Initiative on Stress, Trauma, and Resilience (STAR), Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA.
University of Rhode Island College of Nursing, Providence, RI, USA.
Psychoneuroendocrinology. 2023 Mar;149:106007. doi: 10.1016/j.psyneuen.2022.106007. Epub 2022 Dec 15.
Childhood adversity is a major risk factor for cardiometabolic health problems. Stress-related changes in diet suggest a role for endocrine factors that influence dietary intake, such as leptin and ghrelin. These hormones influence metabolism and may contribute to the relationship of early adversity, mental, and cardiometabolic health. This study examined levels of leptin and ghrelin in a sample of young adults with and without early life stress (ELS).
Young adults ages 18-40 (N = 200; 68.5% female) were recruited from the community. Participants with ELS (N = 118) had childhood maltreatment, and a subset, n = 92 (78.0%) also had parental loss, and n = 65 (55.1%) also had a current psychiatric disorder. Control participants (N = 82) had no maltreatment, parental loss, or psychiatric disorders. Standardized interviews and self-reports assessed demographics, adversity, medical/psychiatric history, and health behaviors. Exclusion criteria included medical conditions and current medications other than hormonal contraceptives. Body Mass Index (BMI) and other anthropometrics were measured, and fasting plasma was assayed for total ghrelin and leptin with the Bio-Plex Pro Human Diabetes Panel.
While ELS was significantly associated with greater leptin (r = .16, p = .025), a finding which held when adjusted for age and sex (F(3196)= 28.32, p = .011), this relationship was abolished when accounting for BMI (p = .44). Participants with ELS also had significantly lower total ghrelin (r = .21, p = .004), which held adjusting for age and sex (p = .002) and was attenuated (p = .045) when the model included BMI (F=46.82, p < .001). Current psychiatric disorder was also a significant predictor of greater leptin (r = .28, p < .001) and lower ghrelin (r = .29, p = .003). In the model with ELS and covariates, psychiatric disorder remained significant (F=7.26, p = .008) and ELS was no longer significant (p = .87). Associations with severity and recent perceived stress were also examined.
The relationship of ELS and leptin was no longer significant when accounting for BMI, suggesting potential avenues for intervention. Ghrelin findings persisted after correction for BMI, which may be secondary to physiological differences in the regulation of these hormones (leptin is produced by adipocytes, whereas ghrelin is produced primarily in the GI tract). Lastly, these findings suggest that psychiatric functioning may be a key component contributing to the relationship of lower total ghrelin and childhood adversity.
童年逆境是影响心血管代谢健康问题的主要风险因素。与应激相关的饮食变化表明，内分泌因素在影响饮食摄入方面发挥着作用，例如瘦素和胃饥饿素。这些激素影响新陈代谢，可能与早期逆境、心理和心血管代谢健康的关系有关。本研究调查了有和没有早期生活压力（ELS）的年轻成年人样本中的瘦素和胃饥饿素水平。
18-40 岁的年轻成年人（N=200；68.5%为女性）从社区招募。有 ELS（N=118）的参与者有儿童期虐待史，其中亚组 n=92（78.0%）也有父母丧失，n=65（55.1%）也有当前的精神疾病。对照组（N=82）没有遭受虐待、父母丧失或精神疾病。标准化访谈和自我报告评估了人口统计学、逆境、医疗/精神病史和健康行为。排除标准包括医疗状况和当前除激素避孕药以外的药物。测量体重指数（BMI）和其他人体测量指标，并使用 Bio-Plex Pro 人类糖尿病面板测定空腹血浆中的总胃饥饿素和瘦素。
尽管 ELS 与更高的瘦素水平显著相关（r=0.16，p=0.025），这一发现在调整年龄和性别后仍然存在（F(3196)=28.32，p=0.011），但当考虑 BMI 时，这种关系就消失了（p=0.44）。有 ELS 的参与者的总胃饥饿素水平也明显较低（r=0.21，p=0.004），在调整年龄和性别后仍然如此（p=0.002），当模型包括 BMI 时，这种关系减弱（p=0.045）（F=46.82，p<0.001）。当前的精神疾病也是更高的瘦素（r=0.28，p<0.001）和更低的胃饥饿素（r=0.29，p=0.003）的显著预测因子。在包含 ELS 和协变量的模型中，精神疾病仍然是显著的（F=7.26，p=0.008），而 ELS 不再显著（p=0.87）。还检查了与严重程度和近期感知压力的关联。
当考虑 BMI 时，ELS 和瘦素之间的关系不再显著，这表明可能有干预的途径。在纠正 BMI 后，胃饥饿素的发现仍然存在，这可能是由于这些激素调节的生理差异所致（瘦素由脂肪细胞产生，而胃饥饿素主要由胃肠道产生）。最后，这些发现表明，精神功能可能是导致总胃饥饿素水平较低与童年逆境之间关系的关键因素。
