Download PDF
Exp Clin Endocrinol Diabetes 2005; 113(8): 444-450
DOI: 10.1055/s-2005-865709
Article

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Relationship between Metabolic Parameters, Blood Pressure, and Sympathoendocrine Function in Healthy Young Adults with Low Birth Weight

G. Weitz1 , P. Wellhoener1 , S. Heindl1 , H. L. Fehm1 , C. Dodt1
  • 1Department of Internal Medicine I, Medical University of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
Further Information

Publication History

Received: October 19, 2004 First decision: March 22, 2005

Accepted: May 2, 2005

Publication Date:
08 September 2005 (online)

Also available at
    Permissions and Reprints

Abstract

The association between low birth weight (LBW) and elevated blood pressure has been attributed to disturbances in the endocrine and sympathetic nervous system. The present study focussed on parameters of cardiovascular and sympathetic function and on adrenocortical activity in 24 healthy subjects aged 20 - 30 years with a birth weight of less than 2500 g at term and a control group of 24 subjects with a normal birth weight (NBW; 3200 - 3700 g) who were thoroughly matched for gender, body mass index (BMI), and age. Blood pressure, heart rate, and insulin resistance (calculated according to the homeostasis model assessment) were determined. Additionally, free salivary cortisol was measured at 08 : 00 am and 11 : 00 pm. In 13 subjects of each group, muscle sympathetic nerve activity (MSNA) was measured microneurographically at rest and after baroreflex stimulation by nitroprusside (12 NBW and 9 LBW subjects). Metabolic parameters, blood pressure, and salivary cortisol did not differ between LBW and NBW subjects. MSNA was significantly lower in the LBW group. In both groups insulin resistance correlated positively with BMI and negatively with morning cortisol. In the LBW group, but not the NBW group, systolic and diastolic blood pressure correlated positively with BMI and insulin resistance, and negatively with morning salivary cortisol. A correlation between morning salivary cortisol and the MSNA was only found in NBW subjects. This positive correlation strengthened when MSNA was stimulated by nitroprusside administration. However, in the same maneuvre a negative correlation between morning salivary cortisol and MSNA was observed in the LBW group. The data indicate that insulin resistance depends on the same factors in LBW and NBW subjects. In LBW subjects the interplay between adrenocortical and sympathetic activity is altered. Furthermore, LBW subjects differ from the NBW group in their significant interrelationship between blood pressure and metabolic factors.

