Normal cortisol response to cold pressor test, but lower free thyroxine, after recovery from undernutrition

Normal cortisol response to cold pressor test, but lower free thyroxine, after recovery from undernutrition

Author Martins, Vinícius José Baccin Autor UNIFESP Google Scholar
Neves, Andréa Prisco de Oliveira Autor UNIFESP Google Scholar
Garcia, Márcia Carvalho Autor UNIFESP Google Scholar
Spadari-Bratfisch, Regina Celia Autor UNIFESP Google Scholar
Clemente, Ana Paula Grotti Google Scholar
Albuquerque, Maria Paula de Autor UNIFESP Google Scholar
Hoffman, Daniel Jay Google Scholar
Sawaya, Ana Lydia [UNIFESP Google Scholar
Abstract Undernutrition is a stressor with long-term consequences, and the effect of nutritional recovery on cortisol and thyroid hormone status is unknown. To investigate basal thyroid hormones and the cortisol response to a cold pressor test in children recovered from undernutrition, a cross-sectional study was undertaken on children (6-16 years) separated into four groups: control (n 41), stunted (n 31), underweight (n 27) and recovered (n 31). Salivary cortisol was collected over the course of 10 h: upon awakening, before and after an unpleasant and a pleasant stimulus. Cortisol upon awakening was highest in the stunted and lowest in the underweight groups: control = 5.05 (95 % CI 3.71, 6.89) nmol/l, stunted = 6.62 (95 % CI 3.97, 11.02) nmol/l, underweight=2.51 (95 % CI 1.75, 3.63) nmol/l and recovered = 3.46 (95 % CI 2.46, 4.90) nmol/l (P = 0.005). Girls had higher cortisol concentrations upon awakening compared with boys (P=0.021). The undernourished groups showed an elevated cortisol response both to the unpleasant stimulus and at the last measurement (16.00 hours) compared with that of the recovered group: AUC, control= 2.07 (95 % CI 1.69, 2.45) nmol/l x 30 min, stunted = 2.48 (95 % CI 1.91, 3.06) nmol/l x 30 min, underweight=2.52 (95 % CI 2.07, 2.97) nmol/l x 30 min, recovered = 1.68 (95 % CI 1.26, 2.11) nmol/l x 30 min (P= 0.042)

and control= 2.03 (95 % CI 1.75, 2.39) nmol/l x 30 min, stunted = 2.51 (95 % CI 1.97, 3.19) nmol/l x 30 min, underweight=2.61 (95 % CI 2.16, 3.16) nmol/l x 30 min, recovered= 1.70 (95 % CI 1.42, 2.03) nmol/l x 30 min (P= 0.009). Lower free thyroxine (T4) was found in the recovered and stunted groups: control= 1.28 (95 % CI 1.18, 1.39) pmol/l, stunted = 0.98 (95 % CI 0.87, 1.10) pmol/l, underweight = 1.10 (95 % CI 1.01, 1.21) pmol/l and recovered= 0.90 (95 % CI 0.83, 0.99) pmol/l (P < 0.001). Multivariate analysis showed a lower cortisol concentration along 10 h (06.00-16.00 hours) in the recovered compared with the other groups (P = 0.017), and similar concentrations between the recovered and control group. In conclusion, the children with recovery in weight and height had a cortisol stress response similar to control but a lower basal free T4. Longitudinal studies are warranted to determine the extent of these endocrine changes after recovery of undernutrition and in adulthood.
Keywords Cortisol Stress Response
Thyroid Status
Nutritional RecoveryPituitary-Adrenocortical Axis
Malnourished Children
Nutritional Recovery
Energy Homeostasis
Short Stature
Language English
Sponsor Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP), Brazil) [2010/51237-2]
Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)
Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) [302740/2010-4]
Grant number FAPESP: 2010/51237-2
CNPq: 302740/2010-4
Date 2016
Published in British Journal Of Nutrition. Cambridge, v. 115, n. 1, p. 14-23, 2016.
ISSN 0007-1145 (Sherpa/Romeo, impact factor)
Publisher Frontiers Media Sa
Extent 14-23
Access rights Closed access
Type Article
Web of Science ID WOS:000367234800003

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