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Liviero F, Scapellato ML, Volpin A, Battistella M, Fabris L, Brischigliaro L, Folino F, Moretto A, Mason P, Pavanello S. Long term follow-up of heart rate variability in healthcare workers with mild COVID-19. Front Neurol 2024; 15:1403551. [PMID: 38827576 PMCID: PMC11141692 DOI: 10.3389/fneur.2024.1403551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/17/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction Prior investigations into post-COVID dysautonomia often lacked control groups or compared affected individuals solely to healthy volunteers. In addition, no data on the follow-up of patients with SARS-CoV-2-related autonomic imbalance are available. Methods In this study, we conducted a comprehensive clinical and functional follow-up on healthcare workers (HCWs) with former mild COVID-19 (group 1, n = 67), to delineate the trajectory of post-acute autonomic imbalance, we previously detected in a case-control study. Additionally, we assessed HCWs for which a test before SARS-CoV-2 infection was available (group 2, n = 29), who later contracted SARS-CoV-2, aiming to validate findings from our prior case-control investigation. We evaluated autonomic nervous system heart modulation by means of time and frequency domain heart rate variability analysis (HRV) in HCWs during health surveillance visits. Short-term electrocardiogram (ECG) recordings, were obtained at about 6, 13 months and both at 6 and 13 months from the negative SARS-CoV-2 naso-pharyngeal swab (NPS) for group 1 and at about 1-month from the negative NPS for group 2. HCWs who used drugs, had comorbidities that affected HRV, or were hospitalized with severe COVID-19 were excluded. Results Group 1 was split into three subgroups clinically and functionally followed at, about 6 months (subgroup-A, n = 17), 13 months (subgroup-B, n = 37) and both at 6 and 13 months (subgroup-C, n = 13) from the negative SARS-CoV-2 NPS. In subgroup-A, at 6-month follow-up compared with baseline, the spectral components in the frequency domain HRV parameters, showed an increase in normalized high frequency power (nHF) (t = 2.99, p = 0.009), a decrease in the normalized low frequency power (nLF) (t = 2.98, p = 0.009) and in the LF/HF ratio (t = 3.13, p = 0.006). In subgroup B, the comparison of the spectral components in the frequency domain HRV parameters, at 13-month follow-up compared with baseline, showed an increase in nHF (t = 2.54, p = 0.02); a decrease in nLF (t = 2.62, p = 0.01) and in the LF/HF ratio (t = 4.00, p = 0.0003). In subgroup-C, at both 6 and 13-month follow-ups, the spectral components in the frequency domain HRV parameters were higher than baseline in nHF (t = 2.64, p = 0.02 and (t = 2.13, p = 0.05, respectively); lower in nLF (t = 2.64, p = 0.02 and (t = 2.13, p = 0.05, respectively), and in LF/HF (t = 1.92, p = 0.08 and (t = 2.43, p = 0.03, respectively). A significant proportion of HCWs reported persistent COVID-19 symptoms at both the 6 and 13-month follow-ups, seemingly unrelated to cardiac autonomic balance. In group 2 HCWs, at 1-month follow-up compared with baseline, the spectral components in the frequency domain HRV parameters, showed a decrease in nHF (t = 2.19, p = 0.04); an increase in nLF (t = 2.15, p = 0.04) and in LF/HF (t = 3.49, p = 0.002). Conclusion These results are consistent with epidemiological data suggesting a higher risk of acute cardiovascular complications during the first 30 days after COVID-19. The SARS-CoV-2 associated autonomic imbalance in the post-acute phase after recovery of mild COVID-19 resolved 6 months after the first negative SARS-CoV-2 NPS. However, a significant proportion of HCWs reported long-term COVID-19 symptoms, which dot not seems to be related to cardiac autonomic balance. Future research should certainly further test whether autonomic imbalance has a role in the mechanisms of long-COVID syndrome.
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Affiliation(s)
- Filippo Liviero
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Anna Volpin
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Monica Battistella
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Laura Fabris
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Laura Brischigliaro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Franco Folino
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Angelo Moretto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Paola Mason
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
| | - Sofia Pavanello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, Padova, Italy
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Mogavero MP, DelRosso LM, Lanza G, Lanuzza B, Bruni O, Strambi LF, Ferri R. Changes in time structure of periodic leg movements during sleep in restless legs syndrome: Effects of sex and age. Sleep Med 2024; 115:137-144. [PMID: 38359593 DOI: 10.1016/j.sleep.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND The objective of this study was to check the hypothesis that in women with restless legs syndrome (RLS) different changes occur in periodic leg movements during sleep (PLMS) during the post-menopausal period (using >50 years as a proxy) than in men of the same age. METHODS We recruited 36 untreated patients aged 18-50 years (19 men, median age 40 years, and 17 women, median age 37 years) while the remaining 67 were >50 years old (24 men, median age 66.6 years, and 43 women, median age 60.0 years). Leg movement activity during sleep was analyzed by means of an approach utilizing indexes especially suitable to assess leg movement periodicity. RESULTS No significant difference was seen between men in the two age groups; conversely, in women, a clear and significant increase in Periodicity Index was observed in the older group, along with a decrease in isolated leg movements. In women, a clear age-related enhancement of PLMS was found in the intermovement interval graphs, especially in the 16-22 s range, which was more evident than that observed in men. The results remained unchanged also when they were replicated by selecting only subjects aged 18-45 years vs. those aged >55 years. CONCLUSIONS Our findings indicate that assessing PLMS in women after menopause is clinically relevant because they are probably connected with the hormonal fluctuations of this period of life. Translationally, identifying and addressing PLMS in post-menopausal women is crucial for optimizing their sleep health and addressing potential health risks associated with sleep disturbances.
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Affiliation(s)
- Maria P Mogavero
- Vita-Salute San Raffaele University, Milan, Italy; Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | | | - Giuseppe Lanza
- Clinical Neurophysiology Research Unit and Sleep Research Centre, Oasi Research Institute-IRCCS, Troina, Italy; Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Bartolo Lanuzza
- Clinical Neurophysiology Research Unit and Sleep Research Centre, Oasi Research Institute-IRCCS, Troina, Italy
| | - Oliviero Bruni
- Department of Social and Developmental Psychology, Sapienza University, Rome, Italy
| | - Luigi Ferini Strambi
- Vita-Salute San Raffaele University, Milan, Italy; Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Raffaele Ferri
- Clinical Neurophysiology Research Unit and Sleep Research Centre, Oasi Research Institute-IRCCS, Troina, Italy.
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Metanephrine and Normetanephrine Urine Excretion in Patients with PCOS. ACTA MEDICA BULGARICA 2022. [DOI: 10.2478/amb-2022-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Aims: The present study aims to investigate the association between catecholamine metabolites (normetanephrine [NMN] and metanephrine [MN]) and polycystic ovarian syndrome (PCOS) and its clinical manifestations.
Materials and methods: A total of 60 female patients (18-37 years) were included in the study. Twenty-five healthy women and 35 patients with PCOS provided blood and urine samples. Anthropometric, biochemical, and hormonal parameters, e.g. immunoreactive insulin, total testosterone, gonadotropins, and dehydroepiandrosterone-sulfate (DHEAS) have been investigated. Twenty-four-hour urinary metanephrines (MN and NMN) were measured by radioimmunoassay technique.
Results: MN and NMN showed a strong positive correlation (r = +0.645, p < 0.001) in women with PCOS, but nephrines were not significantly associated with the hormonal, anthropometric, and metabolic parameters of the patients (p > 0.05 for all). No differences in urinary nephrines concentrations between women with PCOS and healthy individuals after adjustment for age and BMI were established. However, lower 24-hour urinary MN levels predicted the development of menstrual irregularity after adjustment for age and BMI (OR = 1,015 [95% CI 1,001-1,029], p = 0,036).
Conclusions: Adrenomedullary dysfunction might influence the development of chronic anovulation in young women.
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Madjar N, Gazoli R, Manor I, Shoval G. Contrasting effects of music on reading comprehension in preadolescents with and without ADHD. Psychiatry Res 2020; 291:113207. [PMID: 32559672 DOI: 10.1016/j.psychres.2020.113207] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 01/25/2023]
Abstract
Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are advised to study in quiet settings; yet, many professionals assert that environments devoid of external stimulus, are often unnecessary to facilitate optimal learning conditions. Empirical controlled trials examining this assertion are scarce. This study explored whether music improves reading performance of preadolescents with ADHD compared with typically developed (TD) peers, and its correlation with changes in heart rate variability (HRV), an autonomic nervous system indicator. After a pilot phase (N = 20; age = 12.05), additional independent sample of ADHD (n = 25; age = 10.28) and TD (n = 25; age = 10.44) preadolescents completed reading tasks under four conditions: without background music, with calm music without lyrics, calm music with lyrics, and rhythmic music with lyrics. Reading comprehension and mean-levels of HRV changes (before and during each task) were assessed using validated instruments. Reading comprehension significantly improved under the music conditions in ADHD group and deteriorated among TD. Differences in HRV changes were significant between groups, and explained reading performance. These findings suggest that music may improve attentive skills of preadolescents with ADHD, but not TD, and urge the need to identify an optimal fit between individual and contextual characteristics.
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Affiliation(s)
- Nir Madjar
- School of Education, Bar-Ilan University, Ramat-Gan, 5290002 Israel.
| | - Rami Gazoli
- School of Education, Bar-Ilan University, Ramat-Gan, 5290002 Israel
| | - Iris Manor
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 6997801 Israel; Geha Mental Health Center, Petach-Tikvah, Israel
| | - Gal Shoval
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 6997801 Israel; Geha Mental Health Center, Petach-Tikvah, Israel
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Porzionato A, Emmi A, Barbon S, Boscolo-Berto R, Stecco C, Stocco E, Macchi V, De Caro R. Sympathetic activation: a potential link between comorbidities and COVID-19. FEBS J 2020; 287:3681-3688. [PMID: 32779891 PMCID: PMC7405290 DOI: 10.1111/febs.15481] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/04/2020] [Accepted: 07/08/2020] [Indexed: 12/13/2022]
Abstract
In coronavirus disease 2019 (COVID-19), higher morbidity and mortality are associated with age, male gender, and comorbidities, such as chronic lung diseases, cardiovascular pathologies, hypertension, kidney diseases, diabetes mellitus, and obesity. All of the above conditions are characterized by increased sympathetic discharge, which may exert significant detrimental effects on COVID-19 patients, through actions on the lungs, heart, blood vessels, kidneys, metabolism, and/or immune system. Furthermore, COVID-19 may also increase sympathetic discharge, through changes in blood gases (chronic intermittent hypoxia, hyperpnea), angiotensin-converting enzyme (ACE)1/ACE2 imbalance, immune/inflammatory factors, or emotional distress. Nevertheless, the potential role of the sympathetic nervous system has not yet been considered in the pathophysiology of COVID-19. In our opinion, sympathetic overactivation could represent a so-far undervalued mechanism for a vicious circle between COVID-19 and comorbidities.
