Background. A relationship between serum cortisol (F) and insulin resistance has been shown in obese adults and children, suggesting a role for F in the development of the metabolic syndrome (MS). In this regard, F could be an important predictor factor for MS. Objective. The aim of this study was to evaluate the relationship between F and components of MS in obese children and adolescents. Subjects and Methods. This is a retrospective study in 1027 obese children and adolescents (BMI-SDS 2.62±0.51) referred to our endocrine unit in the last 8 y. Waist circumference (WC), systolic and diastolic blood pressure (SP, DP), morning serum concentrations of F, glucose (Glyc), cholesterol HDL, tryglicerides (TG) and HOMA (Glyc(mmol/L)xInsulin(mU/L)/22.5) were evaluated in all subjects. MS was defined according to the IDF criteria (1). Patients were subdivided into 3 age groups: 6-10, 10-16 and >16 y. Results. In univariate regression analysis including the entire cohort, F was weakly associated with SP (r=0.17, P<0.001), DP (r=0.13 P<0.001), Glyc (r=0.16 P<0.001) and HOMA (r=0.15, P<10-5), also when adjusted for age, gender, puberty and BMI-SDS. 14/372 patients aged 10-16 y had MS. Univariate regression analysis in these 372 subjects showed that F was associated with SP (r=0.11, P=0.047), DP (r=0.16 P=0.003) and Glyc (r=0.21 P<0.0001) but not with HOMA. When adjusted for age, gender, puberty and BMI-SDS, F was no longer correlated with SP but was weakly correlated with HOMA (r=0.12, P=0.02). In multivariate regression analysis including age, sex, puberty, BMI-SDS and F as independent variables and one of the component of the MS as the dependent variable, the only models where F was a weak predictor of the variability were one with DP (B=0.02, P=0.009, adjusted R2=0.13) and one with Glyc (B=0.03, P=0.003, adjusted R2=0.12) as dependent variables. Patients were then subdivided into 4 groups according to the WC centile: WC<90, WC>90, WC>90 and 1 of the other components of the MS, WC>90 and 2 of the other components of the MS. Mean F concentrations in the 4 groups was significantly different (F=7.12, P=0.0001), even adjusted for age, gender, puberty and BMI-SDS (F=4.53, P=0.004). Patients with one or more components of the MS had higher F concentrations. Conclusions. In this cohort of obese children and adolescents, F was weakly associated with components of the MS. These findings suggest that F has a minor role, if any, in the development of MS. (1)Zimmet et al., Pediatric Diabetes 2007; 8:299–306.
Relationship between Cortisol and Components of the Metabolic Syndrome in Obese Children and Adolescents
ZAVATTARI, PATRIZIA;Minerba L;
2012-01-01
Abstract
Background. A relationship between serum cortisol (F) and insulin resistance has been shown in obese adults and children, suggesting a role for F in the development of the metabolic syndrome (MS). In this regard, F could be an important predictor factor for MS. Objective. The aim of this study was to evaluate the relationship between F and components of MS in obese children and adolescents. Subjects and Methods. This is a retrospective study in 1027 obese children and adolescents (BMI-SDS 2.62±0.51) referred to our endocrine unit in the last 8 y. Waist circumference (WC), systolic and diastolic blood pressure (SP, DP), morning serum concentrations of F, glucose (Glyc), cholesterol HDL, tryglicerides (TG) and HOMA (Glyc(mmol/L)xInsulin(mU/L)/22.5) were evaluated in all subjects. MS was defined according to the IDF criteria (1). Patients were subdivided into 3 age groups: 6-10, 10-16 and >16 y. Results. In univariate regression analysis including the entire cohort, F was weakly associated with SP (r=0.17, P<0.001), DP (r=0.13 P<0.001), Glyc (r=0.16 P<0.001) and HOMA (r=0.15, P<10-5), also when adjusted for age, gender, puberty and BMI-SDS. 14/372 patients aged 10-16 y had MS. Univariate regression analysis in these 372 subjects showed that F was associated with SP (r=0.11, P=0.047), DP (r=0.16 P=0.003) and Glyc (r=0.21 P<0.0001) but not with HOMA. When adjusted for age, gender, puberty and BMI-SDS, F was no longer correlated with SP but was weakly correlated with HOMA (r=0.12, P=0.02). In multivariate regression analysis including age, sex, puberty, BMI-SDS and F as independent variables and one of the component of the MS as the dependent variable, the only models where F was a weak predictor of the variability were one with DP (B=0.02, P=0.009, adjusted R2=0.13) and one with Glyc (B=0.03, P=0.003, adjusted R2=0.12) as dependent variables. Patients were then subdivided into 4 groups according to the WC centile: WC<90, WC>90, WC>90 and 1 of the other components of the MS, WC>90 and 2 of the other components of the MS. Mean F concentrations in the 4 groups was significantly different (F=7.12, P=0.0001), even adjusted for age, gender, puberty and BMI-SDS (F=4.53, P=0.004). Patients with one or more components of the MS had higher F concentrations. Conclusions. In this cohort of obese children and adolescents, F was weakly associated with components of the MS. These findings suggest that F has a minor role, if any, in the development of MS. (1)Zimmet et al., Pediatric Diabetes 2007; 8:299–306.
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