Diurnal cortisol and obesity in adolescents with and without Down syndrome.
Diurnal cortisol and obesity in adolescents with and without Down syndrome.
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患有和不患有唐氏综合症的青少年的昼夜皮质醇和肥胖。
DOI：
10.1111/jir.12682
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Ulrich,DA
中科院分区：
文献类型：
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作者：
Pitchford,EA;Hasson,RE;Hornyak,JE;Lumeng,JC;Peterson,KE;Ulrich,DA
背景唐氏综合症（DS）青少年的肥胖患病率远远超过一般人群。皮质醇是一种肾上腺激素，如果失调，可能会导致肥胖。然而，尚未在 DS 患者中检查这种激素的昼夜模式。肥胖的变化也可能介导皮质醇调节。本研究旨在探讨 DS 青少年的昼夜皮质醇模式以及皮质醇功能与肥胖之间的关联。 方法 共有 32 名青少年参与了这项初步研究，其中包括 16 名 DS 患者和 16 名具有典型发育 (TD) 的对照组，性别、年龄和 Tanner 青春期阶段相似 (P> 0.05)。参与者完成了双能 X 射线吸收测量扫描来测量身体成分，并在早上、下午和晚上收集唾液样本用于皮质醇测量。使用具有随机截距和重复测量的线性混合模型来检查患有和不患有 DS 的青少年之间对数转换的皮质醇浓度的每日轨迹。第二个模型检查了 DS 与体脂升高之间的相互作用。结果患有 DS 的青少年早晨皮质醇浓度较高（截距 = 0.37 μg/dL），但这与 TD 患者没有显着差异（0.35 μg/dL，P = 0.16）。皮质醇在几个小时内显着下降（b = -0.026 μg/dL/h，P < 0.001），但这种下降也与 TD 中观察到的没有不同（b = -0.024 μg/dL/h，P = 0.43）。虽然体脂升高的青少年皮质醇水平略高，但这种差异并不具有统计学意义（P> 0.05；d= 0.30）。结论这项研究是第一个检查 DS 中昼间皮质醇的研究，但样本量有限。这些初步研究结果表明，患有 DS 和 TD 的青少年之间的昼夜皮质醇模式没有显着差异，并且皮质醇水平与该人群中的肥胖无关。尽管存在这些不显着的差异，患有 DS 的青少年仍然是儿童肥胖的“高危”人群，需要临床干预。
BackgroundThe prevalence of obesity in adolescents with Down syndrome (DS) far exceeds that in the general population. Cortisol, an adrenal hormone, can be obesogenic when dysregulated. However, the diurnal patterns of this hormone have not been examined among individuals with DS. Variations in adiposity may also mediate cortisol regulation. This study sought to examine diurnal cortisol patterns in adolescents with DS as well as associations between cortisol function and obesity.MethodA total of 32 adolescents, including 16 with DS and 16 controls with typical development (TD) of similar sex, age and Tanner pubertal stage (P> 0.05), participated in this preliminary study. Participants completed a dual‐energy X‐ray absorptiometry scan to measure body composition and collected saliva samples for cortisol measurements in the morning, afternoon and night. Linear mixed models with random intercepts and repeated measures were used to examine the daily trajectory of log‐transformed cortisol concentrations between adolescents with and without DS. A second model examined the interaction between DS and presence of elevated body fatness.ResultsAdolescents with DS had higher morning cortisol concentrations (intercept = 0.37 μg/dL), but this was not significantly different than in TD (0.35 μg/dL,P= 0.16). Cortisol significantly declined across hours (b = −0.026 μg/dL/h,P< 0.001), but this decline also did not differ from that observed in TD (b = −0.024 μg/dL/h,P= 0.43). While cortisol levels were slightly higher among adolescents with elevated body fatness, this difference was not statistically significant (P> 0.05;d= 0.30).ConclusionsThis study is the first to examine diurnal cortisol in DS but is limited in sample size. These preliminary findings suggest that diurnal cortisol patterns are not significantly different between adolescents with DS and TD and that cortisol levels are not associated with adiposity in this population. Despite these non‐significant differences, youth with DS continue to be an ‘at‐risk' population for paediatric obesity in need of clinical intervention.