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Affiliation(s)
- Andrea Porzionato
- Section of Anatomy, Department of Neuroscience, University of Padova, Italy
| | - Aron Emmi
- Section of Anatomy, Department of Neuroscience, University of Padova, Italy
| | - Silvia Barbon
- Section of Anatomy, Department of Neuroscience, University of Padova, Italy
| | | | - Carla Stecco
- Section of Anatomy, Department of Neuroscience, University of Padova, Italy
| | - Elena Stocco
- Section of Anatomy, Department of Neuroscience, University of Padova, Italy
| | - Veronica Macchi
- Section of Anatomy, Department of Neuroscience, University of Padova, Italy
| | - Raffaele De Caro
- Section of Anatomy, Department of Neuroscience, University of Padova, Italy
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Hormonal Blood Pressure Regulationduring General Anesthesia Usinga Standardized Propofol Dosagein Children and Adolescents SeemsNot to Be Affected by Body Weight. J Clin Med 2020; 9:jcm9072129. [PMID: 32640705 PMCID: PMC7408938 DOI: 10.3390/jcm9072129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 12/15/2022] Open
Abstract
Obesity in pediatric surgical patients is a challenge for the anesthesiologist. Despite potentially beneficial properties, propofol might also induce hypotension. This study examined whether a dose adjustment in overweight children could avoid hypotension and if there would be differences regarding hormonal regulation in children under anesthesia. Fifty-nine children undergoing surgery under general anesthesia were enrolled in this prospective observational trial. Participants were allocated into two groups according to their BMI. The induction of anesthesia was conducted using propofol (“overweight”: 2 mg/kgBW, “regular”: 3.2 mg/kgBW). The maintenance of anesthesia was conducted as total intravenous anesthesia. Hormone levels of renin, angiotensin II, aldosterone, copeptin, norepinephrine and epinephrine were assessed at different timepoints. Blood pressure dropped after the administration of propofol in both groups, with a nadir 2 min after administration—but without a significant difference in the strength of reduction between the two groups. As a reaction, an increase in the plasma levels of renin, angiotensin and aldosterone was observed, while levels of epinephrine, norepinephrine and copeptin dropped. By adjusting the propofol dosage in overweight children, the rate of preincision hypotension could be reduced to the level of normal-weight patients with a non-modified propofol dose. The hormonal counter regulation was comparable in both groups. The release of catecholamines and copeptin as an indicator of arginine vasopressin seemed to be inhibited by propofol.
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High blood pressure and its relationship to adiposity in a school-aged population: body mass index vs waist circumference. Hypertens Res 2017; 41:135-140. [DOI: 10.1038/hr.2017.93] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 07/10/2017] [Accepted: 07/14/2017] [Indexed: 11/08/2022]
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Mota N, Chaves E, Antunes M, Borges R, Paiva A, Santos V. Contextualized Contribution of Kindness to Favorable Goal- and Circumstantial-Driven Neuropsychological Regulation. Front Psychol 2017; 8:1643. [PMID: 29018378 PMCID: PMC5623185 DOI: 10.3389/fpsyg.2017.01643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 09/07/2017] [Indexed: 11/13/2022] Open
Abstract
Kindness involves care and non-judgmental understanding toward someone. As a prosocial inclination, kindness would increase the possibility of favorable interaction with the environment, with a successful adjustment of one's response in novel or challenging circumstances, taking into account rules or goals. This adjustment ability is commonly referred to as executive functions, dependent on the prefrontal and parietal functioning, still under development during late adolescence. This study aimed to investigate if kindness would relate with the executive functions. If so, it would correlate more with measures of self-regulation, mainly dependent on the medial prefrontal corticosubcortical circuits. Also, among self-regulating processes, kindness would be more associated with autonomic responses—choices guided by one's understanding/intention - than with adaptive responses—changes on one's choices triggered by unfavorable circumstances. A sample of 46 (31 female; 18 to 21 years-old) healthy college students from the University of the State of Rio de Janeiro attended a clinical interview and a comprehensive neuropsychological assessment. Kindness was measured by the Compassion Scale subscore. Generalized non-linear models for each neuropsychological variable were executed on R, followed by an estimation of weighted parameters for each factor. Significant models which included kindness (weighted parameter Pc > 74) and all of their psychosocial or sociodemographic factors on their maximum expression (Pc > 74) were identified. In a contextualized joint influence with other psychosocial and sociodemographic factors, kindness fits equally goal- and circumstantial- self-regulation, as well as integrative organization of information. Kindness is a principle that optimizes a refreshing and prosocial interaction with the environment. As it anticipates sharing and cooperation behaviors, it might have a primordial function on individual and social development.
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Affiliation(s)
- Nayara Mota
- Department of Fundamentals of Psychology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Elenilda Chaves
- Department of Fundamentals of Psychology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Marina Antunes
- Department of Fundamentals of Psychology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Rudi Borges
- Department of Fundamentals of Psychology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Andressa Paiva
- Department of Fundamentals of Psychology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Vanessa Santos
- Department of Fundamentals of Psychology, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Hays CL, Okafor KC, Fan S, High R, Singh DP, Toris CB. Consequences of Puberty on Efficacy of Intraocular Pressure-Lowering Drugs in Male Dutch-Belted Rabbits. J Ocul Pharmacol Ther 2017; 34:76-84. [PMID: 28820646 DOI: 10.1089/jop.2016.0168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To investigate the changes in intraocular pressure (IOP), aqueous flow, and outflow facility, as well as efficacy of IOP-lowering drugs before and after sexual development in rabbits. METHODS Male Dutch-belted rabbits were studied at night between the ages of 8 and 44 weeks. During these times, body weight, testicular volume, and serum testosterone were measured to monitor sexual maturity. Ocular measurements included anterior chamber depth, central corneal thickness, IOP, aqueous flow, and outflow facility. Systemic acetazolamide or topical timolol, latanoprost, or saline were administered pre- and postpuberty to assess drug effects on these parameters. RESULTS Body weight, testicular volume, and serum testosterone increased until 28 weeks of age. IOP increased during prepuberty (R2 = 0.49, P = 0.003), dropped significantly during puberty, rising again immediate postpuberty, and changing little thereafter. Postpuberty compared with prepuberty found higher IOP (P < 0.0001), slower aqueous flow (P = 0.008), lower outflow facility (not statistically significant, P = 0.07), increased central cornea thickness, and increased anterior chamber volume. Timolol lowered IOP both pre- and postpuberty, whereas, latanoprost and acetazolamide decreased IOP postpuberty only. CONCLUSIONS As male rabbits mature, the cornea thickens and the anterior chamber volume increases. At the same time, aqueous flow slows, yet, IOP increases. This suggests that decreased outflow facility and/or increased episcleral venous pressure might contribute to the puberty-related changes in IOP. Underdevelopment of tissues of the outflow pathways may contribute to the differences in drug efficacy in rabbits when young compared with after sexual maturity.
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Affiliation(s)
- Cassandra L Hays
- 1 Department of Ophthalmology, University of Nebraska Medical Center , Omaha, Nebraska
| | - Kingsley C Okafor
- 1 Department of Ophthalmology, University of Nebraska Medical Center , Omaha, Nebraska
| | - Shan Fan
- 1 Department of Ophthalmology, University of Nebraska Medical Center , Omaha, Nebraska
| | - Robin High
- 1 Department of Ophthalmology, University of Nebraska Medical Center , Omaha, Nebraska
| | - Dhirendra P Singh
- 1 Department of Ophthalmology, University of Nebraska Medical Center , Omaha, Nebraska
| | - Carol B Toris
- 1 Department of Ophthalmology, University of Nebraska Medical Center , Omaha, Nebraska.,2 Department of Ophthalmology, Case Western Reserve University , Cleveland, Ohio
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Turcu AF, Mallappa A, Elman MS, Avila NA, Marko J, Rao H, Tsodikov A, Auchus RJ, Merke DP. 11-Oxygenated Androgens Are Biomarkers of Adrenal Volume and Testicular Adrenal Rest Tumors in 21-Hydroxylase Deficiency. J Clin Endocrinol Metab 2017; 102:2701-2710. [PMID: 28472487 PMCID: PMC5546849 DOI: 10.1210/jc.2016-3989] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/24/2017] [Indexed: 01/13/2023]
Abstract
CONTEXT Patients with 21-hydroxylase deficiency (21OHD) have long-term complications, resulting from poor disease control and/or glucocorticoid overtreatment. Lack of optimal biomarkers has made it challenging to tailor therapy and predict long-term outcomes. OBJECTIVE To identify biomarkers of disease control and long-term complications in 21OHD. SETTING AND PARTICIPANTS Cross-sectional study of 114 patients (70 males), ages 2 to 67 years (median, 15 years), seen in a tertiary referral center. METHODS We correlated a mass-spectrometry panel of 23 steroids, obtained before first morning medication, with bone age advancement (children), adrenal volume (adults), testicular adrenal rest tumors (TART), hirsutism, menstrual disorders, and pituitary hormones. RESULTS Total adrenal volume correlated positively with 18 steroids, most prominently 21-deoxycortisol and four 11-oxygenated-C19 (11oxC19) steroids: 11β-hydroxyandrostenedione (11OHA4), 11-ketoandrostenedione (11ketoA4), 11β-hydroxytestosterone (11OHT), and 11-ketotestosterone (11ketoT) (r ≈ 0.7, P < 0.0001). Nine steroids were significantly higher (P ≤ 0.01) in males with TART compared with those without TART, including 11OHA4 (6.8-fold), 11OHT (4.9-fold), 11ketoT (3.6-fold), 11ketoA4 (3.3-fold), and pregnenolone sulfate (PregS; 4.8-fold). PregS (28.5-fold) and 17-hydroxypregnenolone sulfate (19-fold) levels were higher (P < 0.01) in postpubertal females with menstrual disorders. In males, testosterone levels correlated positively with all 11oxC19 steroids in Tanner stages 1 and 2 (r ≈ 0.7; P < 0.001) but negatively in Tanner stage 5 (r = -0.3 and P < 0.05 for 11ketoA4 and 11ketoT). In females, testosterone level correlated positively with all four 11oxC19 steroids across all Tanner stages (r ≈ 0.8; P < 0.0001). CONCLUSION 11oxC19 steroids and PregS might serve as clinically useful biomarkers of disease control and long-term complications in 21OHD.
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Affiliation(s)
- Adina F. Turcu
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan 48109
| | - Ashwini Mallappa
- National Institutes of Health Clinical Center, Bethesda, Maryland 20892
| | | | - Nilo A. Avila
- National Heart, Lung, and Blood Institute, Bethesda, Maryland 20892
- Washington DC Veterans Affairs Medical Center, Radiology Service, Washington, DC 20422
| | - Jamie Marko
- National Institutes of Health Clinical Center, Bethesda, Maryland 20892
| | - Hamsini Rao
- National Institutes of Health Clinical Center, Bethesda, Maryland 20892
| | - Alexander Tsodikov
- School of Public Health, University of Michigan, Ann Arbor, Michigan 48109
| | - Richard J. Auchus
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan 48109
- Department of Pharmacology, University of Michigan, Ann Arbor, Michigan 48109
| | - Deborah P. Merke
- National Institutes of Health Clinical Center, Bethesda, Maryland 20892
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20892
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Sitticharoon C, Sukharomana M, Likitmaskul S, Churintaraphan M, Maikaew P. Increased high molecular weight adiponectin, but decreased total adiponectin and kisspeptin, in central precocious puberty compared with aged-matched prepubertal girls. Reprod Fertil Dev 2017; 29:2466-2478. [DOI: 10.1071/rd16282] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 05/11/2017] [Indexed: 12/13/2022] Open
Abstract
The aim of the present study was to compare serum leptin, kisspeptin, total adiponectin, high molecular weight (HMW) adiponectin and neuropeptide Y (NPY) levels between girls with central precocious puberty (CPP; n = 26, 7–9.5 years old) and age-matched controls (n = 29) including or excluding obese girls. Leptin and NPY levels were comparable between CPP and control girls. Kisspeptin levels were lower in the CPP than control group, and were positively correlated with oestrogen in the control group and with systolic and diastolic blood pressure in the CPP group. Kisspeptin levels were negatively correlated with FSH and LH in the CPP group. Total adiponectin levels were lower in CPP than control girls, and were negatively correlated with Tanner stage and body mass index, but positively correlated with the quantitative insulin sensitivity check index in the control group. HMW adiponectin was higher in the CPP than control group, and was positively correlated with Tanner stage and LH in all girls. Total adiponectin had a strong positive correlation with HMW adiponectin in the CPP group (r = 0.915) compared with the control group (r = 0.371). In conclusion, kisspeptin may be associated with increased oestrogen in prepubertal girls, but with increased blood pressure in girls with CPP. In girls entering puberty, HMW adiponectin was increased and associated with reproductive parameters. Based on these observations, HMW adiponectin probably plays an essential role in the initiation of puberty and is a candidate marker for the prediction of CPP.
