Salivary Cortisol does not Correlate with Metabolic Syndrome Markers or Subjective Stress in Overweight Children

Abstract

Objective Being overweight is a risk factor for metabolic syndrome in children, but not all overweight children develop metabolic syndrome. Cortisol excess from chronic psychological stress has been proposed as an independent risk factor for metabolic syndrome in this already at-risk population. The present study assesses the relationship of biochemical and body composition radiographic markers of metabolic syndrome to salivary cortisol and self-report of chronic psychological stress in a cohort of overweight children. Methods This cross-sectional study took place in a multi-disciplinary pediatric obesity clinic at a tertiary care hospital, and involved fifteen children with BMI at or above the 85th percentile for age and sex, 10 of whom provided salivary cortisol samples. The main outcomes measured were salivary bedtime cortisol, first-waking cortisol, and cortisol awakening response (CAR–the rise in cortisol in the first half hour after waking); fasting serum triglycerides, HDL cholesterol, glucose and insulin for HOMA-IR; the ratio of abdominal fat to total body fat by DXA scan; and scores of validated stress and bullying questionnaires (PANAS-C, PSS, and SEC-Q). Results In this pilot study, no correlation was found between salivary cortisol measures and questionnaire scores of subjective stress or bullying, and no correlation was found between any of these measures and markers of metabolic syndrome (dyslipidemia, insulin resistance, increased abdominal fat). Conclusions These results suggest that measures of psychological stress, whether biochemical or subjective, do not appear to predict risk of metabolic syndrome in overweight children. While ease of collection and demonstrated utility both in detection of pediatric Cushing disease and in adult psychological research make salivary cortisol assessment an attractive clinical tool, further investigation into the value of salivary measures in pediatric stress research is needed.

Prenatal and childhood predictors of hair cortisol concentration in mid-childhood and early adolescence

“…Moreover, other studies also did not observe any associations between these anthropometric measures and HCC in children [49,50]. We also did not observe any prospective or cross-sectional associations of overall metabolic risk with HCC outcomes, which is generally consistent with previous studies that examined some of these relationships using hair, urinary, or salivary cortisol [44,51,52]. Our results therefore suggest that adiposity and cardiometabolic health may not be strong determinants of HCC in children.…”

Behavior Characteristics and Risk for Metabolic Syndrome Among Women in Rural Communities in China

“…30,31 In contrast to sleep, there is a lack of agreement on the relationship between stress and MetS. Although some investigators found no correlation between cortisol levels and risk of MetS, 32,33 others found a positive relationship between psychosocial stress and an increased risk of MetS. 34,35 Unhealthy lifestyles, including unhealthy diet and sedentary behavior, may increase the risk of MetS.…”