رابطة سطح سرمی کورتیزول و ویتامین C با چاقی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناس‌ارشد علوم تغذیه. گروه تغذیه، دانشکدة علوم تغذیه و صنایع غذایی، دانشگاه علوم پزشکی شهید بهشتی تهران، ایران.

2 دکترای علوم تغذیه.گروه تغذیه بالینی و رژیم درمانی، دانشکدة علوم تغذیه و صنایع غذایی، دانشگاه علوم پزشکی شهید بهشتی تهران، ایران.

چکیده

زمینه و هدف: افزایش سطح کورتیزول بدنبال استرس، در پرخوری استرسی و نهایتا چاقی، نقش دارد. از سویی دیگر، افراد دارای سطح سرمی بالای ویتامین C، نشانه­های استرس بدنی و ذهنی کمتری نشان می­دهند و سطح کورتیزول پایین­تری دارند. هدف مطالعه حاضر تعیین رابطه بین سطح سرمی کورتیزول و ویتامین C با چاقی است.                                                                                                                                                                                                   
روش بررسی: در این مطالعة مورد- شاهدی، 140 زن سالم (46 زن چاق و 94 زن دارای وزن طبیعی) 17 تا 44 ساله به روش نمونه­گیری متوالی و آسان انتخاب شد. چاقی به صورت Kg/m2 30 ≤ BMI و چاقی شکمی به صورت دور کمر 88  ≥سانتی­متر تعریف شد. سطح سرمی ویتامین C به روش شیمیایی و سطح کورتیزول با روش الایزا اندازه­گیری شد. از آنجایی که افسردگی، اضطراب و نگرش غذایی منجر به افزایش ترشح کورتیزول می­شوند، نقش آنها به­عنوان فاکتورهای مخدوش­کننده در این مطالعه در نظر گرفته شد. داده­ها با استفاده از آزمون t و رگرسیون لجستیک مورد تجزیه و تحلیل قرار گرفت.  
یافته­ها: ارتباط معناداری بین سطح سرمی ویتامینC با BMI مشاهده نشد (07/0=P). بعد از تعدیل اثر عوامل مخدوش­گر، زنانی که در بالاترین سهک سطح سرمی کورتیزول قرار داشتند، احتمال کمتری برای چاقی عمومی (نسبت شانس: 2/0، 05/0=P) و چاقی شکمی (نسبت شانس:2/0، 02/0=P) داشتند.
نتیجه­گیری: در مطالعة حاضر ارتباط معکوسی بین سطح سرمی کورتیزول صبحگاهی با چاقی عمومی و شکمی وجود داشت، در حالی­که رابطه­ای بین سطح سرمی ویتامین C با چاقی مشاهده نشد. تا جایی که ما می­دانیم، این نوع مطالعه برای اولین بار در زنان ایرانی انجام شده است و مطالعات بیشتری برای تعیین ماهیت این رابطه نیاز است. 