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Schroeder EC, Ranadive SM, Heffernan KS, Jae SY, Fernhall B. The acute effect of maximal aerobic and isometric exercise on arterial stiffness parameters in boys and men. Artery Res 2017. [DOI: 10.1016/j.artres.2017.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Resting Heart Rate Is Not a Good Predictor of a Clustered Cardiovascular Risk Score in Adolescents: The HELENA Study. PLoS One 2015; 10:e0127530. [PMID: 26010248 PMCID: PMC4444318 DOI: 10.1371/journal.pone.0127530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 03/23/2015] [Indexed: 11/26/2022] Open
Abstract
Background Resting heart rate (RHR) reflects sympathetic nerve activity a significant association between RHR and all-cause and cardiovascular mortality has been reported in some epidemiologic studies. Methods To analyze the predictive power and accuracy of RHR as a screening measure for individual and clustered cardiovascular risk in adolescents. The study comprised 769 European adolescents (376 boys) participating in the HELENA cross-sectional study (2006–2008) were included in this study. Measurements on systolic blood pressure, HOMA index, triglycerides, TC/HDL-c, VO2máx and the sum of four skinfolds were obtained, and a clustered cardiovascular disease (CVD) risk index was computed. The receiver operating characteristics curve was applied to calculate the power and accuracy of RHR to predict individual and clustered CVD risk factors. Results RHR showed low accuracy for screening CVD risk factors in both sexes (range 38.5%–54.4% in boys and 45.5%–54.3% in girls). Low specificity’s (15.6%–19.7% in boys; 18.1%–20.0% in girls) were also found. Nevertheless, the sensitivities were moderate-to-high (61.4%–89.1% in boys; 72.9%–90.3% in girls). Conclusion RHR is a poor predictor of individual CVD risk factors and of clustered CVD and the estimates based on RHR are not accurate. The use of RHR as an indicator of CVD risk in adolescents may produce a biased screening of cardiovascular health in both sexes.
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Serebrovskaya TV, Xi L. Intermittent hypoxia in childhood: the harmful consequences versus potential benefits of therapeutic uses. Front Pediatr 2015; 3:44. [PMID: 26042211 PMCID: PMC4436817 DOI: 10.3389/fped.2015.00044] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/07/2015] [Indexed: 12/04/2022] Open
Abstract
Intermittent hypoxia (IH) often occurs in early infancy in both preterm and term infants and especially at 36-44 weeks postmenstrual age. These episodes of IH could result from sleep-disordered breathing or may be temporally unrelated to apnea or bradycardia events. There are numerous reports indicating adverse effects of IH on development, behavior, academic achievement, and cognition in children with sleep apnea syndrome. It remains uncertain about the exact causative relationship between the neurocognitive and behavioral morbidities and IH and/or its associated sleep fragmentation. On the other hand, well-controlled and moderate IH conditioning/training has been used in sick children for treating their various forms of bronchial asthma, allergic dermatoses, autoimmune thyroiditis, cerebral palsy, and obesity. This review article provides an updated and impartial analysis on the currently available evidence in supporting either side of the seemingly contradictory scenarios. We wish to stimulate a comprehensive understanding of such a complex physiological phenomenon as intermittent hypoxia, which may be accompanied by other confounding factors (e.g., hypercapnia, polycythemia), in order to prevent or reduce its harmful consequences, while maximizing its potential utility as an effective therapeutic tool in pediatric patients.
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Affiliation(s)
| | - Lei Xi
- Department of Internal Medicine, Virginia Commonwealth University , Richmond, VA , USA
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15
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Condorelli RA, Calogero AE, Vicari E, Mongioi' L, Favilla V, Morgia G, Cimino S, Russo G, La Vignera S. The gonadal function in obese adolescents: review. J Endocrinol Invest 2014; 37:1133-42. [PMID: 24923899 DOI: 10.1007/s40618-014-0107-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/27/2014] [Indexed: 01/10/2023]
Abstract
This review deals with the relationship between obesity in male adolescents and gonadal function. The article is structured in two main paragraphs; the first one is about population studies that have assessed puberty timing and its mode of onset in relation with body weight to evaluate if and how the latter can influence the gonadal function in this phase of life. These studies analyze issues such as increased BMI and early onset of male puberty, gender differences, secular trend toward early onset of puberty in males, effects of a different body composition on male puberty and consequences of a different stage of childhood obesity on the onset of male puberty. The second paragraph examines the possible mechanisms through which, obesity may alter the timing of puberty in young males, including the role of SHBG, leptin, insulin resistance, ghrelin, GH-IGF-1 axis, AR polymorphisms, primary testicular dysfunction, retinol binding protein 4 (RBP-4) and liver function abnormalities. However, despite the numerous studies in the literature, the etiology of gonadal disfunction in obese adolescents on puberty remains uncertain.
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Affiliation(s)
- Rosita A Condorelli
- Section of Endocrinology, Andrology and Internal Medicine, Department of Medical and Pediatric Sciences, University of Catania, Policlinico "G. Rodolico", Via S. Sofia 78, Building 4, Room 2C18, 95123, Catania, Italy
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16
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de Moraes ACF, Lacerda MB, Moreno LA, Horta BL, Carvalho HB. Prevalence of high blood pressure in 122,053 adolescents: a systematic review and meta-regression. Medicine (Baltimore) 2014; 93:e232. [PMID: 25501086 PMCID: PMC4602805 DOI: 10.1097/md.0000000000000232] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Several studies have reported high prevalence of risk factors for cardiovascular disease in adolescents. To perform: i) systematically review the literature on the prevalence of high blood pressure (HBP) in adolescents; ii) analyze the possible methodological factors associated with HBP; and iii) compare the prevalence between developed and developing countries. We revised 10 electronic databases up to August 11, 2013. Only original articles using international diagnosis of HBP were considered. The pooled prevalence's of HBP were estimated by random effects. Meta-regression analysis was used to identify the sources of heterogeneity across studies. Fifty-five studies met the inclusion criteria and total of 122,053 adolescents included. The pooled-prevalence of HBP was 11.2%, 13% for boys, and 9.6% for girls (P < 0.01). Method of measurement of BP and year in which the survey was conducted were associated with heterogeneity in the estimates of HBP among boys. The data indicate that HBP is higher among boys than girls, and that the method of measurement plays an important role in the overall heterogeneity of HBP value distributions, particularly in boys.
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Affiliation(s)
- Augusto César Ferreira de Moraes
- From the School of Medicine of the University of São Paulo (FMUSP)-Department of Preventive Medicine, São Paulo, Brazil (ACFdeM, MBL, HBC); YCARE (Youth/Child and cARdiovascular Risk and Environmental) Research Group, FMUSP/Brazil (ACFdeM, MBL, HBC); Faculty of Health of the University of Zaragoza, GENUD-Growth, Exercise, Nutrition and Development, Zaragoza, Spain (ACFdeM, LAM); Visiting Professor, School of Medicine of the University of São Paulo-Department of Preventive Medicine, São Paulo, Brazil (LAM); and School of Medicine of the Federal University of Pelotas, Pelotas, Brazil (BLH)
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17
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de Moraes ACF, Cassenote AJF, Moreno LA, Carvalho HB. Potential biases in the classification, analysis and interpretations in cross-sectional study: commentaries - surrounding the article "resting heart rate: its correlations and potential for screening metabolic dysfunctions in adolescents". BMC Pediatr 2014; 14:117. [PMID: 24885992 PMCID: PMC4012522 DOI: 10.1186/1471-2431-14-117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 04/25/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Resting heart rate reflects sympathetic nerve activity. A significant association between resting heart rate (HR) and all causes of cardiovascular mortality has been reported by some epidemiologic studies. Despite suggestive evidence, resting heart rate (RHR) has not been formally explored as a prognostic factor and potential therapeutic outcome and, therefore, is not generally accepted in adolescents. DISCUSSION The core of the debate is the methodological aspects used in "Resting heart rate: its correlations and potential for screening metabolic dysfunctions in adolescents"; the points are: cutoff used for cluster RHR, two different statistical models used to analyze the same set of variables, one for continuous data, and another for categorical data; interpretation of p-value < 0.05, sampling process involving two random stages, analysis of design effect and the parameters of screening tests. SUMMARY Aspects that must be taken into account for evaluation of a screening test to measure the potential for discrimination for a common variable (population with outcome vs. no outcome population), the main indicators are: sensitivity, specificity, accuracy, positive predictive value and negative predictive value. The measures of argumentation equality (CI) or difference (p-valor) are important to validate these indicators but do not indicate quality of screening.
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18
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Song YH, Kim HS, Park HS, Jung JW, Kim NS, Noh CI, Hong YM. Sex differences in the relation of body composition to cardiovascular parameters and functions in Korean adolescents: a school-based study. Obes Facts 2014; 7:165-77. [PMID: 24820977 PMCID: PMC5644790 DOI: 10.1159/000362345] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 09/18/2013] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Obesity in adolescence is associated with increased cardiovascular risk. The patterns of obesity and body composition differ between boys and girls. It is uncertain how body composition correlates with the cardiovascular system and whether such correlations differ by sex in adolescents. METHODS Body composition (fat-free mass (FFM), adipose mass, waist circumference (WC)) and cardiovascular parameters and functions were studied in 676 healthy Korean adolescents aged 12-16 years. Partial correlation and path analyses were done. RESULTS WC correlated with stroke volume (SV) and cardiac output (CO), systolic blood pressure (SBP) and pulse pressure (PP), cardiac diastolic function (ratio of early to late filling velocity (E/A ratio)), and vascular function (pulse wave velocity (PWV)) in boys. Adipose mass was related to SV, CO, SBP, PP, left ventricular mass (LVM), and PWV in girls - and to E/A ratio in both sexes. FFM affected SV, CO, SBP, and PP in both sexes and LVM in boys. Cardiac systolic functions had no relation with any body composition variable in either sex. CONCLUSION In adolescence, the interdependence of the cardiovascular system and the body composition differs between sexes. Understanding of those relations is required to control adolescent obesity and prevent adult cardiovascular disease.
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Affiliation(s)
- Young-Hwan Song
- Department of Pediatrics, Sanggye Paik Hospital, College of Medicine, Inje University, Suwon, South Korea
| | | | - Hae Sook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Suwon, South Korea
| | - Jo Won Jung
- Department of Pediatrics, School of Medicine, Ajou University, Suwon, South Korea
| | - Nam Su Kim
- Department of Pediatrics, School of Medicine, Han Yang University, Suwon, South Korea
| | - Chung Il Noh
- Department of Pediatrics, School of Medicine, Seoul National University, Seoul, Suwon, South Korea
| | - Young Mi Hong
- Department of Pediatrics, Suwon, South Korea
- *Young Mi Hong, MD, Department of Pediatrics, Ewha Womans University School of Medicine, 911-1 Mok-dong, Yangcheon-gu, 158-710 Seoul (South Korea),
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19
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Abstract
In recent years, the interest in studying the impact of sex steroids and gender on the regulation of blood pressure and cardiovascular disease has been growing. Women are protected from most cardiovascular events compared with men until after menopause, and postmenopausal women are at increased risk of cardiovascular complications compared with premenopausal women. The pathophysiological mechanisms have not been elucidated, but are not likely to be as simple as the presence or absence of oestrogens, since hormone replacement therapy in elderly women in the Women's Health Initiative or HERS (Heart and Estrogen/progestin Replacement Study) did not provide primary or secondary prevention against cardiovascular events. Men are also thought to be at risk of cardiovascular disease at earlier ages than women, and these mechanisms too are not likely to be as simple as the presence of testosterone, since androgen levels fall in men with cardiovascular and other chronic diseases. In fact, many investigators now believe that it is the reduction in androgen levels that frequently accompanies chronic disease and may exacerbate cardiovascular disease in men. In the present review, the roles of sex steroids and gender in mediating or protecting against hypertension and cardiovascular disease will be discussed.
