Rothermel Juliane, Kulle Alexandra, Holterhus Paul-Martin, Toschke Christina, Lass Nina, Reinehr Thomas
Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany.
Division of Pediatric Endocrinology and Diabetes, University Hospital of Schleswig Holstein, UKSH, Campus Kiel/Christian-Albrechts-University, CAU, Kiel, Germany.
Clin Endocrinol (Oxf). 2016 Dec;85(6):868-873. doi: 10.1111/cen.13235. Epub 2016 Oct 3.
Copeptin has been reported to be associated with stress, obesity and the metabolic syndrome (MetS) in adults. However, data in childhood are scarce. Therefore, we studied the relationships between copeptin, cortisol, puberty and parameters of the MetS in children.
Cross-sectional study.
A total of 51 obese children (10·8 ± 3·2 years, 39% male, 45% prepubertal, body mass index standard deviation score (BMI-SDS) 2·77 ± 0·56) and 24 lean children of similar age, gender and pubertal stage.
Copeptin, serum cortisol, 24-h urinary free cortisol, BMI-SDS and, as parameters of the MetS, insulin resistance index (HOMA), HbA1c, uric acids, blood pressure and lipids.
Copeptin levels were significantly (P = 0·047) higher in obese children (5·8 ± 2·8pmol/l) compared to lean children (4·6 ± 2·2pmol/l). BMI-SDS (β-coefficient 0·38 ± 0·35, P =0·033), but not any parameter of the MetS, was significantly related to copeptin in multiple linear regression analyses adjusted for age, gender and pubertal stage. A 24-h urinary free cortisol (β-coefficient 0·13 ± 0·06, P < 0·001), but not serum cortisol, was significantly related to copeptin in multiple linear regression analyses adjusted for age, gender, pubertal stage and BMI-SDS. Pubertal boys (6·6 ± 2·8pmol/l) demonstrated significantly (P = 0·042) higher copeptin levels compared to pubertal girls (4·8 ± 2·6pmol/l), while copeptin concentrations did not differ between prepubertal girls and boys.
Copeptin levels are related to 24-h urinary free cortisol in obese children. Pubertal boys, but not prepubertal boys, demonstrated higher copeptin levels than girls, suggesting that sex hormones are involved in the regulation of copeptin levels. Further studies are necessary to understand the relationship between obesity, cortisol, gender, pubertal stage and copeptin levels.
据报道， copeptin与成年人的应激、肥胖及代谢综合征（MetS）有关。然而，关于儿童的数据却很少。因此，我们研究了儿童中copeptin、皮质醇、青春期与MetS各项参数之间的关系。
横断面研究。
共51名肥胖儿童（10.8±3.2岁，39%为男性，45%未进入青春期，体重指数标准差评分（BMI-SDS）为2.77±0.56）以及24名年龄、性别和青春期阶段相似的瘦儿童。
copeptin、血清皮质醇、24小时尿游离皮质醇、BMI-SDS，以及作为MetS参数的胰岛素抵抗指数（HOMA）、糖化血红蛋白（HbA1c）、尿酸、血压和血脂。
肥胖儿童的copeptin水平（5.8±2.8pmol/l）显著高于瘦儿童（4.6±2.2pmol/l）（P = 0.047）。在调整了年龄、性别和青春期阶段的多元线性回归分析中，BMI-SDS（β系数为0.38±0.35，P = 0.033）与copeptin显著相关，但MetS的任何参数均无此相关性。在调整了年龄、性别、青春期阶段和BMI-SDS的多元线性回归分析中，24小时尿游离皮质醇（β系数为0.13±0.06，P < 0.001）与copeptin显著相关，而血清皮质醇则无此相关性。青春期男孩（6.6±2.8pmol/l）的copeptin水平显著高于青春期女孩（4.8±2.6pmol/l）（P = 0.042），而青春期前女孩和男孩的copeptin浓度无差异。
肥胖儿童的copeptin水平与24小时尿游离皮质醇有关。青春期男孩而非青春期前男孩的copeptin水平高于女孩，这表明性激素参与了copeptin水平的调节。有必要进行进一步研究以了解肥胖、皮质醇、性别、青春期阶段与copeptin水平之间的关系。
