Truncal Distribution of Fat Mass, Metabolic Profile and Hypothalamic-Pituitary Adrenal Axis Activity in Prepubertal Obese Children

Pascal Barat, Michelle Gayard-Cros, Ruth Andrew, Jean-Benoît Corcuff, Béatrice Jouret, Nicole Barthe, Paul Perez, Christine Germain, Maïthé Tauber, Brian R. Walker, Pierre Mormede, Martine Duclos
The Journal of Pediatrics. 2007-05-01; 150(5): 535-539.e1
DOI: 10.1016/j.jpeds.2007.01.029

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1. J Pediatr. 2007 May;150(5):535-9, 539.e1.

Truncal distribution of fat mass, metabolic profile and hypothalamic-pituitary
adrenal axis activity in prepubertal obese children.

Barat P(1), Gayard-Cros M, Andrew R, Corcuff JB, Jouret B, Barthe N, Perez P,
Germain C, Tauber M, Walker BR, Mormede P, Duclos M.

Author information:
(1)Department of Pediatric Endocrinology, Centre Hospitalier Universitaire de
Bordeaux, France.

OBJECTIVE: To investigate whether truncal distribution of fat mass (TDFM) is
associated with variations of the hypothalamic-pituitary-adrenocortical (HPA)
axis activity in prepubertal obese children.
STUDY DESIGN: TDFM, assessed with dual energy X-ray absorptiometry and a
comprehensive set of measures of HPA axis activity and reactivity have been
studied in 45 prepubertal obese children aged 6 to 11 years (girls) and 6 to 13
years (boys).
RESULTS: After adjustment for whole body fat mass (%) (WBFM), TDFM correlated
positively with insulin (r = 0.50, 95% CI [0.23; 0.70]) and homeostasis model
assessment of insulin resistance (r = 0.52, 95% CI [0.25; 0.71]). When adjusted
for WBFM, TDFM correlated positively with morning plasma cortisol (r = 0.38, 95%
CI [0.15; 0.64]) in the total population. TDFM correlated negatively with the
rise of salivary cortisol after a standard meal (r = -0.43, 95% CI [-0.71;
-0.02]), obviously in girls. When adjusted for WBFM and TDFM, morning plasma
cortisol correlated positively with total cholesterol (r = 0.41, 95% CI [0.11;
0.65]) and triglyceride (r = 0.44, 95% CI [0.14; 0.67]). The rise of salivary
cortisol after a standard meal was negatively (r = -0.56, 95% CI [-0.85; -0.01])
and positively (r = 0.74, 95% CI [0.16; 0.94]) correlated with homeostasis model
assessment of insulin resistance in boys and girls, respectively.
CONCLUSIONS: Association exists in prepubertal obese children between TDFM and
markers of HPA axis activity. These data suggest that HPA axis could be involved
early in life in obesity associated with pejorative metabolic profile.

DOI: 10.1016/j.jpeds.2007.01.029
PMID: 17452232 [Indexed for MEDLINE]

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