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Affiliation(s)
- Rodrigo Maranon
- Women's Health Research Center and Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA
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20
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Kubera B, Bosy-Westphal A, Peters A, Braun W, Langemann D, Neugebohren S, Heller M, Müller MJ. Energy allocation between brain and body during ontogenetic development. Am J Hum Biol 2013; 25:725-32. [PMID: 24038669 DOI: 10.1002/ajhb.22439] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 06/27/2013] [Accepted: 07/02/2013] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE We here studied how energy is allocated between brain and body both during the ontogenetic development from a child to an adult and during weight loss. METHODS We investigated 180 normal weight female and male children and adolescents (aged 6.1-19.9 years) as well as 35 overweight adolescents undergoing weight reduction intervention. 52 normal weight and 42 obese adult women were used for comparison. We assessed brain mass by magnetic-resonance-imaging and body metabolism by indirect calorimetry. To study how energy is allocated between brain and body, we measured plasma insulin, since insulin fulfils the functions of a glucose allocating hormone, i.e., peripheral glucose uptake depends on insulin, central uptake does not. We used reference data obtained in the field of comparative biology. In a brain-body-plot, we calculated the distance between each subject and a reference mammal of comparable size and named the distance "encephalic measure." With higher encephalic measures, more energy is allocated to the brain. RESULTS We found that ontogenetic development from a child to an adult was indicated by decreasing encephalic measures in females (r = -0.729, P < 0.001) and increasing plasma insulin concentrations (F = 6.6, P = 0.002 in females and F = 8.6, P < 0.001 in males). Weight loss of about 5 kg in females and about 9 kg in males resulted in reduced insulin concentrations and increased encephalic measures. CONCLUSION Our results indicate that the share of energy allocated to the brain increased with weight loss, but decreased during the ontogenetic development from childhood to adolescence. These developmental changes in brain-to-body energy allocation appear to be driven by increasing plasma insulin concentrations.
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Affiliation(s)
- Britta Kubera
- Medical Clinic 1, University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany
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21
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Nisbet LC, Yiallourou SR, Walter LM, Horne RSC. Blood pressure regulation, autonomic control and sleep disordered breathing in children. Sleep Med Rev 2013; 18:179-89. [PMID: 23850404 DOI: 10.1016/j.smrv.2013.04.006] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 04/10/2013] [Accepted: 04/29/2013] [Indexed: 02/07/2023]
Abstract
Sleep disordered breathing (SDB) ranges in severity from primary snoring (PS) to obstructive sleep apnoea (OSA). In adults, SDB is associated with adverse cardiovascular consequences which are mediated, in part, by autonomic dysfunction. Although SDB is common in children, fewer paediatric studies have investigated these cardiovascular effects. Initial research focused on those with OSA, indeed children with PS were occasionally utilised as the comparison control group. However, it is essential to understand the ramifications of this disorder in all its severities, as currently the milder forms of SDB are often untreated. Methodologies used to assess autonomic function in children with SDB include blood pressure (BP), BP variability, baroreflex sensitivity, heart rate variability, peripheral arterial tonometry and catecholamine assays. The aim of this review was to summarise the findings of paediatric studies to date and explore the relationship between autonomic dysfunction and SDB in children, paying particular attention to the roles of disease severity and/or age. This review found evidence of autonomic dysfunction in children with SDB during both wakefulness and sleep. BP dysregulation, elevated generalised sympathetic activity and impairment of autonomic reflexes occur in school-aged children and adolescents with SDB. The adverse effects of SDB seem somewhat less in young children, although more studies are needed. There is mounting evidence that the cardiovascular and autonomic consequences of SDB are not limited to those with OSA, but are also evident in children with PS. The severity of disease and age of onset of autonomic consequences may be important guides for the treatment of SDB.
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Affiliation(s)
- Lauren C Nisbet
- The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia
| | - Stephanie R Yiallourou
- The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia
| | - Lisa M Walter
- The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia
| | - Rosemary S C Horne
- The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia.
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22
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Hwang M, Zebracki K, Betz RR, Mulcahey MJ, Vogel LC. Normative blood pressure and heart rate in pediatric spinal cord injury. Top Spinal Cord Inj Rehabil 2013; 19:87-95. [PMID: 23671378 DOI: 10.1310/sci1902-87] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cardiovascular measures in children with spinal cord injury (SCI) may vary depending on the child's age and physical development in addition to injury-related factors. Developmental changes should be considered when addressing cardiovascular complications in this population. OBJECTIVES To determine baseline blood pressure (BP) and heart rate (HR) measurements in youth with SCI, and to investigate differences in BP and HR in relation to age, gender, body mass index (BMI), and injury-related factors. METHODS Retrospective chart review was conducted for youth under 19 years who had been admitted for rehabilitation at 1 of 2 pediatric SCI programs. Systolic (SBP) and diastolic (DBP) blood pressures and HR were collected in the morning and afternoon on 3 consecutive days. Mean SBP, DBP, and HR were compared among 4 age groups (0-5 years, 6-12 years, 13-15 years, and 16-18 years) and by gender. Diurnal variations were determined according to level and severity of injury. Associations with BMI and injury-related factors were examined. Charts of 315 youths were reviewed: mean age was 12.3 years, 59% were male, 75% were Caucasian, 62% had complete injury, and 66% had paraplegia. RESULTS With increasing age, SBP and DBP increased and HR decreased. SBP and DBP were positively correlated with BMI. SBP was higher in males, those with incomplete injury, and those with paraplegia. HR was higher in females. There was no association between cardiovascular measures and injury duration. CONCLUSION BP and HR are a function of age, BMI, and completeness and level of injury in youth with SCI. Awareness of baseline measures will allow for more effective management of cardiovascular complications, especially in youth presenting with atypical symptoms.
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Affiliation(s)
- Miriam Hwang
- Shriners Hospitals for Children , Chicago, Illinois ; Marquette University , Milwaukee, Wisconsin
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23
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Gozal D, Hakim F, Kheirandish-Gozal L. Chemoreceptors, baroreceptors, and autonomic deregulation in children with obstructive sleep apnea. Respir Physiol Neurobiol 2012; 185:177-85. [PMID: 22954503 DOI: 10.1016/j.resp.2012.08.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 08/21/2012] [Accepted: 08/23/2012] [Indexed: 11/17/2022]
Abstract
Obstructive sleep apnea (OSA) is highly prevalent sleep disorder of breathing in both adults and children that is fraught with substantial cardiovascular morbidities, the latter being attributable to a complex interplay between intermittent hypoxia (IH), episodic hypercapnia, recurrent large intra-thoracic pressure swings, and sleep disruption. Alterations in autonomic nervous system function could underlie the perturbations in cardiovascular, neurocognitive, immune, endocrine and metabolic functions that affect many of the patients suffering from OSA. Although these issues have received substantial attention in adults, the same has thus far failed to occur in children, creating a quasi misperception that children are protected. Here, we provide a critical overview of the evidence supporting the presence of autonomic nervous system (ANS) perturbations in children with OSA, draw some parallel assessments to known mechanisms in rodents and adult humans, particularly, peripheral and central chemoreceptor and baroreceptor pathways, and suggest future research directions.
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Affiliation(s)
- David Gozal
- Department of Pediatrics, Comer Children's Hospital, The University of Chicago, Chicago, IL, USA.
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24
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Adrenarche and middle childhood. HUMAN NATURE-AN INTERDISCIPLINARY BIOSOCIAL PERSPECTIVE 2012; 22:327-49. [PMID: 22388879 DOI: 10.1007/s12110-011-9120-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Middle childhood, the period from 6 to 12 years of age, is defined socially by increasing autonomy and emotional regulation, somatically by the development of anatomical structures for subsistence, and endocrinologically by adrenarche, the adrenal production of dehydroepiandrosterone (DHEA). Here I suggest that DHEA plays a key role in the coordinated development of the brain and body beginning with middle childhood, via energetic allocation. I argue that with adrenarche, increasing levels of circulating DHEA act to down-regulate the release of glucose into circulation and hence limit the supply of glucose which is needed by the brain for synaptogenesis. Furthermore, I suggest the antioxidant properties of DHEA may be important in maintaining synaptic plasticity throughout middle childhood within slow-developing areas of the cortex, including the insula, thamalus, and anterior cingulate cortex. In addition, DHEA may play a role in the development of body odor as a reliable social signal of behavioral changes associated with middle childhood.
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Pausova Z, Mahboubi A, Abrahamowicz M, Leonard GT, Perron M, Richer L, Veillette S, Gaudet D, Paus T. Sex differences in the contributions of visceral and total body fat to blood pressure in adolescence. Hypertension 2012; 59:572-9. [PMID: 22291448 DOI: 10.1161/hypertensionaha.111.180372] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Excess body fat deposited viscerally rather than elsewhere in the body is associated with higher risk for hypertension; this relationship is stronger in men than in women. Here we investigated whether similar sex dimorphism exists already in adolescence. A population-based sample of adolescent boys (n=237) and girls (n=262), age 12 to 18 years, was studied. Total body fat (TBF) was assessed with multifrequency bioelectrical impedance, and visceral fat (VF) was quantified with MRI. Blood pressure (BP) was measured beat by beat during an hour-long protocol, including supine, standing, sitting, mental stress, and poststress sections. Multivariate mixed-model analysis was used to assess the relative contributions of TBF and VF to BP during these sections. In boys, BP was strongly positively associated with VF (P<0.0001), whereas it was less strongly and negatively associated with TBF (P=0.004); these relationships did not substantially vary during the protocol. In contrast, in girls, BP was strongly positively associated with TBF (P=0.0006), whereas it was not associated with VF (P=0.08); the relationship with TBF varied during the protocol and was most apparent during mental stress (TBF*section interaction: P=0.002). Furthermore, when waist circumference was included in multivariate models instead of VF, it was not associated with BP in either sex; this indicates that waist circumference may not be an appropriate surrogate for VF. Thus, in adolescence, adiposity-related BP elevation is driven mainly by visceral fat in males and by fat deposited elsewhere in females. This dimorphism suggests sex-specific mechanisms of obesity-induced hypertension and the need for sex-specific criteria of its prevention.
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Affiliation(s)
- Zdenka Pausova
- Hospital for Sick Children, Toronto, Ontario M5G 1X8, Canada.
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26
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Pausova Z, Abrahamowicz M, Mahboubi A, Syme C, Leonard GT, Perron M, Richer L, Veillette S, Gaudet D, Paus T. Functional Variation in the Androgen-Receptor Gene Is Associated With Visceral Adiposity and Blood Pressure in Male Adolescents. Hypertension 2010; 55:706-14. [DOI: 10.1161/hypertensionaha.109.146720] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Intra-abdominal accumulation of fat is a hallmark of male body-fat distribution and a major risk factor for hypertension. Sympathoactivation may be one of the mechanisms linking intra-abdominal obesity to hypertension. The aim of the present study was to investigate whether a functional variation in the androgen-receptor gene (
AR
, a variable number of CAG repeats in exon 1) is associated with intra-abdominal adiposity, sympathetic modulation of vasomotor tone, and blood pressure in adolescent boys but not girls. We studied 223 boys and 259 girls (age 12 to 18 years) from a French-Canadian founder population. Intra-abdominal fat and subcutaneous-abdominal fat were quantified with an MRI. Blood pressure was recorded beat-to-beat during an hour-long protocol including physical and mental challenges, and these blood pressure time series were used to assess sympathetic modulation of vasomotor tone by power spectral analysis. The results showed that boys with a “low” versus “intermediate” or “high” CAG-repeat number in
AR
demonstrated higher intra-abdominal fat (by 28% and 48%, respectively) but not subcutaneous-abdominal fat. These intra-abdominal fat differences remained significant after adjusting for serum levels of sex hormones and subcutaneous-abdominal fat. Furthermore, boys with low versus intermediate or high CAG-repeat numbers also showed higher blood pressure, with the differences being most pronounced during mental stress (8.0 and 8.5 mm Hg, respectively) and higher sympathetic modulation of vasomotor tone. As expected, no such differences were seen among girls. In adolescent boys, low CAG-repeat numbers in
AR
may be a genetic risk factor for intra-abdominal obesity and hypertension; sympathoactivation may be an underlying link between the 2 conditions.
