Duan X N, Yan S Q, Wang S M, Hu J J, Fang J, Gong C, Wan Y H, Su P Y, Tao F B, Sun Y
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China.
Ma'anshan Maternal and Child Health Center, Ma'anshan 243011, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Aug 10;39(8):1086-1090. doi: 10.3760/cma.j.issn.0254-6450.2018.08.014.
To explore the developmental characteristics of circadian rhythms in hypothalamus-pituitary-adrenal (HPA) axis during puberty. A total of 1 070 students from Grade 2-3 in 3 primary schools in Ma'anshan city, Anhui province, were selected for physical examination and circadian rhythm of HPA axis checked from 2015 to 2017. Saliva samples were collected at each of the following three time points: immediately upon wakening, 30 minutes after wakening and bedtime, with the index of circadian rhythm of HPA axis calculated, which including cortisol awake response (CAR), cortisol in puberty priming and diurnal cortisol slope (DCS). Testicular volume, palpation and visual inspection of breast development were used to assess the state of purbety development on boys and girls. Information on gender, date of birth, time to fall asleep, wake-up time and weekly physical activity were gathered through questionnaire survey. Non-parametric test was used to compare the differences of baseline, follow-up period and different adolescent developmental processes of each index on circadian rhythm of HPA axis. During the period of follow-up program and comparing with the continuous undeveloped group, CAR and the changes of CAR showed significantly increase, both in the puberty priming group and continuous development group, with statistically significant differences (CAR: =8.551, 4.680, respectively; <0.01; the changes of CAR: =4.079, 2.700, respectively, <0.01). There were no significant differences noticed in CAR and the changes of CAR between puberty priming group or continuous development group. The area under the curve (AUC) of cortisol in puberty priming group was slightly higher than that in the persistent undeveloped group (=2.591, =0.010). Both the changes of daily cortisol slope (DCS) in puberty priming group and continuing developed group decreased significantly, when comparing with those in continuous undeveloped group (=-2.450, =-2.151; all <0.05). There was no significant difference noticed in the changes of cortisol in puberty priming and DCS between different puberty development stages (the changes of AUC: (2)=2.747, =0.253; DCS: (2)=4.554, =0.032). The indexes of circadian rhythm of HPA axis were associated with the development of puberty. Both the cortisol awakening response and the total amount of diurnal cortisol secretion showed an increase, along with the puberty development. The change of diurnal cortisol slope declined with the development of puberty.
探讨青春期下丘脑-垂体-肾上腺(HPA)轴昼夜节律的发育特征。2015年至2017年,选取安徽省马鞍山市3所小学二至三年级的1070名学生进行体格检查,并检测HPA轴的昼夜节律。在以下三个时间点采集唾液样本:醒来即刻、醒来30分钟后和就寝时间,计算HPA轴昼夜节律指标,包括皮质醇觉醒反应(CAR)、青春期启动时皮质醇和昼夜皮质醇斜率(DCS)。通过睾丸体积、触诊和乳房发育视诊评估男孩和女孩的青春期发育状态。通过问卷调查收集性别、出生日期、入睡时间、起床时间和每周体育活动等信息。采用非参数检验比较HPA轴昼夜节律各指标在基线、随访期和不同青少年发育过程中的差异。在随访期间,与持续未发育组相比,青春期启动组和持续发育组的CAR及其变化均显著增加,差异有统计学意义(CAR:分别为=8.551、4.680;<0.01;CAR的变化:分别为=4.079、2.700,<0.01)。青春期启动组和持续发育组之间的CAR及其变化无显著差异。青春期启动组皮质醇的曲线下面积(AUC)略高于持续未发育组(=2.591,=0.010)。与持续未发育组相比,青春期启动组和持续发育组的每日皮质醇斜率(DCS)变化均显著降低(=-2.450,=-2.151;均<0.05)。不同青春期发育阶段之间青春期启动时皮质醇和DCS变化无显著差异(AUC的变化:(2)=2.747,=0.253;DCS:(2)=4.554,=0.032)。HPA轴昼夜节律指标与青春期发育相关。随着青春期发育,皮质醇觉醒反应和昼夜皮质醇分泌总量均增加。昼夜皮质醇斜率的变化随着青春期发育而下降。