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Zhang X, Perry RJ. Metabolic underpinnings of cancer-related fatigue. Am J Physiol Endocrinol Metab 2024; 326:E290-E307. [PMID: 38294698 DOI: 10.1152/ajpendo.00378.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/01/2024]
Abstract
Cancer-related fatigue (CRF) is one of the most prevalent and detrimental complications of cancer. Emerging evidence suggests that obesity and insulin resistance are associated with CRF occurrence and severity in cancer patients and survivors. In this narrative review, we analyzed recent studies including both preclinical and clinical research on the relationship between obesity and/or insulin resistance and CRF. We also describe potential mechanisms for these relationships, though with the caveat that because the mechanisms underlying CRF are incompletely understood, the mechanisms mediating the association between obesity/insulin resistance and CRF are similarly incompletely delineated. The data suggest that, in addition to their effects to worsen CRF by directly promoting tumor growth and metastasis, obesity and insulin resistance may also contribute to CRF by inducing chronic inflammation, neuroendocrinological disturbance, and metabolic alterations. Furthermore, studies suggest that patients with obesity and insulin resistance experience more cancer-induced pain and are at more risk of emotional and behavioral disruptions correlated with CRF. However, other studies implied a potentially paradoxical impact of obesity and insulin resistance to reduce CRF symptoms. Despite the need for further investigation utilizing interventions to directly elucidate the mechanisms of cancer-related fatigue, current evidence demonstrates a correlation between obesity and/or insulin resistance and CRF, and suggests potential therapeutics for CRF by targeting obesity and/or obesity-related mediators.
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Affiliation(s)
- Xinyi Zhang
- Departments of Cellular & Molecular Physiology and Medicine (Endocrinology), Yale University School of Medicine, New Haven, Connecticut, United States
| | - Rachel J Perry
- Departments of Cellular & Molecular Physiology and Medicine (Endocrinology), Yale University School of Medicine, New Haven, Connecticut, United States
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Lu D, Yuan Z, Gao Y, Liu W, Zhang J. Central Obesity Is Associated with Variations in TSH and ACTH Levels among Euthyroid Obese Individuals. Int J Endocrinol 2022; 2022:3830380. [PMID: 35311031 PMCID: PMC8930244 DOI: 10.1155/2022/3830380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The interactions of central obesity and body composition with thyroid hormones and the hypothalamus-pituitary-adrenal (HPA) axis are unclear; both central obesity and body composition have an impact on energy homeostasis. Our study aimed to investigate the association between body composition and pituitary hormones, including the HPA axis and pituitary-thyroid axis, in a Chinese population of euthyroid overweight and obese individuals. METHODS This was a cross-sectional study. Overweight and obese patients who regularly visited the multidisciplinary team (MDT) for obesity at Peking University First Hospital were enrolled in the study. Thyroid function, morning serum ACTH and cortisol levels, thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), body composition, and metabolic indicators, including liver function and the lipid profile, were measured at the first visit. Statistical analysis was performed using SPSS version 21.0 (IBM, USA). RESULTS In total, 441 patients with overweight or obesity were enrolled (male/female, 123/318). Patients were assigned to four groups according to the thyroid-stimulating hormone (TSH) level stratified by quartiles, and increased body mass index (BMI) was revealed in the highest TSH quartile group (p=0.002). Hip circumference (HC) of patients in the highest TSH quartile group was significantly increased (p=0.021). Morning ACTH levels and fasting insulin levels were significantly elevated in patients in the highest TSH quartile group (p=0.027 for fasting insulin, p < 0.001 for ACTH). In the female subgroup, patients in the highest TSH quartile group showed increases in BMI (p=0.010), waist circumference (WC) (p=0.007), muscle mass of the lower extremities (p=0.020), fasting C-peptide (p=0.031), and ACTH (p=0.002). In the male subgroup, patients in the highest TSH quartile group exhibited higher BMI (p=0.017), HC (p=0.036), and ACTH (p=0.003). Among patients in the highest ACTH quartile group, there was an elevated proportion of males (p=0.003), and FT3 (p=0.005), fasting insulin (p=0.037), and cortisol (p < 0.001) levels were increased. Weight (p < 0.001), BMI (p < 0.001), WC (p < 0.001), HC (p < 0.001), muscle mass of the upper extremities (p=0.003), muscle mass of the lower extremities (p=0.005), and total muscle mass (p=0.003) were elevated in patients in the highest ACTH quartile group. HC was found to be an independent factor after adjustment for other confounders and was positively associated with the TSH level (p=0.004 for the regression model, B = 0.152, p=0.004). CONCLUSIONS BMI is positively correlated with TSH and ACTH levels in both male and female obese individuals. The ACTH level was positively associated with male sex and increased BMI and muscle mass. Hip circumference was an independent factor that was positively related to TSH levels.
