Entringer Sonja, Buss Claudia, Rasmussen Jerod M, Lindsay Karen, Gillen Daniel L, Cooper Dan M, Wadhwa Pathik D
Department of Pediatrics.
Department of Development, Health, and Disease Research Program, University of California, Irvine, Irvine, California 92697.
J Clin Endocrinol Metab. 2017 Apr 1;102(4):1366-1374. doi: 10.1210/jc.2016-3025.
Glucocorticoids play a key role during intrauterine development in cellular growth and differentiation. Evidence suggests that exposure to inappropriate concentrations of glucocorticoids during sensitive developmental periods may produce alterations in physiological systems that impact obesity risk.
To elucidate the magnitude and stage-of-gestation-specific association of maternal cortisol concentrations during pregnancy with infant adiposity.
DESIGN, PARTICIPANTS, AND SETTING: Sixty-seven mother-child dyads recruited in early pregnancy at university-based obstetric clinics in Southern California were followed with serial assessments from early gestation through birth until 6 months postnatal age. Maternal cumulative cortisol production was assessed over each of 4 consecutive days in early (≅13 weeks), mid (≅24 weeks), and late pregnancy (≅30 weeks) (5 saliva samples/d × 4 days × 3 trimesters = 60 saliva samples/subject). Infant body composition was serially assessed in newborns (at ∼25 days postnatal age) and at ∼6 months age with dual-energy X-ray absorptiometry imaging.
After adjusting for key prenatal, birth, and postnatal covariates, higher maternal cortisol during the early third trimester (conditioned on prior early and midgestation cortisol concentrations) was significantly associated with a greater change in infant percent body fat from 1 to 6 months of age [partial r (adjusted for covariates) = 0.379, P = 0.007], accounting for ∼14% of the variance in this measure of childhood obesity risk.
The present findings suggest a stage-of-gestation-specific effect of maternal cortisol on infant adiposity gain in early postnatal life and provide evidence in humans to support the role of glucocorticoids in fetal programming of childhood obesity risk.
糖皮质激素在子宫内发育过程中对细胞生长和分化起着关键作用。有证据表明，在敏感的发育阶段暴露于不适当浓度的糖皮质激素可能会导致生理系统发生改变，从而影响肥胖风险。
阐明孕期母亲皮质醇浓度与婴儿肥胖之间的关联程度及妊娠阶段特异性关联。
设计、参与者和研究地点：在南加州大学附属产科诊所招募了67对母婴，从妊娠早期到出生，直至产后6个月进行连续评估。在妊娠早期（约13周）、中期（约24周）和晚期（约30周）连续4天评估母亲的累积皮质醇分泌量（每天5份唾液样本×4天×3个孕期=每位受试者60份唾液样本）。使用双能X线吸收测定成像技术对新生儿（出生后约25天）和6个月大的婴儿进行身体成分的连续评估。
在调整关键的产前、出生和产后协变量后，孕晚期早期较高的母亲皮质醇水平（以先前的孕早期和孕中期皮质醇浓度为条件）与婴儿1至6个月龄时体脂百分比的更大变化显著相关[偏相关系数（经协变量调整）=0.379，P=0.007]，占儿童肥胖风险这一指标方差的约14%。
目前的研究结果表明，母亲皮质醇对出生后早期婴儿肥胖增加存在妊娠阶段特异性影响，并为糖皮质激素在儿童肥胖风险的胎儿编程中的作用提供了人体证据。
