{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T02:04:08Z","timestamp":1778292248047,"version":"3.51.4"},"reference-count":68,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T00:00:00Z","timestamp":1678492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004281","name":"National Science Centre, Poland","doi-asserted-by":"publisher","award":["2022\/06\/X\/NZ5\/01633"],"award-info":[{"award-number":["2022\/06\/X\/NZ5\/01633"]}],"id":[{"id":"10.13039\/501100004281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Prenatal alcohol exposure causes growth impairment and a wide range of developmental, physical, and cognitive disorders in children, collectively referred to as fetal alcohol spectrum disorders (FASDs). In the course of FASDs, abnormalities can also affect eating behavior and nutritional status, but these problems have received little attention. Therefore, the aim of our study was to determine the levels of hormones involved in the action of the hypothalamic\u2013pituitary\u2013adrenal axis: proopiomelanocortin (POMC), cortisol, and adrenocorticotropic hormone (ACTH), in the serum of patients with FASDs. To our knowledge, none of these hormones studied have yet been evaluated in FASDs to date. We investigated 62 FASD patients and 23 healthy controls by applying an enzyme-linked immunosorbent method (ELISA). Fasting POMC levels were significantly lower in patients with FASDs (10.97 vs. 18,57 ng\/mL, p = 0.039) compared to controls. However, there were no differences in cortisol concentrations. Additionally, the sex and subgroup status (fetal alcohol syndrome (FAS), neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE), and FASD risk) did not affect hormone levels. POMC was positively correlated with some clinical parameters such as age, BMI percentile, carbohydrate biomarkers, and ACTH. A positive correlation was observed between ACTH and cortisol levels, as well as ACTH and cholesterol levels. Data analysis showed no HPA axis abnormalities in the form of elevated serum cortisol and ACTH levels. Differences in POMC concentration may indicate the involvement and\/or impairment of central nervous system structures in hormonal alterations in FASD individuals, caused by prenatal alcohol exposure. Hormonal dysregulation in FASDs can contribute to reduced growth and development, as well as many other disturbed processes, including neurological\/neurodevelopmental dysfunctions. Further insightful studies involving a larger group of patients are needed to determine the potential impact of the measured hormones.<\/jats:p>","DOI":"10.3390\/nu15061366","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T02:31:55Z","timestamp":1678674715000},"page":"1366","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Association of the Hypothalamic-Pituitary-Adrenal Axis with Appetite Regulation in Children with Fetal Alcohol Spectrum Disorders (FASDs)"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7565-7184","authenticated-orcid":false,"given":"Rafa\u0142","family":"Podg\u00f3rski","sequence":"first","affiliation":[{"name":"Department of Biochemistry, Institute of Medical Sciences, Medical College of Rzeszow University, Warzywna 1a, 35-310 Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1129-3553","authenticated-orcid":false,"given":"Sabina","family":"Galiniak","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Institute of Medical Sciences, Medical College of Rzeszow University, Warzywna 1a, 35-310 Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5393-3515","authenticated-orcid":false,"given":"Artur","family":"Mazur","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Institute of Medical Sciences, Medical College of Rzeszow University, Warzywna 1a, 35-310 Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8326-4850","authenticated-orcid":false,"given":"Agnieszka","family":"Domin","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Institute of Medical Sciences, Medical College of Rzeszow University, Warzywna 1a, 35-310 Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1001\/jamapediatrics.2017.1919","article-title":"Global Prevalence of Fetal Alcohol Spectrum Disorder Among Children and Youth: A Systematic Review and Meta-Analysis","volume":"171","author":"Lange","year":"2017","journal-title":"JAMA Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/S0140-6736(73)91291-9","article-title":"Pattern of Malformation in Offspring of Chronic