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Affiliation(s)
- Difei Lu
- Peking University First Hospital, Department of Endocrinology, Beijing, China
| | - Zhenfang Yuan
- Peking University First Hospital, Department of Endocrinology, Beijing, China
| | - Ying Gao
- Peking University First Hospital, Department of Endocrinology, Beijing, China
| | - Wei Liu
- Peking University First Hospital, Department of Endocrinology, Beijing, China
| | - Junqing Zhang
- Peking University First Hospital, Department of Endocrinology, Beijing, China
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Fan K, Wei D, Liu X, He Y, Tian H, Tu R, Liu P, Nie L, Zhang L, Qiao D, Liu X, Hou J, Li L, Wang C, Huo W, Zhang G, Mao Z. Negative associations of morning serum cortisol levels with obesity: the Henan rural cohort study. J Endocrinol Invest 2021; 44:2581-2592. [PMID: 33829394 DOI: 10.1007/s40618-021-01558-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/22/2021] [Indexed: 12/19/2022]
Abstract
AIMS To evaluate the associations of morning serum cortisol levels with obesity defined by different indices in Chinese rural populations. MATERIALS AND METHODS A cross-sectional study was performed including 6198 participants (2566 males and 3632 females). Serum cortisol was collected in morning and quantified by liquid chromatography-tandem mass spectrometry. Obesity was defined by body mass index (BMI), body fat percentage (BFP), waist-to-height ratio (WHtR), waist circumference (WC), visceral fat index (VFI) and waist-to-hip ratio (WHR). Both multivariable liner regression, logistic regression and restrictive cubic splines models were used to estimate the gender-specific relationships between cortisol levels and obesity defined by different indices, respectively. RESULTS After adjusting for potential confounders, serum cortisol was negatively associated with different obesity measures, except obese females defined by BFP (for instance, overall obesity defined by BMI, Quartile 4 vs. Quartile 1, odds ratio (OR) = 0.25, 95% confidence interval (CI):0.15, 0.41 in males, and OR = 0.58, 95% CI: 0.42,0.80 in females, central obesity defined by WC, OR = 0.52, 95% CI:0.39,0.69 in males and OR = 0.63, 95% CI:0.51,0.77 in females). Similarly, restrictive cubic splines showed the nonlinear relationship between high levels of cortisol and different obesity indices. Furthermore, ROC curve analysis indicated that cortisol could improve the discrimination of model with common biomarkers. CONCLUSION Morning serum cortisol were negatively related to obesity defined by different indices in Chinese rural populations. In addition, cortisol could be as a biomarker for prediction of obesity in males.
