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Blunted hypothalamic-pituitary-adrenal axis and insulin response to psychosocial stress in young adults born preterm at very low birth weight.
Clin Endocrinol (Oxf). 2014 Jan; 80(1):101-6.CE

Abstract

BACKGROUND

Young adults born preterm at very low birth weight (VLBW, ≤1500 g) have higher levels of cardiovascular risk factors, including impaired glucose regulation, than their term-born peers. This could be mediated through altered hypothalamic-pituitary-adrenal axis (HPAA) response to stress.

OBJECTIVE

To compare HPAA, glucose and insulin responses provoked by psychosocial stress in VLBW subjects versus a comparison group of term-born controls.

DESIGN AND PARTICIPANTS

We studied 54 unimpaired young adults, aged 19-27 years, born at VLBW and a comparison group of 40 adults born at term, group-matched for age, sex and birth hospital, from one regional centre in southern Finland. The participants underwent a standardized psychosocial stress test (Trier Social Stress Test, TSST).

MEASUREMENTS

In conjunction with TSST, we measured salivary cortisol, plasma ACTH, cortisol, glucose and insulin. Data were analysed with mixed-effects model and multiple linear regression analyses.

RESULTS

Baseline concentrations for cortisol, ACTH, insulin and glucose were similar in VLBW and comparison groups. During TSST, analysed with mixed-effects model, overall concentrations of plasma cortisol were 17·2% lower (95% CI; 3·5 to 28·9) in the VLBW group. The VLBW group also had lower salivary (P = 0·04) and plasma cortisol (P = 0·02) responses to TSST. Insulin and glucose concentrations correlated with changes in cortisol concentrations. Accordingly, VLBW subjects had 26·5% lower increment in insulin (95% CI; 9·8-40·1). Analyses were adjusted for age, sex, body mass index, hormonal contraception, menstrual cycle phase, time of day and parental education.

CONCLUSIONS

VLBW adults have lower HPAA responses to psychosocial stress than term-born controls. This is accompanied by a lower insulin response.

Authors+Show Affiliations

Department of Chronic Disease and Diabetes Prevention, National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23711202

Citation

Kaseva, Nina, et al. "Blunted Hypothalamic-pituitary-adrenal Axis and Insulin Response to Psychosocial Stress in Young Adults Born Preterm at Very Low Birth Weight." Clinical Endocrinology, vol. 80, no. 1, 2014, pp. 101-6.
Kaseva N, Wehkalampi K, Pyhälä R, et al. Blunted hypothalamic-pituitary-adrenal axis and insulin response to psychosocial stress in young adults born preterm at very low birth weight. Clin Endocrinol (Oxf). 2014;80(1):101-6.
Kaseva, N., Wehkalampi, K., Pyhälä, R., Moltchanova, E., Feldt, K., Pesonen, A. K., Heinonen, K., Hovi, P., Järvenpää, A. L., Andersson, S., Eriksson, J. G., Räikkönen, K., & Kajantie, E. (2014). Blunted hypothalamic-pituitary-adrenal axis and insulin response to psychosocial stress in young adults born preterm at very low birth weight. Clinical Endocrinology, 80(1), 101-6. https://doi.org/10.1111/cen.12251
Kaseva N, et al. Blunted Hypothalamic-pituitary-adrenal Axis and Insulin Response to Psychosocial Stress in Young Adults Born Preterm at Very Low Birth Weight. Clin Endocrinol (Oxf). 2014;80(1):101-6. PubMed PMID: 23711202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Blunted hypothalamic-pituitary-adrenal axis and insulin response to psychosocial stress in young adults born preterm at very low birth weight. AU - Kaseva,Nina, AU - Wehkalampi,Karoliina, AU - Pyhälä,Riikka, AU - Moltchanova,Elena, AU - Feldt,Kimmo, AU - Pesonen,Anu-Katriina, AU - Heinonen,Kati, AU - Hovi,Petteri, AU - Järvenpää,Anna-Liisa, AU - Andersson,Sture, AU - Eriksson,Johan G, AU - Räikkönen,Katri, AU - Kajantie,Eero, Y1 - 2013/06/12/ PY - 2013/03/27/received PY - 2013/04/17/revised PY - 2013/05/20/revised PY - 2013/05/22/accepted PY - 2013/5/29/entrez PY - 2013/5/29/pubmed PY - 2014/7/30/medline SP - 101 EP - 6 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 80 IS - 1 N2 - BACKGROUND: Young adults born preterm at very low birth weight (VLBW, ≤1500 g) have higher levels of cardiovascular risk factors, including impaired glucose regulation, than their term-born peers. This could be mediated through altered hypothalamic-pituitary-adrenal axis (HPAA) response to stress. OBJECTIVE: To compare HPAA, glucose and insulin responses provoked by psychosocial stress in VLBW subjects versus a comparison group of term-born controls. DESIGN AND PARTICIPANTS: We studied 54 unimpaired young adults, aged 19-27 years, born at VLBW and a comparison group of 40 adults born at term, group-matched for age, sex and birth hospital, from one regional centre in southern Finland. The participants underwent a standardized psychosocial stress test (Trier Social Stress Test, TSST). MEASUREMENTS: In conjunction with TSST, we measured salivary cortisol, plasma ACTH, cortisol, glucose and insulin. Data were analysed with mixed-effects model and multiple linear regression analyses. RESULTS: Baseline concentrations for cortisol, ACTH, insulin and glucose were similar in VLBW and comparison groups. During TSST, analysed with mixed-effects model, overall concentrations of plasma cortisol were 17·2% lower (95% CI; 3·5 to 28·9) in the VLBW group. The VLBW group also had lower salivary (P = 0·04) and plasma cortisol (P = 0·02) responses to TSST. Insulin and glucose concentrations correlated with changes in cortisol concentrations. Accordingly, VLBW subjects had 26·5% lower increment in insulin (95% CI; 9·8-40·1). Analyses were adjusted for age, sex, body mass index, hormonal contraception, menstrual cycle phase, time of day and parental education. CONCLUSIONS: VLBW adults have lower HPAA responses to psychosocial stress than term-born controls. This is accompanied by a lower insulin response. SN - 1365-2265 UR - https://www.unboundmedicine.com/medline/citation/23711202/Blunted_hypothalamic_pituitary_adrenal_axis_and_insulin_response_to_psychosocial_stress_in_young_adults_born_preterm_at_very_low_birth_weight_ L2 - https://doi.org/10.1111/cen.12251 DB - PRIME DP - Unbound Medicine ER -