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Exploring the Temporal Relation between Body Mass Index and Corticosteroid Metabolite Excretion in Childhood

Britt J Van Keulen1, Conor V Dolan2, Ruth Andrew3

  • 1Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Endocrinology, Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.

Nutrients
|May 28, 2020
PubMed

Insights

Childhood body mass index (BMI) predicts changes in hypothalamus-pituitary-adrenal (HPA) axis activity, suggesting HPA axis alterations are a consequence, not a cause, of obesity. This finding impacts understanding of childhood obesity development.

Area of Science:

  • Endocrinology
  • Metabolic Health
  • Pediatric Health

Background:

  • Childhood obesity is linked to altered hypothalamus-pituitary-adrenal (HPA) axis activity.
  • The causal relationship between HPA axis function and obesity in children remains unclear.
  • Understanding this temporal relationship is crucial for effective obesity interventions.

Purpose of the Study:

  • To investigate the temporal relationship between body mass index (BMI) and cortisol production/metabolism in children.
  • To determine if BMI predicts HPA axis activity or vice versa.
  • To clarify whether HPA axis alterations are a cause or consequence of childhood obesity.

Main Methods:

  • Prospective follow-up study of 218 children assessed at ages 9, 12, and 17 years.
  • Analysis of morning urine samples for cortisol metabolites using gas chromatography-tandem mass spectrometry.
  • Application of cross-lagged regression models to assess bidirectional relationships between BMI and HPA axis parameters.

Main Results:

  • Childhood BMI positively predicted later cortisol metabolite excretion (p=0.03).
  • BMI also predicted the balance of 11β-hydroxysteroid dehydrogenase (HSD) activities (p=0.07).
  • Cytochrome P450 3A4 activity predicted later BMI (p=0.01), while HPA axis activity did not predict BMI.

Conclusions:

  • Changes in BMI across the normal range predict alterations in HPA axis activity in children.
  • HPA axis alterations observed in childhood obesity are likely a consequence, not a cause, of increased BMI.
  • This research reframes the understanding of the interplay between metabolic status and endocrine function in pediatric obesity.

Keywords:
BMIHPA axisglucocorticoidsobesity

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