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评估儿童慢性应激标志物——应激负荷以及超重的重要性。

Evaluation of Allostatic Load as a Marker of Chronic Stress in Children and the Importance of Excess Weight.

作者信息

Calcaterra Valeria, Vinci Federica, Casari Giulia, Pelizzo Gloria, de Silvestri Annalisa, De Amici Mara, Albertini Riccardo, Regalbuto Corrado, Montalbano Chiara, Larizza Daniela, Cena Hellas

机构信息

Pediatric Unit, Department of the Mother and Child Health, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine University of Pavia, Pavia, Italy.

Pediatric Surgery Department, Children's Hospital "G. di Cristina", ARNAS "Civico-Di Cristina-Benfratelli", Palermo, Italy.

出版信息

Front Pediatr. 2019 Aug 7;7:335. doi: 10.3389/fped.2019.00335. eCollection 2019.

Abstract

Allostatic load (AL) refers to the physiological response associated with the burden of chronic stress. Excessive weight is an important source of physiological stress that promotes a detrimental chronic low-inflammation state. In order to define a correlation between cumulative biological dysregulation and excess weight, we measured AL scores in a pediatric population. We enrolled 164 children and adolescents (11.89 ± 3.89). According to their body mass index (BMI) threshold, subjects were classified as normal in the BMI < 75th percentile, overweight in the BMI 75-95th percentile or obese in the BMI >95th percentile. Data based on 16 biomarkers were used to create the AL score. A dichotomous outcome for high AL was defined in those who had more than four dysregulated components. High AL was noted in 88/164 subjects (53.65%), without significant differences between genders ( = 0.07) or pubertal status ( = 0.10). Subjects with a high AL, in addition to a higher BMI ( < 0.001), showed higher WC and WC/HtR ( < 0.001), triglycerides ( = 0.002), fasting blood glucose ( = 0.03), insulin resistance ( < 0.001), systolic ( < 0.001) and diastolic blood pressure ( = 0.001), GGT ( = 0.01), PCR ( = 0.01), and calprotectin ( < 0.01) as well as lower HDL cholesterol ( = 0.002) than subjects with a low AL. The rate of the cumulative biological dysregulation increased progressively with increases in BMI ( < 0.001). A high AL was associated with excess weight. AL may be considered a significant factor correlated with increased morbidity in children who are overweight/obese.

摘要

应激负荷(AL)是指与慢性应激负担相关的生理反应。超重是生理应激的一个重要来源,会促进有害的慢性低炎症状态。为了确定累积生物失调与超重之间的相关性,我们测量了儿科人群的应激负荷得分。我们招募了164名儿童和青少年(11.89±3.89)。根据他们的体重指数(BMI)阈值,受试者被分类为BMI低于第75百分位数为正常,BMI在第75至95百分位数为超重,BMI高于第95百分位数为肥胖。基于16种生物标志物的数据用于创建应激负荷得分。对于应激负荷高的二分结果定义为失调成分超过四个的受试者。在164名受试者中有88名(53.65%)被发现应激负荷高,性别之间(P = 0.07)或青春期状态之间(P = 0.10)无显著差异。应激负荷高的受试者,除了BMI较高(P < 0.001)外,还表现出较高的腰围(WC)和腰围身高比(WC/HtR)(P < 0.001)、甘油三酯(P = 0.002)、空腹血糖(P = 0.03)、胰岛素抵抗(P < 0.001)、收缩压(P < 0.001)和舒张压(P = 0.001)、γ-谷氨酰转移酶(GGT)(P = 0.01)、C反应蛋白(PCR)(P = 0.01)和钙卫蛋白(P < 0.01),以及比应激负荷低的受试者更低的高密度脂蛋白胆固醇(HDL胆固醇)(P = 0.002)。累积生物失调的发生率随着BMI的增加而逐渐增加(P < 0.001)。高应激负荷与超重相关。应激负荷可能被认为是与超重/肥胖儿童发病率增加相关的一个重要因素。

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