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Title: [Developmental characteristics of circadian rhythms in hypothalamic-pituitary-adrenal axis during puberty].
Author: Duan XN, Yan SQ, Wang SM, Hu JJ, Fang J, Gong C, Wan YH, Su PY, Tao FB, Sun Y.
Journal: Zhonghua Liu Xing Bing Xue Za Zhi; 2018 Aug 10; 39(8):1086-1090. PubMed ID: 30180433.
Abstract:
Objective: To explore the developmental characteristics of circadian rhythms in hypothalamus-pituitary-adrenal (HPA) axis during puberty. Methods: A total of 1 070 students from Grade 2-3 in 3 primary schools in Ma'anshan city, Anhui province, were selected for physical examination and circadian rhythm of HPA axis checked from 2015 to 2017. Saliva samples were collected at each of the following three time points: immediately upon wakening, 30 minutes after wakening and bedtime, with the index of circadian rhythm of HPA axis calculated, which including cortisol awake response (CAR), cortisol in puberty priming and diurnal cortisol slope (DCS). Testicular volume, palpation and visual inspection of breast development were used to assess the state of purbety development on boys and girls. Information on gender, date of birth, time to fall asleep, wake-up time and weekly physical activity were gathered through questionnaire survey. Non-parametric test was used to compare the differences of baseline, follow-up period and different adolescent developmental processes of each index on circadian rhythm of HPA axis. Results: During the period of follow-up program and comparing with the continuous undeveloped group, CAR and the changes of CAR showed significantly increase, both in the puberty priming group and continuous development group, with statistically significant differences (CAR: Z=8.551, 4.680, respectively; P<0.01; the changes of CAR: Z=4.079, 2.700, respectively, P<0.01). There were no significant differences noticed in CAR and the changes of CAR between puberty priming group or continuous development group. The area under the curve (AUC) of cortisol in puberty priming group was slightly higher than that in the persistent undeveloped group (Z=2.591, P=0.010). Both the changes of daily cortisol slope (DCS) in puberty priming group and continuing developed group decreased significantly, when comparing with those in continuous undeveloped group (Z=-2.450, Z=-2.151; all P<0.05). There was no significant difference noticed in the changes of cortisol in puberty priming and DCS between different puberty development stages (the changes of AUC: χ(2)=2.747, P=0.253; DCS: χ(2)=4.554, P=0.032). Conclusions: The indexes of circadian rhythm of HPA axis were associated with the development of puberty. Both the cortisol awakening response and the total amount of diurnal cortisol secretion showed an increase, along with the puberty development. The change of diurnal cortisol slope declined with the development of puberty. 目的： 描述下丘脑-垂体-肾上腺（HPA）轴昼夜节律指标随青春期发育变化的特征。 方法： 2015年10月选择安徽省马鞍山市3所小学1 070名2~3年级学生为研究对象，并于2016年和2017年开展随访调查。调查内容包括体格发育、青春期发育和HPA轴昼夜节律。收集清晨觉醒时、醒后30 min和晚上入睡时3个时点唾液样本，并计算HPA轴昼夜节律指标：皮质醇觉醒应答（CAR）、昼间皮质醇总分泌量及昼夜皮质醇斜率（DCS）。采用睾丸容积、乳房发育分别评价男女童青春期发育阶段。采用问卷调查收集出生日期、入睡与起床时间和每周体力活动等信息。采用非参数检验比较HPA轴昼夜节律基线各指标在基线、随访期及不同青春期发育进程中的差异。 结果： 随访期间，青春期发育启动组和持续发育组CAR值、CAR变化值均高于与持续未发育组，差异有统计学意义（CAR：Z值分别为8.551和4.680，均P<0.01；CAR变化值：Z值分别为4.079和2.700，均P<0.01）；青春期启动组昼间皮质醇总分泌量高于持续未发育组，差异有统计学意义（Z=2.591，P=0.010）。与持续未发育组相比，DCS变化值在青春期启动组和持续发育组中下降明显，差异有统计学意义（Z=-2.450，Z=-2.151；均P<0.05）。昼间皮质醇总分泌量变化值与DCS在不同青春期发育进程组儿童中差异无统计学意义（昼间皮质醇总分泌量变化值：χ(2)=2.747，P=0.253；DCS：χ(2)=4.554，P=0.032）。 结论： HPA轴昼夜节律指标与青春期发育有关，CAR、昼间皮质醇总分泌量随青春期发育进行而升高，昼间皮质醇差值随青春期发育而下降。.

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