کلیدواژه‌ها


1-Farag NH, Moore WE, Lovallo WR, Mills PJ, Khandrika S, Eichner JE. Hypothalamic-pituitary-adrenal axis function: relative contributions of perceived stress and obesity in women. J Womens Health 2008; 17 suppl 10: 1647-55.
2-Torres SJ, Nowson CA. Relationship between stress, eating behaviour and obesity. Nutrition 2007, 23: 887-894.
3-Pasquali R, Cantobelli S, Casimirri F, Capelli M, Bortoluzzi L, Flamia R, Labate AM, Barbara L. The hypothalamic-pituitary-adrenal axis in obese women with different patterns of fat distribution. J Clin Endocrinol Metab 1993; 77: 341-346.
4-Mårin 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.
5-Strain GW, Zumoff B, Kream J, Strain JJ, Levin J, Fukushima D. Sex differences in the influence of obesity on the 24 hr mean plasma concentration of cortisol. Metabolism 1982; 31: 209-212.
6-Björntorp P, Rosmond R. Neuroendocrine abnormalities in visceral obesity. Int J Obes Relat Metab Disord 2000; 24 Suppl 2: S80-S85.
7-Duclos M, Pereira PM, Barat P, Gatta B, Roger P. Increased cortisol bioavailability, abdominal obesity, and the metabolic syndrome in obese women. Obes Res 2005; 13: 1157-1166.
8-Bjőrntorp, P and Rosmond, R. Obesity and Cortisol. Nutr J 2000; 16 suppl 10: 924-936.
9-Wong T, Harber V. Lower excess post exercise oxygen consumption and altered growth hormone and cortisol responses to exercise in obese men. The J of Clin Endocrinol & Metab 2006; 91suppl 2: 678-686.
10-Paul, M. Stewart, Abigall Boulton, Sudhesh Kumar, Penny M.S. Clark, and Cedri H.L. Shackleton. Cortisol metabolism in human obesity: Impaired Cortisone-Cortisol conversion in subjects with Central Adiposity. J Clin Endocrinol & Metab 1999;  84 suppl 3: 1022-1028.
11-Johnston CS, Beezhold BL, Mostow B, Swan PD. Plasma Vitamin C Is Inversely Related to Body Mass Index and Waist Circumference but Not to Plasma Adiponectin in Nonsmoking Adults. J. Nutr 2007; 137: 1757–1762.
12-Canoy D, Wareham N, Welch A, Bingham S, Luben R, Day N, Khaw KT. Plasma ascorbic acid concentrations and fat distribution in 19,068 British men and women in the European Prospective Investigation into Cancer and Nutrition Norfolk cohort study. Am J Clin Nutr 2005; 82: 1203–1209.
13-Gallagber ML. The nutrients and their metabolism. In: Mahan LK, Escott-Stump S (eds). Krauses Food and Nutrition Therapy. 12th ed. Canada: Saunders Press; 2008: 95-97.
14-Vicennati V, Pasquali R. Abnormalities of the hypothalamic-pituitary-adrenal axis in nondepressed women with abdominal obesity and relations with insulin resistance: evidence for a central and a peripheral alteration. J Clin Endocrinol Metab 2000; 85(11): 4093-8.
15-Sample size calculation: influence of confounding and interaction effects, By Kwok Ho Tse, Hong Kong University of Science and Technology, 2006, Page 173.
16-Tashakkori A, Barefoot J, Mehryar AH. What does the Beck Depression Inventory measure in college students? Evidence from a non-western culture. J Clin Psychol 1989; 45: 595–602.
17-Afzali  A, Delavar A, Borjali A, Mirzamani M. Psychometric properties of DASS-42 as assessed in a sampel of kermanshah high school students. Journal of Research In Behavioural Sciences 2007; 5: 81-92.
18-Babaei S, Khodapanahi MK, Saleh SB. Validating and investigating reliability of the Eating Attitude Test. Journal of  Behavioural Sciences 2007; 1 suppl 1: 61-68.
19-Expert WHO Committee on Physical Status. The use and interpretation of anthropometry. Report of WHO expert committee. Geneva: WHO; 1995.
20-World Health Organisation. Measuring Obesity-Classification and Description of Anthropometric Data. Report on a WHO Consultation of the Epidemiology of Obesity. Copenhagen, Denmark: Nutrition Unit WHO, EUR/FHA; 1989.
21-Le Roux CW, Meeran K, Aghband-Zadeh J: Is a 0900-h serum cortisol useful prior to a short synacthen test in outpatient assessment? Ann Clin Biochem 2002; 39: 148-150.
22-Lowry OH, Lopez JA, Bessey OA. The  determination of ascorbic acid in small amounts of blood serum. J Biol Chem 1945; 160: 609-615.
23-Wani TA, Samad A, Tandon M, Saini GS, Sharma PL, Pillai KK. The Effects of Rosuvastatin on the Serum Cortisol, Serum Lipid, and Serum Mevalonic Acid Levels in the Healthy Indian Male Population. AAPS Pharm Sci Tech 2010; 11(1): 425-32.
24-Esmaillzadeh A, Azadbakht L. Major dietary patterns in relation to general obesity and central adiposity among Iranian women. J Nutr 2008; 138: 358-63.