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Affiliation(s)
- Zdenka Pausova
- From the Brain and Body Centre (Z.P., C.S., T.P.), University of Nottingham, Nottingham, United Kingdom; Research Centre-Centre Hospitalier de l'Université de Montréal (Z.P.), Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics (M.A., A.M.) and Montreal Neurological Institute (G.T.L., T.P.), McGill University, Montreal, Quebec, Canada; Groupe Étude des COnditions de vie et des BESoins de la population (M.P., S.V.), Jonquière, Quebec, Canada; Department of Psychology,
| | - Michal Abrahamowicz
- From the Brain and Body Centre (Z.P., C.S., T.P.), University of Nottingham, Nottingham, United Kingdom; Research Centre-Centre Hospitalier de l'Université de Montréal (Z.P.), Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics (M.A., A.M.) and Montreal Neurological Institute (G.T.L., T.P.), McGill University, Montreal, Quebec, Canada; Groupe Étude des COnditions de vie et des BESoins de la population (M.P., S.V.), Jonquière, Quebec, Canada; Department of Psychology,
| | - Amel Mahboubi
- From the Brain and Body Centre (Z.P., C.S., T.P.), University of Nottingham, Nottingham, United Kingdom; Research Centre-Centre Hospitalier de l'Université de Montréal (Z.P.), Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics (M.A., A.M.) and Montreal Neurological Institute (G.T.L., T.P.), McGill University, Montreal, Quebec, Canada; Groupe Étude des COnditions de vie et des BESoins de la population (M.P., S.V.), Jonquière, Quebec, Canada; Department of Psychology,
| | - Catriona Syme
- From the Brain and Body Centre (Z.P., C.S., T.P.), University of Nottingham, Nottingham, United Kingdom; Research Centre-Centre Hospitalier de l'Université de Montréal (Z.P.), Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics (M.A., A.M.) and Montreal Neurological Institute (G.T.L., T.P.), McGill University, Montreal, Quebec, Canada; Groupe Étude des COnditions de vie et des BESoins de la population (M.P., S.V.), Jonquière, Quebec, Canada; Department of Psychology,
| | - Gabriel T. Leonard
- From the Brain and Body Centre (Z.P., C.S., T.P.), University of Nottingham, Nottingham, United Kingdom; Research Centre-Centre Hospitalier de l'Université de Montréal (Z.P.), Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics (M.A., A.M.) and Montreal Neurological Institute (G.T.L., T.P.), McGill University, Montreal, Quebec, Canada; Groupe Étude des COnditions de vie et des BESoins de la population (M.P., S.V.), Jonquière, Quebec, Canada; Department of Psychology,
| | - Michel Perron
- From the Brain and Body Centre (Z.P., C.S., T.P.), University of Nottingham, Nottingham, United Kingdom; Research Centre-Centre Hospitalier de l'Université de Montréal (Z.P.), Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics (M.A., A.M.) and Montreal Neurological Institute (G.T.L., T.P.), McGill University, Montreal, Quebec, Canada; Groupe Étude des COnditions de vie et des BESoins de la population (M.P., S.V.), Jonquière, Quebec, Canada; Department of Psychology,
| | - Louis Richer
- From the Brain and Body Centre (Z.P., C.S., T.P.), University of Nottingham, Nottingham, United Kingdom; Research Centre-Centre Hospitalier de l'Université de Montréal (Z.P.), Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics (M.A., A.M.) and Montreal Neurological Institute (G.T.L., T.P.), McGill University, Montreal, Quebec, Canada; Groupe Étude des COnditions de vie et des BESoins de la population (M.P., S.V.), Jonquière, Quebec, Canada; Department of Psychology,
| | - Suzanne Veillette
- From the Brain and Body Centre (Z.P., C.S., T.P.), University of Nottingham, Nottingham, United Kingdom; Research Centre-Centre Hospitalier de l'Université de Montréal (Z.P.), Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics (M.A., A.M.) and Montreal Neurological Institute (G.T.L., T.P.), McGill University, Montreal, Quebec, Canada; Groupe Étude des COnditions de vie et des BESoins de la population (M.P., S.V.), Jonquière, Quebec, Canada; Department of Psychology,
| | - Daniel Gaudet
- From the Brain and Body Centre (Z.P., C.S., T.P.), University of Nottingham, Nottingham, United Kingdom; Research Centre-Centre Hospitalier de l'Université de Montréal (Z.P.), Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics (M.A., A.M.) and Montreal Neurological Institute (G.T.L., T.P.), McGill University, Montreal, Quebec, Canada; Groupe Étude des COnditions de vie et des BESoins de la population (M.P., S.V.), Jonquière, Quebec, Canada; Department of Psychology,
| | - Tomas Paus
- From the Brain and Body Centre (Z.P., C.S., T.P.), University of Nottingham, Nottingham, United Kingdom; Research Centre-Centre Hospitalier de l'Université de Montréal (Z.P.), Montreal, Quebec, Canada; Department of Epidemiology and Biostatistics (M.A., A.M.) and Montreal Neurological Institute (G.T.L., T.P.), McGill University, Montreal, Quebec, Canada; Groupe Étude des COnditions de vie et des BESoins de la population (M.P., S.V.), Jonquière, Quebec, Canada; Department of Psychology,
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Ribeiro J, Santos P, Duarte J, Mota J. Association between overweight and early sexual maturation in Portuguese boys and girls. Ann Hum Biol 2009; 33:55-63. [PMID: 16500811 DOI: 10.1080/00207390500434135] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the relationship between sexual maturation (SM), and the prevalence of overweight among boys and girls. SUBJECTS AND METHODS The sample of this cross-sectional study included 819 children and adolescents (382 boys and 437 girls), aged 10-15 years old randomly selected from 30 schools in the Porto region. Anthropometrical measurements (body height, weight and skinfolds thickness) were determined by standard anthropometrical methods. Body mass index (BMI) was calculated from the ratio weight/height(2) (kg/m(2)). The sum of tricipital and subscapular skinfolds (TriSub) was also used. Physicians collected data on Tanner stages during physical examination. Subjects were grouped using the quartiles of the decimal age adjusted for Tanner stages of SM and gender. RESULTS The prevalence of overweight was higher in early maturing boys (30.5%) and early maturing girls (32.7%). The late maturers presented a lower prevalence (p < 0.05) of overweight (20.3% boys and 18.3% girls). Logistic regression analysis illustrates that early maturing is associated with an increased risk for overweight or obesity for boys (OR: 1.87 and 95% CI: 0.99-3.50) and girls (OR: 2.14 and 95% CI: 1.12-4.07), when compared with the boys and girls of the fourth quartile (p < 0.05). CONCLUSIONS We conclude that there is an association between early SM and the prevalence of overweight in both genders.
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Affiliation(s)
- J Ribeiro
- Research Centre in Physical Activity Health and Leisure, Faculty of Sports Sciences and Physical Education University of Porto, Portugal.
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The onset of puberty: effects on the psychophysiology of defensive and appetitive motivation. Dev Psychopathol 2009; 21:27-45. [PMID: 19144221 DOI: 10.1017/s0954579409000030] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We examined puberty-specific effects on affect-related behavior and on the psychophysiology of defensive and appetitive motivation while controlling for age. Adolescents (N = 94, ages = 12 and 13 years) viewed 75 pictures (International Affective Picture System: pleasant, neutral, and aversive) while listening to auditory probes. Startle response and postauricular (PA) reflex were collected as measures of defensive and appetitive motivation, respectively. Pubertal status and measures of anxiety/stress reaction and sensation/thrill seeking were obtained. Mid-/late pubertal adolescents showed enhanced startle amplitude across all picture valences. A Puberty x Valence interaction revealed that mid-/late pubertal adolescents showed appetitive potentiation of the PA, whereas pre-/early pubertal adolescents showed no modulation of the PA reflex. Mid-/late pubertal adolescents also scored significantly higher on measures of sensation/thrill seeking than did their pre-/early pubertal peers and puberty moderated the association between psychophysiology and behavioral measures, suggesting that it plays a role in reorganizing defensive and appetitive motivational systems.
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Semen quality and reproductive hormones according to birthweight and body mass index in childhood and adult life: two decades of follow-up. Fertil Steril 2009; 94:610-8. [PMID: 19328465 DOI: 10.1016/j.fertnstert.2009.01.142] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Revised: 01/12/2009] [Accepted: 01/21/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the association between childhood body mass index (BMI), birth weight, and adulthood BMI, and adult semen quality and level of reproductive hormones. DESIGN Follow-up study. SETTING From a pregnancy cohort established in 1984-1987. PATIENT(S) 347 out of 5,109 sons were selected for a study conducted 2005 to 2006. INTERVENTION(S) Semen and blood samples were related to information on BMI in boys (5-8 years), birth weight, and adult BMI. MAIN OUTCOME MEASURE(S) Semen characteristics and reproductive hormones. RESULT(S) Neither childhood BMI, birth weight, nor adulthood BMI were significantly associated with semen quality. Men with the 33% highest childhood BMI had 15% lower sex hormone binding globulin, 8% lower testosterone, and 16% lower FSH than men with the 33% lowest childhood BMI. Men with high adulthood BMI had 14% lower testosterone, 9% lower inhibin B, 31% lower sex hormone binding globulin, and 20% higher estradiol than men with low adulthood BMI. CONCLUSION(S) The results do not indicate an effect of childhood BMI, birth weight, or adult BMI on semen quality, but the exposure contrast in our study was limited. The hormonal status was affected by adult BMI.
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Hausner E, Fiszman ML, Hanig J, Harlow P, Zornberg G, Sobel S. Long-term consequences of drugs on the paediatric cardiovascular system. Drug Saf 2009; 31:1083-96. [PMID: 19026026 DOI: 10.2165/0002018-200831120-00005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Many pharmacological and toxicological actions of drugs in children cannot be fully predicted from adult clinical experience or from standard non-clinical toxicology studies. Numerous drugs have direct or indirect pharmacological effects on the heart and are prescribed for children of all ages. Toxicity or secondary effects may be immediate or delayed for years after drug exposure has ceased. Originally, the aim of this review was to compile information on the effect of specific drugs on the post-natal development of the cardiovascular system and to examine long-term follow-up of the use of cardio-active drugs in children. The limited database of published information caused the original question to evolve into an examination of the medical literature for three areas of information: (i) whether vulnerable developmental windows have been identified that reflect the substantial functional development that the cardiovascular system undergoes after birth; (ii) what is known about pharmacological perturbation of development; and (iii) what the likelihood is of drug exposure during childhood. We examined different scenarios for exposure including random, isolated exposure, conditions historically associated with adults, primary or secondary cardiac disease, psychiatric and neurological conditions, asthma, cancer and HIV. Except for random, isolated drug exposures, each category of possible exposure contained numerous drugs known to have either primary or secondary effects on the cardiovascular system or to influence factors associated with atherosclerosis. It is likely that a significant number of children will be prescribed drugs having either direct or indirect effects upon the immature cardiovascular system. A confounding factor is the simultaneous use of over-the-counter medications and herbal or nutraceutical preparations that a patient, parent or guardian does not mention to a prescribing physician. Metabolism is also important in assessing drug effects in children. Differences in body water : body fat ratio, age-related gastrointestinal absorption, distribution, excretion, renal function and drug metabolizing capabilities make it possible for children to have a different metabolite profile for a drug compared with adults. There is little examination of drug effects on the interdependent processes of cardiac maturation and less examination of metabolite effects. It is difficult to identify delayed toxicities in children as these adverse events may take years to manifest with many patients lost to follow-up. Clearly this is an area of study where intermediate endpoints and surrogate markers would be of great benefit. Pharmacogenomics may be useful in providing markers of increased risk or susceptibility. A perspective must be kept in balancing the possibility of a problem with the very real benefits that many children experience from the use of these pharmaceuticals.
