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Size at birth, the metabolic syndrome and 24-h salivary cortisol profile
Eero Kajantie1, Johan Eriksson, Clive Osmond
1National Public Health Institute, Helsinki, Finland. eero.kajantie@helsinki.fi
Insights
Cortisol levels measured in daily life did not link small birth size to metabolic syndrome in elderly women. Further HPAA stimulation tests may be needed to find such associations.
Area of Science:
- Endocrinology
- Human Physiology
- Metabolic Health
Background:
- Hypothalamic-pituitary-adrenal axis (HPAA) function variations may link early life factors to adult metabolic syndrome.
- Previous human studies on this link have yielded inconsistent results and were conducted in clinical settings.
Purpose of the Study:
- To investigate the relationship between HPAA activity during everyday living and the metabolic syndrome.
- To assess if HPAA activity is associated with birth size and metabolic syndrome components in elderly women.
Main Methods:
- A clinical birth cohort study involving 151 women born between 1924-1933 in Helsinki, Finland.
- Salivary cortisol was measured over a 24-hour period, with calculations for awakening response and diurnal variability.
- Cortisol levels were correlated with birth measurements and components of the metabolic syndrome.
Main Results:
- Salivary cortisol awakening response showed correlations with serum cortisol measures (fasting, ACTH-stimulated, dexamethasone-suppressed).
- No salivary cortisol measurement was significantly associated with any component of the metabolic syndrome (e.g., waist circumference, triglycerides, blood pressure).
- No correlation was found between salivary cortisol levels and birth size parameters (weight, length, ponderal index, gestational age).
Conclusions:
- Cortisol concentrations measured in an everyday environment are not associated with the metabolic syndrome or birth size in elderly women.
- Detecting relationships between HPAA function, prenatal influences, and adult disease may necessitate HPAA stimulation tests.
Objective:
Individual variation in hypothalamic-pituitary-adrenal axis (HPAA) function has been suggested to be important in linking small size at birth with adult cardiovascular disease and its risk factors, in particular the metabolic syndrome. Human studies have, however, so far only been performed in clinic settings, and their results have not been consistent. Our aim was to assess whether HPAA activity in everyday living circumstances is related to the metabolic syndrome and size at birth.
Design:
Clinical birth cohort study.
Subjects:
A total of 151 women born between 1924 and 1933 in Helsinki, Finland, with measurements at birth recorded. The subjects had previously undergone detailed clinical examinations including fasting cortisol measurement and 1 micro g ACTH1-24 and overnight 0.25 mg dexamethasone tests.
Measurements:
Salivary cortisol concentration was measured during a normal 24-h period: at awakening, 15 and 30 min thereafter, at 12.00 h, 17.00 h and 22.00 h and the following morning. In addition, the following summary variables were calculated: awakening response (mean of the three awakening measurements), mean of all individual measurements, and mean, SD and contrast (a measure of blunted diurnal variability, calculated as mean of morning minus mean of 1200, 1700 and 2200) of all individual z scores.
Results:
Salivary cortisol awakening response was correlated with serum fasting (r = 0.17; P = 0.04), ACTH1-24-stimulated (r = 0.32; P < 0.0001), and dexamethasone-suppressed (r = 0.29; P = 0.0004) cortisol concentrations. However, no salivary cortisol measurement was associated with any component of the metabolic syndrome (waist circumference, serum triglyceride, HDL cholesterol or glucose concentration, or blood pressure). Moreover, no correlation was observed between salivary cortisol and weight, length, ponderal index, or gestational age at birth.
Conclusions:
In elderly women, cortisol concentrations in an everyday environment do not appear to be associated with the metabolic syndrome or size at birth. We propose that detecting relationships between HPAA function, prenatal events and adult disease might require a test involving HPAA stimulation.
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