The Journal of Pediatrics
Volume 150, Issue 5 , Pages 535-539.e1 , May 2007

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

  • Pascal Barat, MD, PhD

      Affiliations

    • From the Department of Pediatric Endocrinology, Centre Hospitalier Universitaire de Bordeaux, France
    • Corresponding Author InformationReprint requests: Dr Pascal Barat, Pediatric Endocrinology, Centre Hospitalier Universitaire de Bordeaux, Hôpital des Enfants—Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France.
    • ,
  • Michelle Gayard-Cros, MD

      Affiliations

    • Department of Pediatric Endocrinology, Centre Hospitalier Universitaire de Toulouse, France
    • ,
  • Ruth Andrew, PhD

      Affiliations

    • Endocrinology Unit, Centre of Cardiovascular Science, University of Edinburgh, United Kingdom.
    • ,
  • Jean-Benoît Corcuff, MD, PhD

      Affiliations

    • Department of Nuclear Medicine, Centre Hospitalier Universitaire de Bordeaux, France
    • ,
  • Béatrice Jouret, MD

      Affiliations

    • Department of Pediatric Endocrinology, Centre Hospitalier Universitaire de Toulouse, France
    • ,
  • Nicole Barthe, MD

      Affiliations

    • Department of Nuclear Medicine, Centre Hospitalier Universitaire de Bordeaux, France
    • ,
  • Paul Perez, MD, PhD

      Affiliations

    • Clinical Epidemiology Unit, Centre Hospitalier Universitaire de Bordeaux, France
    • ,
  • Christine Germain, MSc

      Affiliations

    • Clinical Epidemiology Unit, Centre Hospitalier Universitaire de Bordeaux, France
    • ,
  • Maïthé Tauber, MD, PhD

      Affiliations

    • Department of Pediatric Endocrinology, Centre Hospitalier Universitaire de Toulouse, France
    • ,
  • Brian R. Walker, MD

      Affiliations

    • Endocrinology Unit, Centre of Cardiovascular Science, University of Edinburgh, United Kingdom.
    • ,
  • Pierre Mormede, PhD

      Affiliations

    • Laboratoire Neurogénétique et Stress, University of Bordeaux, France
    • ,
  • Martine Duclos, MD, PhD

      Affiliations

    • Laboratoire Neurogénétique et Stress, University of Bordeaux, France

Received 25 April 2006 ,Revised 16 September 2006 ,Accepted 24 January 2007.

