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Children's stress-related reports and stress biomarkers interact in their association with metabolic syndrome risk

Journal article
Authors N. Michels
D. Matthys
B. Thumann
Staffan Mårild
S. De Henauw
Published in Stress and Health
Volume 34
Issue 4
Pages 523-533
ISSN 1532-3005
Publication year 2018
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 523-533
Language en
Keywords autonomic nervous system, cardiovascular disease prevention, cortisol, metabolic health, heart-rate-variability, pituitary-adrenal axis, body-mass index, salivary cortisol, obese children, hypercortisolemic depression, physical-activity, serum cortisol, blood-pressure, adolescents, Psychology, Psychiatry, rousos gp, 1992, jama-journal of the american medical association, v267, p1244, rges sw, 1995, neuroscience and biobehavioral reviews, v19, p225
Subject categories Child and adolescent psychiatry, Psychiatry, Psychology


The purpose was to examine the cross-sectional associations of stress-related reports and stress biomarkers with metabolic syndrome (MetS) risk in children while also testing the interaction between stress biomarkers and stress reports. In 353 children (5-10years old, 7.9% overweight/obese), MetS risk was measured by blood pressure, waist circumference, glucose homeostasis, triglycerides, and high-density cholesterol. Stress was measured by stress-related reports (events, emotions, and internalizing/externalizing problems) and two biomarkers: salivary cortisol (total-day and morning output) and heart rate variability (percentage of consecutive normal RR intervals differing more than 50ms and low-to-high-frequency ratio). Cross-sectional regression analyses with z scored total MetS risk as outcome were adjusted for age, sex, and socio-economic status. Only internalizing problems were directly related to a higher MetS risk score (=0.236). Cortisol and heart rate variability were significant moderators: High cortisol morning output resulted in a positive (unfavourable) report-MetS relationship (=0.259-0.552), whereas low percentage of consecutive normal RR intervals differing more than 50ms resulted in a negative (favourable) report-MetS relationship (=-0.298) and low low-to-high-frequency ratio in a positive (unfavourable) report-MetS relationship (=0.478). In conclusion, stress can sometimes be a disadvantageous factor in metabolic health of otherwise healthy children. The cortisol biomarker seems relevant because metabolic risk was highest when stress-related reports were accompanied by high morning cortisol output.

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