Alcoholic Mothers","volume":"1","author":"Jones","year":"1973","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e006323","DOI":"10.1136\/bmjopen-2014-006323","article-title":"Prevalence and Predictors of Alcohol Use during Pregnancy: Findings from International Multicentre Cohort Studies","volume":"5","author":"Kearney","year":"2015","journal-title":"BMJ Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e290","DOI":"10.1016\/S2214-109X(17)30021-9","article-title":"Estimation of National, Regional, and Global Prevalence of Alcohol Use during Pregnancy and Fetal Alcohol Syndrome: A Systematic Review and Meta-Analysis","volume":"5","author":"Popova","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1542\/peds.2014-2171","article-title":"Misdiagnosis and Missed Diagnoses in Foster and Adopted Children with Prenatal Alcohol Exposure","volume":"135","author":"Chasnoff","year":"2015","journal-title":"Pediatrics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e20154256","DOI":"10.1542\/peds.2015-4256","article-title":"Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders","volume":"138","author":"Hoyme","year":"2016","journal-title":"Pediatrics"},{"key":"ref_7","first-page":"e416","article-title":"Validation of THE fetal alcohol spectrum Disorder (FASD) 4-digit diagnostic code","volume":"20","author":"Astley","year":"2013","journal-title":"J. Popul. Ther. Clin. Pharmacol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1503\/cmaj.141593","article-title":"Fetal Alcohol Spectrum Disorder: A Guideline for Diagnosis across the Lifespan","volume":"188","author":"Cook","year":"2016","journal-title":"CMAJ"},{"key":"ref_9","first-page":"1-CE-4","article-title":"Guidelines for Identifying and Referring Persons with Fetal Alcohol Syndrome","volume":"54","author":"Bertrand","year":"2005","journal-title":"Morb. Mortal. Wkly. Rep. Recomm. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1111\/acer.12284","article-title":"Inappropriate Feeding Behaviors and Dietary Intakes in Children with Fetal Alcohol Spectrum Disorder or Probable Prenatal Alcohol Exposure","volume":"38","author":"Werts","year":"2014","journal-title":"Alcohol Clin. Exp. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.jpeds.2015.10.049","article-title":"Abnormal Eating Behaviors Are Common in Children with Fetal Alcohol Spectrum Disorder","volume":"169","author":"Fink","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.2105\/AJPH.84.9.1421","article-title":"Prenatal Alcohol Exposure, Birthweight, and Measures of Child Size from Birth to Age 14 Years","volume":"84","author":"Sampson","year":"1994","journal-title":"Am. J. Public Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1111\/j.1530-0277.2012.01940.x","article-title":"Fetal Alcohol-Related Growth Restriction from Birth through Young Adulthood and Moderating Effects of Maternal Prepregnancy Weight","volume":"37","author":"Carter","year":"2013","journal-title":"Alcohol Clin. Exp. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1111\/j.1530-0277.2002.tb02459.x","article-title":"Prenatal Alcohol Exposure Predicts Continued Deficits in Offspring Size at 14 Years of Age","volume":"26","author":"Day","year":"2002","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2502","DOI":"10.1111\/acer.12516","article-title":"Overweight and Obesity Among Children and Adolescents with Fetal Alcohol Spectrum Disorders","volume":"38","author":"Fuglestad","year":"2014","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1136\/adc.2005.073759","article-title":"The Regulation of Appetite","volume":"91","author":"Druce","year":"2005","journal-title":"Arch. Dis. Child."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Joost, H.-G. (2012). Appetite Control, Springer. Handbook of Experimental Pharmacology.","DOI":"10.1007\/978-3-642-24716-3"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1677\/joe.1.05866","article-title":"Appetite Control","volume":"184","author":"Wynne","year":"2005","journal-title":"J. Endocrinol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.psyneuen.2017.05.018","article-title":"Diurnal Cortisol Slopes and Mental and Physical Health Outcomes: A Systematic Review and Meta-Analysis","volume":"83","author":"Adam","year":"2017","journal-title":"Psychoneuroendocrinology"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Okulicz-Kozaryn, K., Maryniak, A., Borkowska, M., \u015amigiel, R., and Dylag, K.A. (2021). Diagnosis of Fetal