25-Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA, et al. Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr 1991; 45(12): 569-81.
26-Johansson L, Solvoll K, Bjorneboe GE, Drevon CA. Under- and overreporting of energy intake related to weight status and lifestyle in a nationwide sample. Am J Clin Nutr 1998; 68(2): 266-74.
27-Aadalh M, Jorgensen T. Validation of a new self-repot instrument for measuring physical activity. Med Sci Sports Exerc 2003; 35: 1196-202.
28-Kelishadi R, Ardalan G, Gheiratmand R, Gouya MM, Razaghi EM, Delavari A, et al. Association of physical activity and dietary behaviors in relation to the body mass index in a national sample of Iranian children and adolescents: CASPIAN Study. Bull World Health Organ 2007; 85: 19-26.
29-Duclos M, Cordcuff J-B, Etcheverry N, Rashedi M, Tabarin A, Roger P. Abdominal obesity increases overnight cortisol excretion. J Endocrinol Invest 1999; 22: 465-471.
30-Larsson CA, Gullberg B, Råstam L, Lindblad U.  Salivary cortisol differs with age and sex and shows inverse associations with WHR in Swedish women: a cross-sectional study. BMC Endocr Disord 2009; 9: 16. 
31-Grossniklaus DA, Gary RA, Higgins MK, Dunbar SB. Biobehavioral and psychological differences between overweight adults with and without waist circumference risk. Res Nurs Health 2010; 33 suppl 6: 539-51.
32-Kumari M, Chandola T, Brunner E, Kivimaki M. A nonlinear relationship of generalized and central obesity with diurnal cortisol secretion in the Whitehall II study. J Clin Endocrinol Metab 2010; 95 suppl 9: 4415-23. 
33-Fraser R, Ingram MC, Anderson NH, Morrison C, Davies E, Connell JM. cortisol effects on body mass, blood pressure, and cholesterol in general population. Hypertension. 1999; 33 suppl 6: 1364-8.  
34-Fall CH, Dennison E, Cooper C, Pringle J, Kellingray SD, Hindmarsh P  Does birth weight predict adult serum cortisol concentrations? Twenty-fourhour profiles in the United Kingdom 1920–1930 Hertfordshire Birth Cohort. J Clin Endocrinol Metab 2002; 87: 2001-2007.
35-Ranjit N, Young EA, Raghunathan TE, Kaplan GA. Modeling cortisol rhythms in a population-based study. Psychoneuroendocrinology 2005; 30: 615-624.
36-Steptoe A, Kunz-Ebrecht SR, Brydon L, Wardle J.  Central adiposity and cortisol responses to waking in middle-aged men and women. Int J Obes Relat Metab Disord 2004; 28: 1168-1173.
37-Pedersen SB, Jonler M, Richelsen B. Characterization of regional and gender differences in glucocorticoid receptors and lipoprotein lipase activity in human adipose tissue. J Clin Endocrinol Metab 1994, 78:1354-1359.
38-Andrew R, Phillips DI, Walker BR. Obesity and gender influence cortisol secretion and metabolism in men. J Clin Endocrinol Metab 1998, 83:1806-1809.
39-Stewart PM, Boulton A, Kumar S, Clark PM, Shackleton CH: Cortisol metabolism in human obesity: Impaired cortisone cortisol conversion in subjects with central adiposity. J Clin Endocrinol Metab 1999; 84: 1022-1027.
40-Clasey JL, Bouchard C, Teates CD, Riblett JE, Thorner MO, Hartman ML, Weltman A: The use of anthropometric and dual-energy X-ray absorptiometry (DXA) measures to estimate total abdominal and abdominal visceral fat in men and women. Obes Res 1999; 7: 256-264.
41-Kudielka BM, Buske-Kirschbaum A, Hellhammer DH, Kirschbaum C. HPA axis responses to laboratory psychosocial stress in healthy elderly adults, younger adults, and children: impact of age and gender. Psychoneroendocrinology 2004; 29: 83-98.
42-Giordano R, Bo M, Pellegrino M, Vezzari M, Baldi M, Picu A, Balbo M, Bonelli L, Migliaretti G, Ghigo E, Arvat E. Hypothalamus-pituitaryadrenal hyperactivity in human aging is partially refractory  to stimulation by mineralocorticoid receptor blockade. J Clin Endocrinol Metab 2005; 90: 5656-5662.
43-Tomiyama AJ, Mann T, Vinas D, Hunger JM, DeJager J, Taylor S. Low Calorie Dieting Increases Cortisol. Psychosom Med 2010; 72 suppl 4: 357-364.
44-Drewnowski A, Rock CL, Henderson SA, Shore AB, Fischler C, Galan P, Pereziosi P, Hercberg S. Serum β-carotene and vitamin C as biomarkers of vegetable and fruit intakes in a community based sample of French adults. Am J Clin Nutr 1997; 65: 1796-802.   
45-Aasheim ET, Hofsø D, Hjelmesaeth J, Birkeland KI, Bøhmer T. Vitamin status in morbidly obese patients: a cross-sectional study. Am J Clin Nutr 2008; 87 suppl 2: 362-9.  
46-Ondrak KS, McMurray RG, Hackney AC, Harrell JS. Interrelationships among changes in leptin, insulin, cortisol and growth hormone and weight status in youth. J Clin Res Pediatr Endocrinol 2011; 3 suppl 1: 22-8.