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Affiliation(s)
- K Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - D Wei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - X Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Y He
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - H Tian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - R Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - P Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Nie
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - D Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - X Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - J Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - L Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - C Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - W Huo
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - G Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
| | - Z Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
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Roelfsema F, Liu PY, Yang R, Takahashi P, Veldhuis JD. Interleukin-2 drives cortisol secretion in an age-, dose-, and body composition-dependent way. Endocr Connect 2020; 9:637-648. [PMID: 32520721 PMCID: PMC7424344 DOI: 10.1530/ec-20-0211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/08/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Interleukin-2 (IL-2), one of the proinflammatory cytokines, is used in the treatment of certain malignancies. In some studies, transient increases in cortisol and ACTH secretion occurred. Thus, this agent may be used as an experimental probe of adrenal cortisol secretion. OBJECTIVE This study quantifies the effects of low and moderate doses of IL-2 on cortisol secretion and assesses the modulation by age, dose and body composition. SITE Mayo Clinical Translational Research Unit. SUBJECTS Study comprised 35 healthy men, 17 young and 18 older. METHODS Randomized prospective double-blind saline-controlled study of IL-2 administration in two doses with concurrent 10-min blood sampling for 24 h. OUTCOME MEASURES Deconvolution analysis and approximate entropy of cortisol secretion. RESULTS Low-dose IL-2 administration increased nocturnal pulsatile cortisol secretion from 1460 ± 160 to 2120 ± 220 nmol/L/8 h in young subjects and from 1680 ± 105 to 1960 ± 125 nmol/L/8 h (treatment P < 0.0001, but more in young than older, P = 0.02). Comparable results were obtained for total cortisol secretion (P treatment <0.0001, age effect P = 0.005). The higher IL-2 dose caused a large increase in young (P < 0.0001), but not in older (P = 0.90) subjects. This dose also increased approximate entropy from 0.877 ± 0.041 to 1.024 ± 0.049 (P = 0.008), pointing to reduced secretory orderliness. Incremental cortisol (nocturnal) secretion correlated negatively with visceral fat mass (R = -0.41, P = 0.019). CONCLUSION In healthy men, IL-2 injection drives pulsatile cortisol secretion in a dose-dependent way in young, but not older, individuals and erodes cortisol secretory orderliness at a higher dose in young subjects. Cortisol responses are diminished with increasing abdominal visceral fat mass.
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Affiliation(s)
- Ferdinand Roelfsema
- Department of Internal Medicine, Section Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Y Liu
- Department of Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, California, USA
| | - Rebecca Yang
- Endocrine Research Unit, Mayo Clinic College of Medicine, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota, USA
| | - Paul Takahashi
- Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Johannes D Veldhuis
- Endocrine Research Unit, Mayo Clinic College of Medicine, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota, USA
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Marceau K, Abel EA, Duncan RJ, Moore PJ, Leve LD, Reiss D, Shaw DS, Natsuaki M, Neiderhiser JM, Ganiban JM. Longitudinal Associations of Sleep Duration, Morning and Evening Cortisol, and BMI During Childhood. Obesity (Silver Spring) 2019; 27:645-652. [PMID: 30816633 PMCID: PMC6462140 DOI: 10.1002/oby.22420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 12/19/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study aimed to examine associations between sleep duration, BMI, and cortisol levels across childhood. METHODS Participants included 361 children adopted domestically in the United States. Random-intercept cross-lagged panel models tested for between-person and bidirectional within-person associations of sleep duration, BMI, and morning and evening cortisol at age 4.5 to 9 years. RESULTS Sleep duration and BMI were stable during childhood, inversely associated at the between-person level, and unrelated to morning or evening cortisol. BMI at age 6 years predicted longer sleep duration and lower evening cortisol at age 7 years, and lower morning cortisol at age 7 years predicted higher BMI at age 9 years within individuals. CONCLUSIONS The association between sleep and BMI is more likely a stable between-person phenomenon rather than a unidirectional association that develops within individuals over time.