Alcohol Spectrum Disorders (FASDs): Guidelines of Interdisciplinary Group of Polish Professionals. Int. J. Environ. Res. Public. Health, 18.","DOI":"10.3390\/ijerph18147526"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.ejphar.2010.10.107","article-title":"Hypothalamic Proopiomelanocortin Processing and the Regulation of Energy Balance","volume":"660","author":"Wardlaw","year":"2011","journal-title":"Eur. J. Pharmacol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E121","DOI":"10.1152\/ajpendo.00555.2006","article-title":"Transgenic MSH Overexpression Attenuates the Metabolic Effects of a High-Fat Diet","volume":"293","author":"Lee","year":"2007","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_23","first-page":"1442","article-title":"Clinical Review 127: Obesity as a Neuroendocrine Disease: Lessons to Be Learned from Proopiomelanocortin and Melanocortin Receptor Mutations in Mice and Men","volume":"86","author":"Wardlaw","year":"2001","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3624","DOI":"10.1523\/JNEUROSCI.2742-12.2013","article-title":"Acute and Long-Term Suppression of Feeding Behavior by POMC Neurons in the Brainstem and Hypothalamus, Respectively","volume":"33","author":"Zhan","year":"2013","journal-title":"J. Neurosci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.peptides.2005.02.029","article-title":"The Melanocortin System and Energy Balance","volume":"27","author":"Butler","year":"2006","journal-title":"Peptides"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1038\/12506","article-title":"Obesity in the Mouse Model of Pro-Opiomelanocortin Deficiency Responds to Peripheral Melanocortin","volume":"5","author":"Yaswen","year":"1999","journal-title":"Nat. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2557","DOI":"10.1210\/jc.2004-0428","article-title":"Proopiomelanocortin and Energy Balance: Insights from Human and Murine Genetics","volume":"89","author":"Coll","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"7965","DOI":"10.1523\/JNEUROSCI.0284-20.2020","article-title":"Alcohol Increases Exosome Release from Microglia to Promote Complement C1q-Induced Cellular Death of Proopiomelanocortin Neurons in the Hypothalamus in a Rat Model of Fetal Alcohol Spectrum Disorders","volume":"40","author":"Mukherjee","year":"2020","journal-title":"J. Neurosci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.1111\/acer.12497","article-title":"Fetal Alcohol Programming of Hypothalamic Proopiomelanocortin System by Epigenetic Mechanisms and Later Life Vulnerability to Stress","volume":"38","author":"Bekdash","year":"2014","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.biopsych.2012.04.006","article-title":"Male Germline Transmits Fetal Alcohol Adverse Effect on Hypothalamic Proopiomelanocortin Gene across Generations","volume":"72","author":"Govorko","year":"2012","journal-title":"Biol. Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"17669","DOI":"10.1038\/s41598-022-21851-8","article-title":"Serum Kisspeptin and Proopiomelanocortin in Cystic Fibrosis: A Single Study","volume":"12","author":"Galiniak","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1007\/s40519-022-01388-5","article-title":"Anti-Hypothalamus Autoantibodies in Anorexia Nervosa: A Possible New Mechanism in Neuro-Physiological Derangement?","volume":"27","author":"Escelsior","year":"2022","journal-title":"Eat. Weight Disord.-Stud. Anorex. Bulim. Obes."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"E1838","DOI":"10.1210\/jc.2014-1448","article-title":"Clinical Utility of Plasma POMC and AgRP Measurements in the Differential Diagnosis of ACTH-Dependent Cushing\u2019s Syndrome","volume":"99","author":"Freda","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"E458","DOI":"10.1152\/ajpendo.00206.2015","article-title":"Proopiomelanocortin, Agouti-Related Protein, and Leptin in Human Cerebrospinal Fluid: Correlations with Body Weight and Adiposity","volume":"309","author":"Meece","year":"2015","journal-title":"Am. J. Physiol.-Endocrinol. