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

Abstract

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 (5-10 years 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 50 ms 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 (β = 0.236). Cortisol and heart rate variability were significant moderators: High cortisol morning output resulted in a positive (unfavourable) report-MetS relationship (β = 0.259-0.552), whereas low percentage of consecutive normal RR intervals differing more than 50 ms resulted in a negative (favourable) report-MetS relationship (β = -0.298) and low low-to-high-frequency ratio in a positive (unfavourable) report-MetS relationship (β = 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.

Association between Metabolic Syndrome Components and Cardiac Autonomic Modulation among Children and Adolescents: A Systematic Review and Meta-Analysis

“…Three studies showed significant negative associations with SDNN and rMSSD [ 16 , 19 , 20 ]. Three studies showed significant positive associations with the LF/HF ratio [ 6 , 16 , 20 ]. On the other hand, two studies [ 16 , 27 ] showed significant positive and two studies [ 19 , 20 ] reported negative significant associations with LF.…”

“…Two studies reported significant negative associations with both LF and SDNN [ 17 , 19 ]. Two studies [ 17 , 19 ] reported a significant positive association and one study [ 6 ] reported a significant negative association with LF/HF.…”

“…Two studies reported significant positive associations with SDNN [ 18 , 19 ]. Two studies [ 6 , 17 ] reported significant positive associations and one study [ 19 ] reported a significant negative association with LF/HF [ 18 , 19 ]. Two studies reported significant positive associations with LF [ 17 , 19 ].…”

“…Low HRV indicates that there is a reduction in parasympathetic cardiac control. This has been associated with type 2 diabetes (T2D), with traditional/Metabolic syndrome (MetS) and non-traditional cardiovascular risk factors (stress, cortisol level, inflammatory biomarkers) [ 5 , 6 ]. MetS or pre-diabetes is the clustering of metabolic risk factors (CMRF) including high blood pressure (BP), high triglyceride (TGs) levels, low/high density lipoprotein (HDL), high fasting glucose levels (FGL), high waist circumference (WC) and high/low density lipoprotein (LDL) [ 7 ].…”

The role of lifestyle and non-modifiable risk factors in the development of metabolic disturbances from childhood to adolescence

“…As a consequence of the worldwide obesity epidemic, metabolic disturbances such as dyslipidemia, hypertension, and insulin resistance are on the rise already in childhood and adolescence and the prevalence of metabolic syndrome (MetS) in children is also increasing [ 1 ]. Lifestyle factors such as a high consumption of processed and snack foods and a low consumption of vegetables and wholemeal products [ 2 , 3 ], lack of physical activity (PA), high levels of media use and sedentary behaviors (SB) [ 4 , 5 ] as well as low well-being e.g., due to psychosocial stress [ 6 , 7 ] are associated with an increased risk for overweight, obesity and metabolic disturbances. Apart from lifestyle, non-modifiable 1 risk factors such as family history of MetS components, parental education, maternal body mass index (BMI), breastfeeding duration, birth weight as well as pubertal development also influence the risk of metabolic disturbances [ 8 – 12 ].…”