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Affiliation(s)
- Kristine Marceau
- Department of Human Development and Family Studies, Purdue
University, West Lafayette, IN, USA
| | - Emily A. Abel
- Department of Human Development and Family Studies, Purdue
University, West Lafayette, IN, USA
| | - Robert J. Duncan
- Department of Human Development and Family Studies, Purdue
University, West Lafayette, IN, USA
| | - Phillip J. Moore
- Department of Psychology, George Washington University,
Washington DC, USA
| | - Leslie D. Leve
- Department of Counseling Psychology and Human Services,
University of Oregon, Eugene, OR, USA
| | - David Reiss
- Child Study Center, Yale University, New Haven, CT,
USA
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh,
Pittsburgh, PA, USA
| | - Misaki Natsuaki
- Department of Psychology, University of California,
Riverside, Riverside, CA, USA
| | | | - Jody M. Ganiban
- Department of Psychology, George Washington University,
Washington DC, USA
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Krishnamurthy D, Rahmoune H, Guest PC. Mass Spectrometry Profiling of Pituitary Glands. Methods Mol Biol 2018; 1735:439-447. [PMID: 29380334 DOI: 10.1007/978-1-4939-7614-0_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Many chronic diseases are associated with hypothalamic-pituitary-adrenal axis dysfunction. Therefore, proteomic profiling of the pituitary gland has potential to uncover new information on the underlying pathways affected in these conditions. This could lead to identification of new biomarkers or drug targets for development of novel therapeutics. Here we present a protocol for preparation of pituitary protein extracts and analysis of the major hormones and accessory proteins using liquid chromatography tandem mass spectrometry (LC-MS/MS). The same methods can be applied in the study of other tissues of the diffuse neuroendocrine system.
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Affiliation(s)
- Divya Krishnamurthy
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - Hassan Rahmoune
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, UK
| | - Paul C Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, SP, Brazil.
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Roelfsema F, van Heemst D, Iranmanesh A, Takahashi P, Yang R, Veldhuis JD. Impact of age, sex and body mass index on cortisol secretion in 143 healthy adults. Endocr Connect 2017; 6:500-509. [PMID: 28760748 PMCID: PMC5597974 DOI: 10.1530/ec-17-0160] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 07/31/2017] [Indexed: 11/18/2022]
Abstract
CONTEXT Studies on 24-h cortisol secretion are rare. The impact of sex, age and adiposity on cortisol levels, often restricted to one or a few samples, are well recognized, but conflicting. OBJECTIVE To investigate cortisol dynamics in 143 healthy men and women, spanning 7 decades and with a 2-fold body mass index (BMI) range with different analytic tools. SETTING Clinical Research Unit. DESIGN Cortisol concentrations in 10-min samples collected for 24 h. Outcomes were mean levels, deconvolution parameters, approximate entropy (ApEn, regularity statistic) and 24-h rhythms. RESULTS Total 24-h cortisol secretion rates estimated by deconvolution analysis were sex, age and BMI independent. Mean 24-h cortisol concentrations were lower in premenopausal women than those in men of comparable age (176 ± 8.2 vs 217 ± 9.4 nmol/L, P = 0.02), but not in subjects older than 50 years. This was due to lower daytime levels in women, albeit similar in the quiescent overnight period. Aging increased mean cortisol by 10 nmol/L per decade during the quiescent secretory phase and advanced the acrophase of the diurnal rhythm by 24 min/decade. However, total 24-h cortisol secretion rates estimated by deconvolution analysis were sex, age and BMI independent. ApEn of 24-h profiles was higher (more random) in premenopausal women than those in men (1.048 ± 0.025 vs 0.933 ± 0.023, P = 0.001), but not in subjects older than 50 years. ApEn peaked during the daytime. CONCLUSION Sex and age jointly determine the 24-h cortisol secretory profile. Sex effects are largely restricted to age <50 years, whereas age effects elevate concentrations in the late evening and early night and advance the timing of the peak diurnal rhythm.
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Affiliation(s)
- Ferdinand Roelfsema
- Department of Internal MedicineLeiden University Medical Center, Leiden, The Netherlands
| | - Diana van Heemst
- Department of Internal MedicineSection Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Ali Iranmanesh
- Endocrine SectionMedical Service, Salem Veterans Affairs Medical Center, Salem, Virginia, USA
| | - Paul Takahashi
- Primary Care Internal MedicineMayo Clinic, Rochester, Minnesota, USA
| | - Rebecca Yang
- Endocrine Research UnitMayo Medical and Graduate Schools, Clinical Translational Research Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Johannes D Veldhuis
- Endocrine Research UnitMayo Medical and Graduate Schools, Clinical Translational Research Center, Mayo Clinic, Rochester, Minnesota, USA
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