References 

  1. Grundy SM. Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab. 2004;89:2595–2600
  2. Rosmond R, Dallman MF, Bjorntorp P. Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities. J Clin Endocrinol Metab. 1998;83:1853–1859
  3. Pasquali R, Anconetani B, Chattat R, Biscotti M, Spinucci G, Casimirri F, et al. Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in women with visceral and subcutaneous obesity: effects of the corticotropin-releasing factor/arginine-vasopressin test and of stress. Metabolism. 1996;45:351–356
  4. Pasquali R, Biscotti D, Spinucci G, Vicennati V, Genazzani AD, Sgarbi L, et al. Pulsatile secretion of ACTH and cortisol in premenopausal women: effect of obesity and body fat distribution. Clin Endocrinol (Oxf). 1998;48:603–612
  5. Duclos M, Gatta B, Corcuff JB, Rashedi M, Pehourcq F, Roger P. Fat distribution in obese women is associated with subtle alterations of the hypothalamic-pituitary-adrenal axis activity and sensitivity to glucocorticoids. Clin Endocrinol (Oxf). 2001;55:447–454
  6. Jessop DS, Dallman MF, Fleming D, Lightman SL. Resistance to glucocorticoid feedback in obesity. J Clin Endocrinol Metab. 2001;86:4109–4114
  7. Rask E, Walker BR, Soderberg S, Livingstone DE, Eliasson M, Johnson O, et al. Tissue-specific changes in peripheral cortisol metabolism in obese women: increased adipose 11beta-hydroxysteroid dehydrogenase type 1 activity. J Clin Endocrinol Metab. 2002;87:3330–3336
  8. Wake DJ, Rask E, Livingstone DE, Soderberg S, Olsson T, Walker BR. Local and systemic impact of transcriptional up-regulation of 11beta-hydroxysteroid dehydrogenase type 1 in adipose tissue in human obesity. J Clin Endocrinol Metab. 2003;88:3983–3988
  9. Lindsay RS, Wake DJ, Nair S, Bunt J, Livingstone DE, Permana PA, et al. Subcutaneous adipose 11 beta-hydroxysteroid dehydrogenase type 1 activity and messenger ribonucleic acid levels are associated with adiposity and insulinemia in Pima Indians and Caucasians. J Clin Endocrinol Metab. 2003;88:2738–2744
  10. Sandeep TC, Andrew R, Homer NZ, Andrews RC, Smith K, Walker BR. Increased in vivo regeneration of cortisol in adipose tissue in human obesity and effects of the 11{beta}-hydroxysteroid dehydrogenase type 1 inhibitor carbenoxolone. Diabetes. 2005;54:872–879
  11. Ferguson MA, Gutin B, Owens S, Litaker M, Tracy RP, Allison J. Fat distribution and hemostatic measures in obese children. Am J Clin Nutr. 1998;67:1136–1140
  12. Higgins PB, Gower BA, Hunter GR, Goran MI. Defining health-related obesity in prepubertal children. Obes Res. 2001;9:233–240
  13. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–1243
  14. Daniels SR, Morrison JA, Sprecher DL, Khoury P, Kimball TR. Association of body fat distribution and cardiovascular risk factors in children and adolescents. Circulation. 1999;99:541–545
  15. Pugeat MM, Chrousos GP, Nisula BC, Loriaux DL, Brandon D, Lipsett MB. Plasma cortisol transport and primate evolution. Endocrinology. 1984;115:357–361
  16. Best R, Walker BR. Additional value of measurement of urinary cortisone and unconjugated cortisol metabolites in assessing the activity of 11 beta-hydroxysteroid dehydrogenase in vivo. Clin Endocrinol (Oxf). 1997;47:231–236
  17. Andrews RC, Herlihy O, Livingstone DE, Andrew R, Walker BR. Abnormal cortisol metabolism and tissue sensitivity to cortisol in patients with glucose intolerance. J Clin Endocrinol Metab. 2002;87:5587–5593
  18. Fernandez-Real JM, Pugeat M, Grasa M, Broch M, Vendrell J, Brun J, et al. Serum corticosteroid-binding globulin concentration and insulin resistance syndrome: a population study. J Clin Endocrinol Metab. 2002;87:4686–4690
  19. Pasquali R, Ambrosi B, Armanini D, Cavagnini F, Uberti ED, Del Rio G, et al. Cortisol and ACTH response to oral dexamethasone in obesity and effects of sex, body fat distribution, and dexamethasone concentrations: a dose-response study. J Clin Endocrinol Metab. 2002;87:166–175
  20. Bujalska IJ, Kumar S, Hewison M, Stewart PM. Differentiation of adipose stromal cells: the roles of glucocorticoids and 11beta-hydroxysteroid dehydrogenase. Endocrinology. 1999;140:3188–3196
  21. Seckl JR, Walker BR. 11beta-hydroxysteroid dehydrogenase type 1 as a modulator of glucocorticoid action: from metabolism to memory. Trends Endocrinol Metab. 2004;15:418–424
  22. Andrew R, Phillips DI, Walker BR. Obesity and gender influence cortisol secretion and metabolism in man. J Clin Endocrinol Metab. 1998;83:1806–1809
  23. Stewart PM, Boulton A, Kumar S, Clark PM, Shackleton CH. Cortisol metabolism in human obesity: impaired cortisone—>cortisol conversion in subjects with central adiposity. J Clin Endocrinol Metab. 1999;84:1022–1027
  24. Follenius M, Brandenberger G, Hietter B. Diurnal cortisol peaks and their relationships to meals. J Clin Endocrinol Metab. 1982;55:757–761
  25. Duclos M, Marquez PP, Barat P, Gatta B, Roger P. Increased cortisol bioavailability, abdominal obesity, and the metabolic syndrome in obese women. Obes Res. 2005;13:1157–1166
  26. Hershberger AM, McCammon MR, Garry JP, Mahar MT, Hickner RC. Responses of lipolysis and salivary cortisol to food intake and physical activity in lean and obese children. J Clin Endocrinol Metab. 2004;89:4701–4707
  27. Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition. J Atheroscler Thromb. 2005;12:295–300

 Supported by the Institut National de la Santé et de la Recherche Médicale. This work was funded by the Centre Hospitalier Universitaire de Bordeaux.

PII: S0022-3476(07)00103-5

doi: 10.1016/j.jpeds.2007.01.029

The Journal of Pediatrics
Volume 150, Issue 5 , Pages 535-539.e1 , May 2007

Article Tools