Blunted hypothalamic‐pituitary‐adrenal axis and insulin response to psychosocial stress in young adults born preterm at very low birth weight. (12th June 2013)

• Record Type: Journal Article
• Authors: Kaseva, Nina; Wehkalampi, Karoliina; Pyhälä, Riikka; Moltchanova, Elena; Feldt, Kimmo; Pesonen, Anu‐Katriina; Heinonen, Kati; Hovi, Petteri; Järvenpää, Anna‐Liisa; Andersson, Sture; Eriksson, Johan G.; Räikkönen, Katri; Kajantie, Eero
• Is Part Of: Clinical endocrinology. Volume 80:Number 1(2014:Jan.)
• Page Start: 101
• Page End: 106
• Publication Date: 2013-06-12
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12251
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12251-abs-0001"> <title>Summary</title> <sec id="cen12251-sec-0001" sec-type="section"> <title>Background</title> <p>Young adults born preterm at very low birth weight (VLBW, ≤1500 g) have higher levels of cardiovascular risk factors, including impaired glucose regulation, than their term‐born peers. This could be mediated through altered hypothalamic‐pituitary‐adrenal axis (HPAA) response to stress.</p> </sec> <sec id="cen12251-sec-0002" sec-type="section"> <title>Objective</title> <p>To compare HPAA, glucose and insulin responses provoked by psychosocial stress in VLBW subjects versus a comparison group of term‐born controls.</p> </sec> <sec id="cen12251-sec-0003" sec-type="section"> <title>Design and participants</title> <p>We studied 54 unimpaired young adults, aged 19–27 years, born at VLBW and a comparison group of 40 adults born at term, group‐matched for age, sex and birth hospital, from one regional centre in southern Finland. The participants underwent a standardized psychosocial stress test (Trier Social Stress Test, TSST).</p> </sec> <sec id="cen12251-sec-0004" sec-type="section"> <title>Measurements</title> <p>In conjunction with TSST, we measured salivary cortisol, plasma ACTH, cortisol, glucose and insulin. Data were analysed with mixed‐effects model and multiple linear regression analyses.</p> </sec> <sec id="cen12251-sec-0005" sec-type="section"> <title>Results</title> <p>Baseline concentrations for cortisol, ACTH, insulin and glucose were similar in VLBW and comparison groups. During TSST, analysed with mixed‐effects model, overall concentrations of plasma cortisol were 17·2% lower (95% CI; 3·5 to 28·9) in the VLBW group. The VLBW group also had lower salivary (<italic>P</italic> = 0·04) and plasma cortisol (<italic>P</italic> = 0·02) responses to TSST. Insulin and glucose concentrations correlated with changes in cortisol concentrations. Accordingly, VLBW subjects had 26·5% lower increment in insulin (95% CI; 9·8–40·1). Analyses were adjusted for age, sex, body mass index, hormonal contraception, menstrual cycle phase, time of day and parental education.</p> </sec> <sec id="cen12251-sec-0006" sec-type="section"> <title>Conclusions</title> <p>VLBW adults have lower HPAA responses to psychosocial stress than term‐born controls. This is accompanied by a lower insulin response.</p> </sec> </abstract>