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Kaditis AG, Alexopoulos EI, Damani E, Hatzi F, Chaidas K, Kostopoulou T, Tzigeroglou A, Gourgoulianis K. Urine levels of catecholamines in Greek children with obstructive sleep-disordered breathing. Pediatr Pulmonol 2009; 44:38-45. [PMID: 19085921 DOI: 10.1002/ppul.20916] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Adults with obstructive sleep apnea have increased sympathetic activity. It was hypothesized that in children with symptoms of obstructive sleep-disordered breathing (SDB), morning urine levels of catecholamines correlate with severity of nocturnal hypoxemia. METHODS Children with snoring referred for polysomnography and controls without snoring were recruited. Morning urine norepinephrine, epinephrine, normetanephrine, and metanephrine levels were measured (ng/mg urine creatinine). RESULTS Twelve children (age 5.2 +/- 2.3 years) with severe hypoxemia (oxygen saturation of hemoglobin-SpO2 nadir < or =86%), 20 subjects (age 6.1 +/- 2.1 years) with moderate hypoxemia (SpO2 nadir < or =90% and >86%), 22 children (age 6.6 +/- 1.5 years) with mild nocturnal hypoxemia (SpO2 nadir >90%), and 10 controls (age 7.1 +/- 2.8 years) were studied. Children with severe hypoxemia had significantly higher log-transformed norepinephrine levels (1.63 +/- 0.29) compared to those with moderate hypoxemia (1.43 +/- 0.22; P < 0.05) or compared to controls (1.39 +/- 0.31; P < 0.05). In subjects with SDB, log-transformed oxygen desaturation of hemoglobin index or SpO2 nadir predicted log-transformed norepinephrine levels after adjustment by age, gender and body mass index (r2 = 0.24; and r2 = 0.24, respectively; P < 0.01). CONCLUSIONS Severity of nocturnal hypoxemia in children with intermittent upper airway obstruction during sleep correlates with morning urine levels of norepinephrine suggesting increased sympathetic tone.
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Affiliation(s)
- Athanasios G Kaditis
- Sleep Disorders Laboratory, University of Thessaly School of Medicine, Larissa University Hospital, Larissa, Greece.
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Walker E, Mittal V, Tessner K. Stress and the hypothalamic pituitary adrenal axis in the developmental course of schizophrenia. Annu Rev Clin Psychol 2008; 4:189-216. [PMID: 18370616 DOI: 10.1146/annurev.clinpsy.4.022007.141248] [Citation(s) in RCA: 426] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Diathesis-stress models of schizophrenia and other psychotic disorders have dominated theorizing about etiology for over three decades. More recently, with advances in our understanding of the biological processes mediating the effects of stress, these models have incorporated mechanisms to account for the adverse impact of stress on brain function. This review examines recent scientific findings on the role of the hypothalamic-pituitary-adrenal (HPA) axis, one of the primary neural systems triggered by stress exposure, in the expression of vulnerability for schizophrenia. The results indicate that psychotic disorders are associated with elevated baseline and challenge-induced HPA activity, that antipsychotic medications reduce HPA activation, and that agents that augment stress hormone (cortisol) release exacerbate psychotic symptoms. The cumulative findings are discussed in light of a neural diathesis-stress model that postulates that cortisol has the potential to increase activity of dopamine pathways that have been implicated in schizophrenia and other psychotic disorders.
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Affiliation(s)
- Elaine Walker
- Department of Psychology, Emory University, Atlanta, Georgia 30322, USA.
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Riddell MC. The endocrine response and substrate utilization during exercise in children and adolescents. J Appl Physiol (1985) 2008; 105:725-33. [PMID: 18420724 DOI: 10.1152/japplphysiol.00031.2008] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Adolescence is a time of rapid growth caused by significant changes in hormone levels. For many, it is also a time of increased physical activity and sport that places a large demand on energy reserves. Exercise is known to cause perturbations in endocrine and metabolic systems in children and adolescents, yet careful characterization of these responses is only now being conducted. It does not appear that prepubertal youth have a different muscle composition than adults. However, these youth do have a lower anaerobic capacity and a greater reliance on aerobic metabolism during activity. Prepubertal adolescents may have an immature glucose regulatory system that influences glycemic regulation at the onset of moderate exercise. During heavy exercise, muscle and blood lactate levels are lower in children than in adults and there is a greater reliance on fat as fuel. The exercise intensity that causes maximal fat oxidation rate and the relative rate of fat oxidation decreases as adolescents develop through puberty. The mechanism for the attenuated lipid utilization with the advancement of puberty, and the impact that this may have on body composition, are unknown. Surprisingly, prepubertal adolescents have relatively high rates of exogenous glucose oxidation, perhaps because of their smaller endogenous carbohydrate reserves. Further study is needed to determine the optimal exogenous carbohydrate feeding regimen for peak performance in adolescence. Studies are also needed to determine whether physical activity, at an intensity targeted to maximize fat oxidation, help to lower body adiposity in overweight youth.
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Affiliation(s)
- Michael C Riddell
- School of Kinesiology and Health Science, Faculty of Health York University, Toronto, ON, Canada M3J 1P3.
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Heyman E, Delamarche P, Berthon P, Meeusen R, Briard D, Vincent S, DeKerdanet M, Delamarche A. Alteration in sympathoadrenergic activity at rest and during intense exercise despite normal aerobic fitness in late pubertal adolescent girls with type 1 diabetes. DIABETES & METABOLISM 2007; 33:422-9. [DOI: 10.1016/j.diabet.2007.10.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2007] [Accepted: 04/01/2007] [Indexed: 11/15/2022]
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Meikle AW, Kushnir MM, Rockwood AL, Pattison EG, Terry AH, Sandrock T, Bunker AM, Phanslkar AR, Owen WE, Roberts WL. Adrenal steroid concentrations in children seven to seventeen years of age. J Pediatr Endocrinol Metab 2007; 20:1281-91. [PMID: 18341088 DOI: 10.1515/jpem.2007.20.12.1281] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
During puberty, serum steroid concentrations change dramatically. The objective of this study was to determine the adrenal steroid concentrations in children from 7 to 17 years of age. Tanner stage was determined in each child by physical examination. 11-Deoxycortisol, pregnenolone, 17-hydroxypregnenolone, 17-hydroxyprogesterone and testosterone were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Androstenedione and dehydroepiandrosterone sulfate were measured by immunoassay. The median and central 95% of the steroid concentrations were determined for age, gender, and Tanner stage. Except for 11-deoxycortisol, all of the steroids exhibited an increase in concentration after age 7-9 years in both boys and girls. 11-Deoxycortisol, which is made exclusively in the adrenal cortex, declined with age and Tanner stage. This suggests that a rise in gonadal function and decreased efficiency of 11beta-hydroxylase with age may contribute to an increase in the remaining steroids. Testosterone concentrations increased more dramatically in boys, but increases were seen with each Tanner stage in girls.
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Affiliation(s)
- A Wayne Meikle
- Department of Medicine, University of Utah Health Science Center, UT, USA.
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36
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Green-Golan L, Yates C, Drinkard B, VanRyzin C, Eisenhofer G, Weise M, Merke DP. Patients with classic congenital adrenal hyperplasia have decreased epinephrine reserve and defective glycemic control during prolonged moderate-intensity exercise. J Clin Endocrinol Metab 2007; 92:3019-24. [PMID: 17535996 DOI: 10.1210/jc.2007-0493] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Patients with classic congenital adrenal hyperplasia (CAH) have adrenomedullary dysplasia and hypofunction, and their lack of adrenomedullary reserve has been associated with a defective glucose response to brief high-intensity exercise. OBJECTIVE Our objective was to assess hormonal, metabolic, and cardiovascular response to prolonged moderate-intensity exercise comparable to brisk walking in adolescents with classic CAH. SUBJECTS AND METHODS We compared six adolescents with classic CAH (16-20 yr old) with seven age-, sex-, and body mass index group-matched controls (16-23 yr old) using a 90-min standardized ergometer test. Metabolic, hormonal, and cardiovascular parameters were studied during exercise and recovery. RESULTS Glucose did not change throughout exercise and recovery for controls, whereas CAH patients showed a steady decline in glucose during exercise with an increase in glucose in the postexercise period. Glucose levels were significantly lower in CAH patients at 60 (P = 0.04), 75 (P = 0.01), and 90 (P = 0.03) min of exercise and 15 (P = 0.02) min post exercise, whereas glucose levels were comparable between the two groups early in exercise and at 30 min (P = 0.19) post exercise. As compared with controls, CAH patients had significantly lower epinephrine (P = 0.002) and cortisol (P < or = 0.001) levels throughout the study and similar norepinephrine, glucagon, and GH levels. Patients with CAH and controls had comparable cardiovascular parameters and perceived level of exertion. Despite having lower glucose levels, insulin levels were slightly higher in CAH patients during the testing period (P = 0.17), suggesting insulin insensitivity. CONCLUSION CAH patients have defective glycemic control and altered metabolic and hormonal responses during prolonged moderate-intensity exercise comparable to brisk walking.
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Affiliation(s)
- Liza Green-Golan
- National Institutes of Health Clinical Center, Bethesda, Maryland 20892-1932, USA
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Baquedano MS, Saraco N, Berensztein E, Pepe C, Bianchini M, Levy E, Goñi J, Rivarola MA, Belgorosky A. Identification and developmental changes of aromatase and estrogen receptor expression in prepubertal and pubertal human adrenal tissues. J Clin Endocrinol Metab 2007; 92:2215-22. [PMID: 17405842 DOI: 10.1210/jc.2006-2329] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The mechanisms of postnatal adrenal zonation remain unclear. OBJECTIVE To provide a clue for a possible role of estrogens in adrenarche, we studied the expression of estrogen receptor (ER)alpha, ERbeta, G protein-coupled receptor (GPR)30, and cP450aromatase (cP450arom) in human adrenal tissue. DESIGN Human adrenal tissue was collected from three postnatal age groups (Grs): Gr 1, younger than 3 months (n = 12), fetal zone involution; Gr 2, 3 months to 6 yr (n = 17), pre-adrenarche; and Gr 3, older than 6-20 yr (n = 12), post-adrenarche period. RESULTS ERbeta mRNA in Grs 1 and 3 was higher than in Gr 2 (P < 0.05). By immunohistochemistry and laser capture microdissection followed by RT-PCR, ERbeta was expressed in zona reticularis and fetal zone, GPR30 in zona glomerulosa (ZG) and adrenal medulla, while ERalpha mRNA and protein were undetectable. cP450arom mRNA in Gr 3 was higher than in Grs 1 and 2 (P < 0.05), and localized to ZG and adrenal medulla by laser capture microdissection. cP450arom Immunoreactivity was observed in adrenal medulla in the three Grs and in subcapsular ZG of Gr 3. Double-immunofluorescence studies revealed that cP450arom and chromogranin A only colocalize in adrenal medulla of subjects younger than 18 months. In these samples, exon 1.b-derived transcript was 3.5-fold higher, while exon 1.a-, 1.c-, and 1.d-derived transcripts were 3.3-, 1.9-, and 1.7-fold lower, respectively, than in subjects older than 6 yr. CONCLUSIONS Our results suggest that estrogens produced locally in adrenal medulla would play a role in zona reticularis functional differentiation through ERbeta. The cP450arom and GPR30 expression in subcapsular ZG, colocalizing with a high-cell proliferation index, previously reported, suggests a local GPR30-dependent estrogen action in proliferation and migration of progenitor adrenal cells.