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2828","DOI":"10.1210\/en.2006-1606","article-title":"Alcohol Exposure during the Developmental Period Induces Beta-Endorphin Neuronal Death and Causes Alteration in the Opioid Control of Stress Axis Function","volume":"148","author":"Sarkar","year":"2007","journal-title":"Endocrinology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.alcohol.2015.01.005","article-title":"Hypothalamic-Pituitary-Adrenal Axis and Behavioral Dysfunction Following Early Binge-like Prenatal Alcohol Exposure in Mice","volume":"49","author":"Wieczorek","year":"2015","journal-title":"Alcohol Fayettev. N"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Gangisetty, O., Bekdash, R., Maglakelidze, G., and Sarkar, D.K. (2014). Fetal Alcohol Exposure Alters Proopiomelanocortin Gene Expression and Hypothalamic-Pituitary-Adrenal Axis Function via Increasing MeCP2 Expression in the Hypothalamus. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0113228"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1159\/000216184","article-title":"Regulation of the Hypothalamic-Pituitary-Adrenal Axis","volume":"16","author":"Papadimitriou","year":"2009","journal-title":"Neuroimmunomodulation"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/nrn1683","article-title":"Stress and the Brain: From Adaptation to Disease","volume":"6","author":"Holsboer","year":"2005","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"25","DOI":"10.18388\/abp.2017_2343","article-title":"Congenital Adrenal Hyperplasia: Clinical Symptoms and Diagnostic Methods","volume":"65","author":"Aebisher","year":"2018","journal-title":"Acta Biochim. Pol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/S0306-4530(00)00061-5","article-title":"Psychological, Cardiovascular, and Metabolic Correlates of Individual Differences in Cortisol Stress Recovery in Young Men","volume":"26","author":"Roy","year":"2001","journal-title":"Psychoneuroendocrinology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/00075198-200208000-00002","article-title":"Steroids","volume":"8","author":"Riad","year":"2002","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/19315864.2016.1183246","article-title":"Regulatory Behaviors and Stress Reactivity among Infants at High Risk for Fetal Alcohol Spectrum Disorders: An Exploratory Study","volume":"9","author":"Jirikowic","year":"2016","journal-title":"J. Ment. Health Res. Intellect. Disabil."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.alcohol.2014.11.004","article-title":"Salivary Cortisol Levels Are Elevated in the Afternoon and at Bedtime in Children with Prenatal Alcohol Exposure","volume":"49","author":"Keiver","year":"2015","journal-title":"Alcohol"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1093\/jpepsy\/21.6.833","article-title":"Effect of Prenatal Alcohol and Cigarette Exposure on Two- and Six-Month-Old Infants\u2019 Adrenocortical Reactivity to Stress1","volume":"21","author":"Ramsay","year":"1996","journal-title":"J. Pediatr. Psychol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1139\/bcb-2017-0064","article-title":"Understanding and Managing Sleep Disruption in Children with Fetal Alcohol Spectrum Disorder","volume":"96","author":"Chen","year":"2018","journal-title":"Biochem. Cell Biol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1002\/dev.20334","article-title":"The Association between Prenatal Exposure to Cigarettes and Cortisol Reactivity and Regulation in 7-Month-Old Infants","volume":"50","author":"Schuetze","year":"2008","journal-title":"Dev. Psychobiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.biopsych.2005.10.014","article-title":"Cortisol Circadian Rhythm Alterations in Psychotic Major Depression","volume":"60","author":"Keller","year":"2006","journal-title":"Biol. Psychiatry"},{"key":"ref_49","first-page":"E317","article-title":"Effects of Glucocorticoids on Energy Metabolism and Food Intake in Humans","volume":"271","author":"Tataranni","year":"1996","journal-title":"Am. J. Physiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0306-4530(00)00035-4","article-title":"Stress May Add Bite to Appetite in Women: A Laboratory Study of Stress-Induced Cortisol and Eating Behavior","volume":"26","author":"Epel","year":"2001","journal-title":"Psychoneuroendocrinology"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1111\/j.1749-6632.2002.tb04293.x","article-title":"Leptin Signaling, Adiposity, and Energy Balance","volume":"967","year":"2002","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.biopsych.2013.01.032","article-title":"Stress as a Common Risk Factor for Obesity and Addiction","volume":"73","author":"Sinha","year":"2013","journal-title":"Biol. Psychiatry"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1016\/S0140-6736(06)68699-6","article-title":"Cushing\u2019s