综合征的成年生活。
Recent studies have shown that reduced fetal growth is associated with the development of the insulin resistance syndrome in adult life. The mechanisms are not known. However increased activity of the hypothalamic-pituitary-adrenal axis (HPAA) may underlie this association; the axis is known to be reset by fetal growth retardation in animals, and there is evidence in humans of an association between raised HPAA activity and the insulin resistance syndrome. We have, therefore, examined the relations among size at birth, plasma cortisol concentrations, and components of the insulin resistance syndrome in a sample of healthy men. We measured 0900 h fasting plasma cortisol and corticosteroid-binding globulin levels in 370 men who were born in Hertfordshire, UK, between 1920-1930 and whose birth weights were recorded. Fasting plasma cortisol concentrations varied from 112-702 nmol/L and were related to systolic blood pressure (P = 0.02), fasting and 2-h plasma glucose concentrations after an oral glucose tolerance test (P = 0.0002 and P = 0.04), plasma triglyceride levels (P = 0.009), and insulin resistance (P = 0.006). Plasma cortisol concentrations fell progressively (P = 0.007) from 408 nmol/L in men whose birth weights were 5.5 lb (2.50 kg) or less to 309 nmol/L among those who weighed 9.5 Ib (4.31 kg) or more at birth, a trend independent of age and body mass index. These findings suggest that plasma concentrations of cortisol within the normal range could have an important effect on blood pressure and glucose tolerance. Moreover, this study provides the first evidence that intrauterine programming of the HPAA may be a mechanism underlying the association between low birth weight and the insulin resistance syndrome in adult life.