Key words

Low birth weight - salivary cortisol - insulin resistance - blood pressure

References

  • 1 Barbazanges A, Piazza P V, Le Moal M, Maccari S. Maternal glucocorticoid secretion mediates long-term effects of prenatal stress.  J Neurosci. 1996;  16 3943-3949
    PubMedGoogle Scholar
  • 2 Barker D JP, Osmond C, Golding J, Kuh D, Wadsworth M EJ. Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease.  BMJ. 1989;  298 564-567
    CrossrefPubMedGoogle Scholar
  • 3 Boguszewski M C, Johannsson G, Fortes L C, Sverrisdottir Y B. Low birth weight and final height predict high sympathetic nerve activity in adulthood.  J Hypertens. 2004;  22 1157-1163
    CrossrefPubMedGoogle Scholar
  • 4 Brown M R, Fisher L A. Glucocorticoid suppression of the sympathetic nervous system and the adrenal medulla.  Life Sci. 1986;  39 1003-1012
    CrossrefPubMedGoogle Scholar
  • 5 Chrousos G P. The role of stress and the hypothalamic-pituitary-adrenal axis in the pathogenesis of the metabolic syndrome: neuro-endocrine and target tissue-related causes.  Int J Obes. 2000;  24 S50-S55
    CrossrefPubMedGoogle Scholar
  • 6 Clark P M, Hindmarsh P C, Shiell A W, Law C M, Honour J W, Barker D JP. Size at birth and adrenocortical function in childhood.  Clin Endocrinol. 1996;  45 721-726
    CrossrefPubMedGoogle Scholar
  • 7 Dallman M F. Stress update. Adaptation of the hypothalamic-pituitary-adrenal axis to chronic stress.  Trends Endocrinol Metab. 1993;  4 62-69
    PubMedGoogle Scholar
  • 8 Dodt C, Keyser B, Mölle M, Fehm H L, Elam M. Acute suppression of muscle sympathetic nerve activity by hydrocortisone in humans.  Hypertension. 2000;  35 758-763
    PubMedGoogle Scholar
  • 9 Dodt C, Wallin G, Fehm H L, Elam M. The stress hormone adrenocorticotropin enhances sympathetic outflow to the muscle vascular bed in humans.  J Hypertens. 1998;  16 195-201
    CrossrefPubMedGoogle Scholar
  • 10 Fall C HD, Dennison E, Cooper C, Pringle J, Kellingray S D, Hindmarsh P. Does birth weight predict adult serum cortisol concentrations? Twenty-four-hour profiles in the United Kingdom 1920 - 1930 Hertfordshire birth cohort.  J Clin Endocrinol Metab. 2002;  87 2001-2007
    CrossrefPubMedGoogle Scholar
  • 11 Ferrannini E. Physiological and metabolic consequences of obesity.  Metabolism. 1995;  44 15-17
    PubMedGoogle Scholar
  • 12 Grassi G, Seravalle G, Dell'Oro R, Turri C, Pasqualinotto L, Colombo M, Mancia G. Participation of the hypothalamus-hypophysis axis in the sympathetic activation of human obesity.  Hypertension. 2001;  38 1316-1320
    PubMedGoogle Scholar
  • 13 IJzerman R G, Stehouwer C DA, de Geus E J, van Weissenbruch M M, Delemarre-van de Waal H A, Boomsma D I. Low birth weight is associated with increased sympathetic activity-dependence on genetic factors.  Circulation. 2003;  108 566-571
    CrossrefPubMedGoogle Scholar
  • 14 Kajantie E, Eriksson J, Osmond C, Wood P J, Forsén T, Barker D JP, Phillips D IW. Size at birth, the metabolic syndrome and 24-h salivary cortisol profile.  Clin Endocrinol. 2004;  60 201-207
    CrossrefPubMedGoogle Scholar
  • 15 Levitt N S, Lambert E V, Woods D, Hales C N, Andrew R, Seckl J R. Impaired glucose tolerance and elevated blood pressure in low birth weight, nonobese, young South African adults: early programming of cortisol axis.  J Clin Endocrinol Metab. 2000;  85 4611-4618
    CrossrefPubMedGoogle Scholar
  • 16 Ljung T, Andersson B, Bengtsson B A, Björntorp P, Marin P. Inhibition of cortisol secretion by dexamethasone in relation to body fat distribution: a dose response study.  Obes Res. 1996;  4 277-282
    PubMedGoogle Scholar
  • 17 Marin P, Darin N, Amemiya T, Andersson B, Jern S, Björntorp P. Cortisol secretion in relation to body fat distribution in obese premenopausal women.  Metabolism. 1992;  41 882-886
    CrossrefPubMedGoogle Scholar
  • 18 Matthews D R, Hosker J P, Rudenski A S, Naylor B A, Treacher D F, Turner R C. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.  Diabetologica. 1985;  28 412-419
    Google Scholar
  • 19 Nilsson P M, Ostergren P O, Nyberg P, Soderstrom M, Allebeck P. Low birth weight is associated with elevated systolic blood pressure in adolescence: a prospective study of a birth cohort of 149 378 Swedish boys.  J Hypertens. 1997;  15 1627-1631
    CrossrefPubMedGoogle Scholar
  • 20 Phillips D IW, Barker D JP, Fall C HD, Seckl J R, Whorwood C B, Walker B R. Elevated plasma cortisol concentrations: a link between low birth weight and the insulin resistance syndrome?.  J Clin Endocrinol Metab. 1998;  83 757-760
    CrossrefPubMedGoogle Scholar
  • 21 Phillips D IW, Walker B R, Reynolds R M, Flanagan D EH, Wood P J, Osmond C, Barker D JP, Whorwood C B. Low birth weight predicts elevated plasma cortisol concentrations in adults from 3 populations.  Hypertension. 2000;  35 1301-1306
    CrossrefPubMedGoogle Scholar
  • 22 Reynolds R M, Walker B R, Syddall H E, Andrew R, Wood P J, Whorwood C B, Phillips D IW. Altered control of cortisol secretion in adult men with low birth weight and cardiovascular disease.  J Clin Endocrinol Metab. 2001;  86 245-250
    PubMedGoogle Scholar
  • 23 Rosmond R, Björntorp P. Blood pressure in relation to obesity, insulin and the hypothalamic-pituitary-adrenal axis in Swedish men.  J Hypertens. 1998;  16 1721-1726
    CrossrefPubMedGoogle Scholar
  • 24 Rosmond R, Dallman M F, Björntorp 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
    CrossrefPubMedGoogle Scholar
  • 25 Rosmond R, Wallerius S, Wanger P, Martin L, Holm G, Björntorp P. A 5-year follow-up study of disease incidence in men with an abnormal hormone pattern.  J Intern Med. 2003;  254 386-390
    CrossrefPubMedGoogle Scholar
  • 26 Scherrer U, Vollenweider P, Randin D, Jequier E, Nicod P, Tappy L. Suppression of alcohol-induced sympathetic activation and vasodilatation by dexamethason in humans.  Circulation. 1993;  88 388-394
    PubMedGoogle Scholar
  • 27 Spraul M, Ravussin E, Fontvieille A M, Rising A, Larson D E, Anderson E A. Reduced sympathetic nervous activity. A potential mechanism predisposing to body weight gain.  J Clin Invest. 1993;  92 1730-1735
    PubMedGoogle Scholar
  • 28 Uiterwaal C S, Anthony S, Launer L J, Witteman J C, Trouwborst A M, Hofman A, Grobbee D E. Birth weight, growth and blood pressure: an annual follow-up study of children aged 5 through 21 years.  Hypertension. 1997;  30 267-271
    PubMedGoogle Scholar
  • 29 Weitz G, Deckert P, Heindl S, Struck J, Perras B, Dodt C. Evidence for lower sympathetic nerve activity in young adults with low birth weight.  J Hypertens. 2003;  21 943-950
    CrossrefPubMedGoogle Scholar
  • 30 Young J B, Morrison S F. Effects of fetal and neonatal environment on sympathetic nervous system development.  Diabetes Care. 1998;  21 (Suppl 2) B156-B160
    PubMedGoogle Scholar

Dr. Gunther Weitz

Department of Internal Medicine I
Medical University of Schleswig-Holstein
Campus Lübeck

Ratzeburger Allee 160

23538 Lübeck

Germany

Phone: + 494515002351

Fax: + 49 45 15 00 33 66

Email: gunther.weitz@ukl.uni-luebeck.de

      >