Syndrome","volume":"367","author":"Bertagna","year":"2006","journal-title":"Lancet"},{"key":"ref_54","first-page":"1853","article-title":"Stress-Related Cortisol Secretion in Men: Relationships with Abdominal Obesity and Endocrine, Metabolic and Hemodynamic Abnormalities","volume":"83","author":"Rosmond","year":"1998","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/0196-9781(86)90104-X","article-title":"ACTH-(1-24) and Alpha-MSH Antagonize Feeding Behavior Stimulated by Kappa Opiate Agonists","volume":"7","author":"Poggioli","year":"1986","journal-title":"Peptides"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1111\/j.1530-0277.1996.tb01636.x","article-title":"Alcohol Stimulates ACTH Secretion in the Rat: Mechanisms of Action and Interactions with Other Stimuli","volume":"20","author":"Rivier","year":"1996","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_57","first-page":"1144","article-title":"The Melanocortin Melanocyte-Stimulating Hormone\/Adrenocorticotropin(4-10) Decreases Body Fat in Humans","volume":"86","author":"Fehm","year":"2001","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"4633","DOI":"10.1210\/jc.2003-030502","article-title":"Obesity Due to Proopiomelanocortin Deficiency: Three New Cases and Treatment Trials with Thyroid Hormone and ACTH4-10","volume":"88","author":"Krude","year":"2003","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.alcohol.2016.03.003","article-title":"Dysregulation of the Cortisol Diurnal Rhythm Following Prenatal Alcohol Exposure and Early Life Adversity","volume":"53","author":"McLachlan","year":"2016","journal-title":"Alcohol"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"5305","DOI":"10.1113\/jphysiol.2009.179192","article-title":"Hormone and Glucose Signalling in POMC and AgRP Neurons","volume":"587","author":"Belgardt","year":"2009","journal-title":"J. Physiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1067\/mpd.2002.120765","article-title":"Correlation between Plasma and Salivary Cortisol Levels in Preterm Infants","volume":"140","author":"Calixto","year":"2002","journal-title":"J. Pediatr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"T135","DOI":"10.1530\/JME-15-0257","article-title":"60 YEARS OF POMC: Adrenal and Extra-Adrenal Functions of ACTH","volume":"56","year":"2016","journal-title":"J. Mol. Endocrinol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1046\/j.1365-2265.1999.00801.x","article-title":"The Short Synacthen Test: Is Less Best?","volume":"51","author":"Stewart","year":"1999","journal-title":"Clin. Endocrinol."},{"key":"ref_64","first-page":"536","article-title":"Circadian Cortisol Rhythms in Healthy Boys and Girls: Relationship with Age, Growth, Body Composition, and Pubertal Development*","volume":"82","author":"Knutsson","year":"1997","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1203\/00006450-199207000-00012","article-title":"Corticotropin Releasing Hormone Stimulation Test and Nocturnal Cortisol Levels in Normal Children","volume":"32","author":"Dahl","year":"1992","journal-title":"Pediatr. Res."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Martens, A., Duran, B., Vanbesien, J., Verheyden, S., Rutteman, B., Staels, W., Anckaert, E., Gies, I., and De Schepper, J. (2021). Clinical and Biological Correlates of Morning Serum Cortisol in Children and Adolescents with Overweight and Obesity. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0258653"},{"key":"ref_67","first-page":"525","article-title":"Establishment of Reference Ranges for Cortisol in Neonates, Infants, Children and Adolescents","volume":"31","author":"Wiedemann","year":"1993","journal-title":"Eur. J. Clin. Chem. Clin. Biochem. J. Forum Eur. Clin. Chem. Soc."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1203\/00006450-199504000-00020","article-title":"Salivary Cortisol Levels throughout Childhood and Adolescence: Relation with Age, Pubertal Stage, and Weight","volume":"37","author":"Kiess","year":"1995","journal-title":"Pediatr. Res."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/6\/1366\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:52:42Z","timestamp":1760122362000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/6\/1366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,11]]},"references-count":68,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["nu15061366"],"URL":"https:\/\/doi.org\/10.3390\/nu15061366","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,11]]}}}