Cortisol Profiles in Obese Children

Dysregulation of the Hypothalamic-Pituitary-Adrenal Axis and Its Effect on Anxiety and Depression

Sad looking obese young boyIt’s an unfortunate occurrence that obese children often also develop anxiety and/or depression—and those conditions can exacerbate the metabolic and cardiovascular risks that come with obesity.

The pathophysiology of anxiety, depression, and obesity could all be tied to dysregulation of the hypothalamic-pituitary-adrenal axis; depending on a child’s level of psychological distress, differing levels of cortisol concentrations are seen.

To further examine this connection, researchers looked at the cortisol profiles of obese children (those with and without anxiety and depression).  Their study was published online on April 30, 2012, in an article titled “Circadian cortisol profiles, anxiety and depressive symptomatology, and body mass index in a clinical population of obese children.”  It will be published in the journal Stress.

In the study, there were 128 children; 53% were female, and the mean age ± SD was 11.2 ± 2.2 years.  All children were patients at a pediatric obesity clinic.  There was also a control group of non-obese children.

Using appropriate instruments, symptoms of anxiety and depression were studied in the children.  Also, the researchers measured morning serum and 5 diurnal salivary cortisol concentrations.

It was seen that obese children were 3.1 times more likely than the control group to report state anxiety; they were 2.3 times more likely to report trait anxiety.  Additionally, it was 3.6 times more likely that they would report symptoms associated with depression.

A significant positive correlation was noted between trait anxiety and noon salivary cortisol concentrations (p = 0.002).

Obese children with anxiety and/or depression had higher overall salivary cortisol concentrations than obese children without any affective imorbidty (p = 0.02); they also had higher overall salivary cortisol concentrations than obese children with anxiety and depression co-morbidity (p = 0.02).

This study shows that obese children who experience anxiety and/or depression may have changes in their circadian cortisol profiles—changes that may reflect a possible pathway for further psychological morbidity.  The researchers recommend longitudinal studies to examine the role of cortisol in linking obesity anxiety, and depression to developing more psychological and physical morbidity.

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