Inflammatory, endocrine and metabolic correlates of fatigue in obese children.

Pascal Barat, Marie-Claire Meiffred, Julie Brossaud, Dietmar Fuchs, Jean-Benoit Corcuff, Helene Thibault, Lucile Capuron
Psychoneuroendocrinology. 2016-12-01; 74: 158-163
DOI: 10.1016/j.psyneuen.2016.09.002

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1. Psychoneuroendocrinology. 2016 Dec;74:158-163. doi:
10.1016/j.psyneuen.2016.09.002. Epub 2016 Sep 8.

Inflammatory, endocrine and metabolic correlates of fatigue in obese children.

Barat P(1), Meiffred MC(2), Brossaud J(3), Fuchs D(4), Corcuff JB(3), Thibault
H(2), Capuron L(5).

Author information:
(1)CHU Bordeaux, Centre Spécialise Obésité, Hopital des Enfants, F-33076
Bordeaux, France; Univ Bordeaux, Nutrition and Integrative Neurobiology, F-33076
Bordeaux, France. Electronic address: .
(2)CHU Bordeaux, Centre Spécialise Obésité, Hopital des Enfants, F-33076
Bordeaux, France.
(3)Univ Bordeaux, Nutrition and Integrative Neurobiology, F-33076 Bordeaux,
France; CHU Bordeaux, Nuclear Medecine, F-33604 Pessac, France.
(4)Division of Biological Chemistry, Biocenter Innsbruck Medical University
Center for Chemistry and Biomedicine, A-6020 Innsbruck, Austria.
(5)Univ Bordeaux, Nutrition and Integrative Neurobiology, F-33076 Bordeaux,
France; INRA, Nutrition and Integrative Neurobiology, F-33076 Bordeaux, France.

Alterations in endocrine functions and low-grade systemic inflammation represent
fundamental characteristics of obesity. These biological systems have been
repeatedly linked to fatigue symptoms. The aim of the study was to assess the
relationship between fatigue dimensions and metabolic/inflammatory markers in a
sample of non-diabetic obese children. The possibility that inflammation-induced
alterations in tryptophan metabolism relates to specific dimensions of fatigue
was also investigated in a subsample of patients. The study was conducted in 41
obese children, median aged 12 [9-15] years, recruited in a pediatric tertiary
center. Three dimensions of fatigue (e.g., general fatigue, sleep/rest, cognitive
fatigue) were assessed using the Pediatric Quality of Life Inventory
Multidimentional Fatigue Scale. In addition, a principal component analysis was
performed to identify fatigue dimensions that were specific to the population
under study. This analysis extracted five relevant dimensions corresponding
respectively to concentration, energy, self-perceived cognitive efficiency,
sleep/rest and motivation/anhedonia. Blood samples were collected for the
measurement of inflammatory and metabolic markers, including high sensitivity
C-reactive protein (hs-CRP), insulin, uricemia and glycaemia. Tryptophan,
kynurenine and neopterin levels were also determined in a subsample of 17
patients. In the whole population under study, cognitive fatigue and reduced
motivation/anhedonia were associated with BMI, independently of sex and age. The
dimension of reduced motivation/anhedonia was associated with insulin resistance
and inflammatory biomarkers. The association with insulin resistance persisted
when the extent of fat mass (BMI-SDS) was taken into account. No association was
found between tryptophan metabolism and specific dimensions of fatigue, but
kynurenine and the kynurenine/tryptophan ratio correlated with insulin and
HOMA-IR. These data indicate that insulin resistance in non diabetic obese
children is associated with both cognitive fatigue and reduced
motivation/anhedonia and with alterations in tryptophan metabolism. Further
investigations are needed to determine whether inflammation-induced alterations
in tryptophan metabolism is directly or indirectly implicated in insulin
resistance and related fatigue.

Copyright © 2016 Elsevier Ltd. All rights reserved.

DOI: 10.1016/j.psyneuen.2016.09.002
PMID: 27627133 [Indexed for MEDLINE]

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