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Affiliation(s)
- María Sonia Baquedano
- Endocrinology Service, Hospital de Pediatria Garrahan, C de los Pozos 1881, Buenos Aires, Argentina
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Di Luigi L, Guidetti L, Baldari C, Gallotta MC, Sgrò P, Perroni F, Romanelli F, Lenzi A. Cortisol, dehydroepiandrosterone sulphate and dehydroepiandrosterone sulphate/cortisol ratio responses to physical stress in males are influenced by pubertal development. J Endocrinol Invest 2006; 29:796-804. [PMID: 17114910 DOI: 10.1007/bf03347373] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To evaluate the influence of chronological age and pubertal development on the hypothalamus-pituitary-adrenal (HPA) axis response to stress, we studied the possible correlations between male pubertal characteristics and salivary cortisol (C), DHEAS and the DHEAS/C ratio before (pre-stress) and after acute exercise-stress in young male volunteers (no. 87; 13.3+/-2.1 yr). In our overall study population, the mean pre-stress salivary C and DHEAS concentrations, significantly increased after exercise-related stress, whereas the DHEAS/C ratio significantly decreased. Pre-stress salivary C was positively correlated with chronological age, and after-stress salivary C concentration variations were negatively correlated with pubertal stage, mean testis volume and pre-stress salivary DHEAS. Furthermore, salivary DHEAS concentrations and the DHEAS/C ratio, before and after exercise stress, were positively correlated with chronological age, pubertal stage, pre-stress salivary testosterone (T), testis volume and body mass index (BMI). In contrast with late pubertal stages (P4, P5), young individuals at early stages of puberty (P1 to P3) showed higher C increase and lower DHEAS/C ratio after exercise-related stress. In conclusion, since C is also a mediator of stress-related negative effects on health and the DHEAS/C ratio has been hypothesized as an index for the degree to which an individual is buffered against the negative effects of stress, these data might suggest potentially increased stress-related risks at early stages of male puberty.
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Affiliation(s)
- L Di Luigi
- Unit of Endocrinology, Department of Health Sciences, University of Rome IUSM, Rome, Italy.
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Okada T, Saito E, Kuromori Y, Miyashita M, Iwata F, Hara M, Harada K. Relationship between serum adiponectin level and lipid composition in each lipoprotein fraction in adolescent children. Atherosclerosis 2006; 188:179-83. [PMID: 16307747 DOI: 10.1016/j.atherosclerosis.2005.10.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2005] [Revised: 09/30/2005] [Accepted: 10/18/2005] [Indexed: 12/29/2022]
Abstract
The association of lipid composition in each lipoprotein fraction with adiponectin level in relation to body fatness was investigated. The subjects were 283 children (144 boys and 139 girls) aged 11.6 years (S.D. 1.5). Cholesterol (C) and triglyceride (TG) levels in each lipoprotein fraction were measured by a combination of agarose gel electrophoresis and differential staining. Adiponectin level was not significantly different between girls and boys. In simple regression analyses, an association of adiponectin level with lipoprotein lipid profile was shown only in girls, and not in boys at all. In girls, very low-density lipoprotein (VLDL)-C, low-density lipoprotein (LDL)-C, VLDL-TG and LDL-TG were negatively correlated with adiponectin level, and high-density lipoprotein (HDL)-C and HDL-C/TG ratio were positively correlated. Multiple regression analyses including adiponectin level and body mass index (BMI) as predictors for the lipoprotein lipid profile demonstrated that adiponectin level was a significant independent predictor of VLDL-TG, LDL-C, LDL-TG, HDL-C and HDL-C/TG ratio. In conclusion, adiponectin level correlates with lipoprotein lipid profile independent of body fatness in adolescent girls.
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Affiliation(s)
- Tomoo Okada
- Department of Pediatrics, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi Itabashi-ku, Tokyo 173-8610, Japan.
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Sandhu J, Ben-Shlomo Y, Cole TJ, Holly J, Davey Smith G. The impact of childhood body mass index on timing of puberty, adult stature and obesity: a follow-up study based on adolescent anthropometry recorded at Christ's Hospital (1936-1964). Int J Obes (Lond) 2006; 30:14-22. [PMID: 16344844 DOI: 10.1038/sj.ijo.0803156] [Citation(s) in RCA: 162] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine the impact of childhood body mass index (BMI) on timing of puberty, adult stature and obesity. DESIGN A retrospective school-based cohort follow-up study. SUBJECTS A total of 1520 men born between 1927 and 1956 with serial height and weight measurements from the age of 9 to 18, followed up in adulthood at a mean age of 63 years. MEASUREMENTS Prepubertal (child) BMI; age at peak height velocity (APHV); adult leg length, waist and hip circumference (self-reported), and height and weight (measured). RESULTS Boys with a higher childhood BMI tended to have an earlier puberty (per s.d. increase in child BMI: -0.31 years, 95% confidence interval (CI): -0.23 to -0.39, P < 0.001). Childhood BMI correlated strongly and positively with adult adiposity, as measured by BMI (1.24 kg/m(2), 95% CI: 1.04-1.45, P < 0.001), waist (1.94 cm, 95% CI: 1.50-2.37, P < 0.001) and hip (1.91 cm, 95% CI: 1.55-2.28, P < 0.001). It correlated inversely with leg length (-0.40 cm, 95% CI: -0.68 to -0.12, P = 0.005), but not significantly with height or trunk length. Boys with a later puberty tended to be taller (per s.d. increase in APHV: 0.57 cm, 95% CI: 0.17-0.97, P = 0.006) and less adipose as adults (-0.55 kg/m(2), 95% CI: -0.33 to -0.77, P < 0.001). CONCLUSION The long-term consequences of childhood obesity into adulthood are well known, but the potential impact on early pubertal maturation is less well appreciated. The factors that contribute to the onset and persistence of childhood obesity require more public health focus.
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Affiliation(s)
- J Sandhu
- Department of Social Medicine, University of Bristol, UK.
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41
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Vogl SE, Worda C, Egarter C, Bieglmayer C, Szekeres T, Huber J, Husslein P. Mode of delivery is associated with maternal and fetal endocrine stress response. BJOG 2006; 113:441-5. [PMID: 16489937 DOI: 10.1111/j.1471-0528.2006.00865.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine whether mode of delivery is associated with the endocrine stress response in mother and child. DESIGN Prospective observational study. SETTING Tertiary care centre, University hospital. POPULATION A total of 103 nulliparous women with uncomplicated singleton pregnancies at term undergoing either spontaneous labour for vaginal delivery or delivering by caesarean section without labour. Thirty women delivered vaginally without any pain relief, 21 women delivered vaginally with epidural anaesthesia, 23 women had ventouse extraction and 29 women underwent caesarean section with epidural analgesia. METHODS After delivery, maternal and umbilical cord blood was collected for determination of different stress-associated hormones. MAIN OUTCOME MEASURES Concentrations of epinephrine (EP), norepinephrine (NOR), adrenocorticotropic hormone (ACTH), cortisol (CORT), prolactin (PRL), corticotropin-releasing factor and beta-endorphin (BE). RESULTS Caesarean section was associated with significantly lower maternal concentrations of EP, NOR, ACTH, CORT, PRL and BE and lower newborn levels of EP, NOR and CORT compared with all other modes of delivery. Concentrations of EP, ACTH and BE differed significantly in newborns delivered by normal vaginal delivery, vaginal delivery with epidural anaesthesia and ventouse extraction. CONCLUSIONS The mode of delivery and analgesia used during birth are associated with maternal and fetal endocrine stress responses.
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Affiliation(s)
- S E Vogl
- Department of Obstetrics and Gynecology, Division of Obstetrics, University of Vienna Medical School, Vienna, Austria.
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42
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Ronsaville DS, Municchi G, Laney C, Cizza G, Meyer SE, Haim A, Radke-Yarrow M, Chrousos G, Gold PW, Martinez PE. Maternal and environmental factors influence the hypothalamic–pituitary–adrenal axis response to corticotropin-releasing hormone infusion in offspring of mothers with or without mood disorders. Dev Psychopathol 2006; 18:173-94. [PMID: 16478558 DOI: 10.1017/s095457940606010x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Individuals with melancholic major depression exhibit basal hypercortisolism and an attenuated ACTH response to exogenous corticotropin-releasing hormone (CRH) infusion. Given the greater incidence of depression in children of depressed parents, we examined the ACTH and cortisol responses to ovine CRH (oCRH) infusion in 63 adolescent offspring of mothers with major depression, bipolar illness, or no psychiatric illness. Psychiatric and observational assessments of these families had been conducted over the course of 10 years preceding this study. We examined the children's responses to CRH in relation to maternal characteristics and family environment and found the following: (a) cortisol responses were negatively related to chronic family stress and (b) offspring of depressed mothers with an avoidant personality disorder showed an exaggerated ACTH response. In addition, adolescents in late puberty (Tanner 4 and 5) had lower ACTH and cortisol responses to oCRH infusion than those in early puberty. Further, offspring with early histories of mood problems, and those who developed major depressive disorder as young adults, did not exhibit basal hypercortisolism but did show an attenuated ACTH response to CRH. Our results add to the growing body of literature showing the influence of maternal characteristics and environmental factors on hypothalamic-pituitary-adrenal axis patterns in children.
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43
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Bond LJ, Vella ET, Kiparissis Y, Wynne-Edwards KE. Anthropometry and body composition do not predict bioavailable androgen or progesterone concentration in adolescent girls. Am J Hum Biol 2006; 18:639-53. [PMID: 16917896 DOI: 10.1002/ajhb.20534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Our objective was to test the hypothesis that anthropometry and body composition were independently associated with sex-steroid concentration in adolescent girls. Premenarcheal (age, mean +/- SD = 10.9 +/- 0.6, N = 51), perimenarcheal (age = 13.7 +/- 0.6, N = 74), and postmenarcheal (age = 16.7 +/- 0.6, N = 44) cohorts provided saliva at morning recess during the schoolday over 6 weeks. Estradiol, testosterone, progesterone, and dehydroepiandrosterone (DHEA) were quantified. Age, developmental cohort, self-reported Tanner stage of breast development and pubic-hair distribution, gynecological age, height, weight, waist/hip ratio, and percent body fat (by impedance) were assessed. Repeated measures were reduced to a mean. Data were hierarchically standardized for sexual maturation status, and then used to predict anthropometry/percent body fat. After intensive repeated sampling, individuals still varied widely in testosterone, progesterone, and DHEA concentrations within a developmental cohort (35.0 < or = coefficient of variation < or = 66.5%). Individual hormone concentration was repeatable across 2 years (0.51 < or = r(2) < or = 0.73). In spite of the variability within a cohort, there was no evidence for an association between the standardized hormone and body mass index, percent body fat, or waist/hip ratio, whether or not measures were age-adjusted (21 univariate tests; 0.19 < or = P < or = 0.96). Stratification by developmental cohort also did not reveal associations. Low estradiol assay precision precluded analyses. In conclusion, despite considerable population variation in hormone concentration after repeated sampling, no evidence supported an association between anthropometry or pecent body fat and testosterone, progesterone, or DHEA in adolescent girls.
