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极低出生体重的早产青年成人对心理社会应激的肾上腺素、去甲肾上腺素及心率反应

Adrenalin, noradrenalin and heart rate responses to psychosocial stress in young adults born preterm at very low birthweight.

作者信息

Kaseva Nina, Pyhälä Riikka, Wehkalampi Karoliina, Feldt Kimmo, Pesonen Anu-Katriina, Heinonen Kati, Hovi Petteri, Järvenpää Anna-Liisa, Eriksson Johan G, Andersson Sture, Räikkönen Katri, Kajantie Eero

机构信息

Department of Chronic Disease and Diabetes Prevention, National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.

出版信息

Clin Endocrinol (Oxf). 2014 Aug;81(2):231-7. doi: 10.1111/cen.12425. Epub 2014 Mar 7.

Abstract

OBJECTIVE

Adults born preterm at very low birthweight (VLBW; ≤ 1500 g) have high levels of cardiovascular risk factors and altered responses to psychosocial stress including higher blood pressure and lower cortisol. Our aim was to investigate adrenalin (A), noradrenalin (NA) and heart rate (HR) responses to psychosocial stress in adults born preterm at VLBW.

DESIGN AND PARTICIPANTS

We studied 50 young adults, aged 19-27 years, born at VLBW and 39 term-born controls, group-matched for age, sex and birth hospital. They underwent a standardized psychosocial stress test, the Trier Social Stress Test (TSST).

MEASUREMENTS

During TSST, A, NA (baseline and 0, 10 and 90 min after stress) and HR were measured. Data were analysed with mixed-effects and linear regression models, adjusted for age, sex, body mass index, hormonal contraception, time of day and highest parental educational attainment.

RESULTS

Baseline concentrations, peak after stress, increments and area under the curve for A and NA were similar in VLBW and control groups. In women, NA concentrations were 27.7% lower (95% CI; 3.1-52.2) in VLBW compared with control women; in men, there was no significant difference. A concentrations were similar for VLBW and control groups in both sexes. Mean HR at baseline, task and HR reactivity was also similar in VLBW and control groups.

CONCLUSIONS

Very low-birthweight women seem to have a lower NA response to stress compared with term-born peers. If replicated, this could be a protective characteristic for cardiovascular diseases.

摘要

目的

极低出生体重(VLBW;≤1500克)的早产成人具有高水平的心血管危险因素,且对心理社会应激的反应发生改变,包括血压升高和皮质醇降低。我们的目的是研究极低出生体重的早产成人对心理社会应激的肾上腺素(A)、去甲肾上腺素(NA)和心率(HR)反应。

设计与参与者

我们研究了50名年龄在19 - 27岁的极低出生体重的年轻成人以及39名足月出生的对照组,两组在年龄、性别和出生医院方面进行了匹配。他们接受了标准化的心理社会应激测试,即特里尔社会应激测试(TSST)。

测量

在TSST期间,测量A、NA(基线以及应激后0、10和90分钟)和HR。数据采用混合效应和线性回归模型进行分析,并根据年龄、性别、体重指数、激素避孕、一天中的时间以及父母的最高教育程度进行了调整。

结果

极低出生体重组和对照组中A和NA的基线浓度、应激后的峰值、增加值和曲线下面积相似。在女性中,与对照组女性相比,极低出生体重组的NA浓度低27.7%(95%可信区间;3.1 - 52.2);在男性中,无显著差异。两组男女的A浓度相似。极低出生体重组和对照组在基线、任务期间的平均心率以及心率反应性也相似。

结论

与足月出生的同龄人相比,极低出生体重的女性对应激的NA反应似乎较低。如果得到重复验证,这可能是心血管疾病的一种保护特征。

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