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Affiliation(s)
- Lea J Bond
- Department of Biology, Queen's University, Kingston, Ontario K7L 3N6, Canada
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44
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Khasar SG, Dina OA, Green PG, Levine JD. Estrogen regulates adrenal medullary function producing sexual dimorphism in nociceptive threshold and beta-adrenergic receptor-mediated hyperalgesia in the rat. Eur J Neurosci 2005; 21:3379-86. [PMID: 16026475 DOI: 10.1111/j.1460-9568.2005.04158.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Epinephrine produces sexually dimorphic beta(2)-adrenergic receptor-mediated mechanical hyperalgesia, with male rats exhibiting greater hyperalgesia. Because female rats have higher plasma epinephrine levels, and beta-adrenergic receptor sensitivity is affected by chronic exposure to agonists, we tested the hypothesis that this sexual dimorphism is due to epinephrine-induced desensitization of beta(2)-adrenergic receptors. Following gonadectomy, epinephrine hyperalgesia, as measured by the Randall-Selitto paw-withdrawal test, was unchanged in male rats while in females it was increased. Prepubertal male and female rats do not demonstrate sexual dimorphism in either plasma epinephrine level or epinephrine-induced hyperalgesia. Adrenal medullectomy and adrenal denervation both significantly enhanced epinephrine hyperalgesia, but only in females. In contrast, the sexually dimorphic hyperalgesia induced by prostaglandin E(2), another agent that acts directly to sensitize primary afferent nociceptors, was not enhanced by adrenal medullectomy or denervation. Chronic administration of epinephrine in male rats, to produce plasma levels similar to those of gonad-intact females, significantly attenuated epinephrine-induced hyperalgesia, making it similar to that in females. These results strongly support the suggestion that estrogen regulates plasma epinephrine in female rats and differential sensitivity to beta(2)-adrenergic agonists accounts for the sexual dimorphism in epinephrine-induced hyperalgesia. Unexpectedly, regulation of adrenal medullary function by estrogen was also found to modulate baseline nociceptive threshold such that females had a lower nociceptive threshold.
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Affiliation(s)
- Sachia G Khasar
- Department of Medicine, University of California at San Francisco, CA 94143-0440, USA
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45
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Hodes GE, Shors TJ. Distinctive stress effects on learning during puberty. Horm Behav 2005; 48:163-71. [PMID: 15885691 PMCID: PMC3364669 DOI: 10.1016/j.yhbeh.2005.02.008] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Revised: 02/03/2005] [Accepted: 02/07/2005] [Indexed: 11/19/2022]
Abstract
Puberty is a time of significant change in preparation for adulthood. Here, we examined how stressful experience affects cognitive and related hormonal responses in male and female rats prior to, during and after puberty. Groups were exposed to an acute stressor of brief periodic tailshocks and tested 24 h later in an associative memory task of trace eyeblink conditioning. Exposure to the stressor did not alter conditioning in males or females prior to puberty but enhanced conditioning in both males and females during puberty. The enhancement occurred in pubescent females irrespective of the estrous cycle. In adulthood, sex differences in trace conditioning and the response to stress emerged: females outperformed males under unstressed conditions, but after stressor exposure, trace conditioning in females was impaired whereas that in males was enhanced. These differences were not related to changes in gross motor activity or other nonspecific measures of performance. The effects of acute stress on corticosterone, estradiol, progesterone, and testosterone were also measured. Stressor exposure increased the concentration of corticosterone in all age groups, although sex differences were only evident in adults. All reproductive hormones except estradiol increased with age in a predictable and sex dependent fashion and none were affected by stressor exposure. Estradiol decreased in male rats across age, and remained stable for female rats. Together, these data indicate that males and female respond similarly to learning opportunities and stressful experience before and during puberty; it is in adulthood that sex differences and the opposite responses to stress arise.
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Affiliation(s)
- Georgia E. Hodes
- Department of Psychology and Center for Collaborative Neuroscience, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ 08854, USA
| | - Tracey J. Shors
- Department of Psychology and Center for Collaborative Neuroscience, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ 08854, USA
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46
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Walker EF, Sabuwalla Z, Huot R. Pubertal neuromaturation, stress sensitivity, and psychopathology. Dev Psychopathol 2005; 16:807-24. [PMID: 15704816 DOI: 10.1017/s0954579404040027] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Normal adolescent development is often accompanied by transient emotional and behavioral problems. For most individuals with postpubertal-onset adjustment problems, there is a resolution by early adulthood and relative stability through the adult life span. But for a minority, adjustment problems escalate during adolescence and portend the development of serious mental illness in adulthood. In this article, we explore adolescent behavioral changes and neurodevelopmental processes that might contribute to stress sensitivity and vulnerability for the emergence of the mental disorders. Of particular interest is the role that hormonal changes might play in the expression of genetic vulnerabilities for psychopathology. Drawing on recent findings from clinical research and behavioral neuroscience, we describe the ways in which postpubertal hormones might alter brain function and, thereby, behavior. It is concluded that there are both activational and organization effects of hormones on the adolescent brain, and these contribute to developmental discontinuities in behavioral adjustment. Implications for adult psychopathology and preventive intervention are discussed.
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Affiliation(s)
- Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA 30322, USA.
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47
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Irmak MK, Oztas E, Vural H. Dependence of fetal hairs and sebaceous glands on fetal adrenal cortex and possible control from adrenal medulla. Med Hypotheses 2004; 62:486-92. [PMID: 15050094 DOI: 10.1016/j.mehy.2004.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2004] [Accepted: 01/12/2004] [Indexed: 10/26/2022]
Abstract
Human fetal adrenal development is characterized by rapid growth, high steroidogenic activity, and a distinct morphology, including a unique cortical compartment known as the fetal zone. For most of gestation, the predominant fetal zone accounts for 80-90% of the cortical volume and is the primary site of growth and steroidogenesis, producing 100-200 mg/day of the androgenic steroid, dehydroepiandrosterone sulfate (DHEA-S). The physiological role of this zone during intrauterine life is not well understood. While the glands appear to be capable of DHEA-S synthesis early in gestation (8-10 weeks), we noticed that this event precedes the differentiation of hairs and sebaceous glands. Hairs begin to develop between 9 and 12 weeks and sebaceous glands between 13 and 15 weeks of gestation. Sebaceous glands form an oily secretion - sebum that mixes with desquamated epidermal cells to form vernix caseosa. Vernix caseosa protects the developing skin from constant exposure to amniotic fluid, and hairs helps to hold the vernix caseosa on the skin. We suggest therefore that the human fetal adrenal cortex produces DHEA-S beginning at around 8-10 weeks of gestation in sufficient quantities to influence the growth of hairs and sebaceous glands. Soon after birth, the fetal zone atrophies, and adrenal androgen production decreases to minimal levels. As a consequence, in concordance with the rapid decrease in adrenal androgen levels and in consistent with our hypothesis, fetal hairs are shed and sebaceous glands shrink to small structures. The mechanism that regulates fetal adrenal androgen production is a key unanswered problem in human adrenal biology. Since there exists a close relationship between epinephrine and DHEA-S levels during adrenarche which shows modulatory interactions between adrenal androgen production and adrenomedullary function, we suggest again that adrenomedullary function might play a role in the control of fetal adrenal androgen secretion.
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Affiliation(s)
- M K Irmak
- Department of Histology and Embryology, School of Medicine, Gulhane Military Medical Academy, Ankara, Turkey.
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48
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Hadtstein C, Wühl E, Soergel M, Witte K, Schaefer F. Normative values for circadian and ultradian cardiovascular rhythms in childhood. Hypertension 2004; 43:547-54. [PMID: 14744931 DOI: 10.1161/01.hyp.0000116754.15808.d8] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To assess the prevalence and characteristics of physiological circadian (24-hour) and ultradian (12-, 8-, and 6-hour) rhythms of mean arterial blood pressure (BP) and heart rate (HR), we analyzed 24-hour ambulatory BP profiles from 938 healthy school children aged 5 to 18 years. Cosine harmonics were fitted by Fourier analysis, and an amplitude and acrophase (time of peak) were calculated for each rhythm. Ninety percent of children displayed circadian rhythmicity of BP, independent of age, whereas circadian HR rhythmicity decreased with puberty from 96% to 87% (P<0.0001). Puberty had marked effects on the prevalence of ultradian rhythmicity: 12- and 6-hour rhythms increased for BP (27% to 47%, P<0.0001; 18% to 25%, P=0.01) and HR (36% to 47%, 17% to 31%, both P=0.001), whereas 8-hour BP rhythms decreased (34% to 23%, P=0.002). Median amplitudes were 10.1, 5.9, 5.6, and 5.2 mm Hg for the 24-, 12-, 8-, and 6-hour BP rhythms, respectively, and 13.4, 7.7, 6.8, and 6.4 bpm for HR. The acrophase occurred at approximately 14:00 hours, 8:00 hours, 5:30 hours, and 2:00 hours (military time) for the four BP rhythms, and at 13:30 hours, 08:30 hours, 01:50 hours, and 02:00 hours for HR. For the combined curve, the peak-trough difference was 25.9 mm Hg and 35 bpm for BP and HR, respectively, with the peaks occurring at 13:50 hours and 13:10 hours. There was marked association between BP and HR rhythms, both for prevalence (P<0.0001 for coupling of BP and HR rhythms of the same period length) and timing, with a median time lag of BP after HR acrophase of only 21, 16, 13, and 5 minutes for the four rhythms, respectively.
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Affiliation(s)
- Charlotte Hadtstein
- University Children's Hospital, Im Neuenheimer Feld 151, 69120 Heidelberg, Germany
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Coutant R, Maurey H, Rouleau S, Mathieu E, Mercier P, Limal JM, Le Bouil A. Defect in epinephrine production in children with craniopharyngioma: functional or organic origin? J Clin Endocrinol Metab 2003; 88:5969-75. [PMID: 14671198 DOI: 10.1210/jc.2003-030552] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Despite pituitary hormone replacement, patients with craniopharyngioma often complain of fatigue. They may have deficient control of catecholamine secretion caused by hypothalamic lesion. Another hypothesis is a functional defect in catecholamine production through either glucocorticoid deficiency because high intraadrenal glucocorticoid concentration is necessary for epinephrine synthesis or unrecognized hypoglycemia, which can intrinsically alter epinephrine secretion. We measured catecholamine response to insulin-induced hypoglycemia and orthostasis, and 24-h urinary catecholamine excretion, in 16 children with craniopharyngioma (patients) and 27 sex- and age-matched short children. We also studied the influence of a 4-fold increase in the usual daily dose of hydrocortisone on catecholamine excretion (50 vs. 12 mg/m(2) of body surface area) in the glucocorticoid-deficient patients. Last, we compared 24-h continuous sc glucose in patients and 10 sex- and age-matched healthy children. The results are expressed as medians (25th, 75th). For a similar blood glucose nadir after insulin administration, peak plasma epinephrine in response to hypoglycemia was lower in patients vs. controls [420 (120, 715) vs. 730 (460, 1200) ng/liter, P < 0.01], whereas peak plasma norepinephrine was higher [390 (280, 550) vs. 270 (180, 280) ng/liter, P < 0.05]. Catecholamine response to orthostasis did not differ between groups. Urinary epinephrine was significantly lower in patients (P < 0.001), whereas urinary norepinephrine was similar. The extent of epinephrine deficiency correlated with neither tumor size nor hypothalamic involvement. A 4-fold higher hydrocortisone dose did not correct the defective epinephrine excretion in the glucocorticoid-deficient patients. Last, the 24-h sc glucose values were similar between patients and controls. In conclusion, children with craniopharyngioma have a defect in epinephrine but not norepinephrine production. There is no proof of a univocal origin, either organic or functional. Whether abnormal catecholamine secretion alters glucose level during fasting or acute illness, or hampers adaptation to exercise, requires further studies.
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Affiliation(s)
- Régis Coutant
- Department of Pediatrics, University Hospital, 49000 Angers, France.
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