1
|
Mazgelytė E, Karčiauskaitė D. Cortisol in metabolic syndrome. Adv Clin Chem 2024; 123:129-156. [PMID: 39181620 DOI: 10.1016/bs.acc.2024.06.008] [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: 08/27/2024]
Abstract
Cortisol, a stress hormone, plays a crucial role in regulating metabolic, hemodynamic, inflammatory, and behavioral processes. Its secretion is governed by the hypothalamic-pituitary-adrenal axis. However, prolonged activation of this axis and increased cortisol bioavailability in tissues can result in detrimental metabolic effects. Chronic exposure to excessive cortisol is associated with insulin resistance and visceral obesity, both significant contributors to metabolic syndrome. This review delves into the regulation of the hypothalamic-pituitary-adrenal axis, the molecular mechanisms underlying cortisol synthesis and its actions, as well as the key factors influencing cortisol bioavailability. Furthermore, it provides a summary of available clinical research data on the involvement of cortisol in metabolic syndrome, alongside a discussion on the various biomatrices used for cortisol measurement in clinical settings.
Collapse
Affiliation(s)
- Eglė Mazgelytė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
| | - Dovilė Karčiauskaitė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| |
Collapse
|
2
|
Li C, Tao T, Tang Y, Lu H, Zhang H, Li H, Liu X, Guan W, Niu Y. The association of psychological stress with metabolic syndrome and its components: cross-sectional and bidirectional two-sample Mendelian randomization analyses. Front Endocrinol (Lausanne) 2023; 14:1212647. [PMID: 38144566 PMCID: PMC10749192 DOI: 10.3389/fendo.2023.1212647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/07/2023] [Indexed: 12/26/2023] Open
Abstract
Background Metabolic syndrome (MetS) is a group of co-occurring conditions that increase the risk of cardiovascular disease, which include the conditions of hypertension, overweight or obesity, hyperglycemia, and dyslipidemia. Psychological stress is gradually being taken seriously, stemming from the imbalance between environmental demands and individual perceptions. However, the potential causal relationship between psychological stress and MetS remains unclear. Method We conducted cross-sectional and bidirectional Mendelian randomization (MR) analyses to clarify the potential causal relationship of psychological stress with MetS and its components. Multivariable logistic regression models were used to adjust for potential confounders in the cross-sectional study of the Chinese population, including 4,933 individuals (70.1% men; mean age, 46.13 ± 8.25). Stratified analyses of sexual characteristics were also performed. Bidirectional MR analyses were further carried out to verify causality based on summary-level genome-wide association studies in the European population, using the main analysis of the inverse variance-weighted method. Results We found that higher psychological stress levels were cross-sectionally associated with an increased risk of hypertension in men (odds ratio (OR), 1.341; 95% confidence interval (CI), 1.023-1.758; p = 0.034); moreover, higher levels of hypertension were cross-sectionally associated with an increased risk of psychological stress in men and the total population (men: OR, 1.545 (95% CI, 1.113-2.145); p = 0.009; total population: OR, 1.327 (95% CI, 1.025-1.718); p = 0.032). Genetically predicted hypertension was causally associated with a higher risk of psychological stress in the inverse-variance weighted MR model (OR, 2.386 (95% CI, 1.209-4.710); p = 0.012). However, there was no association between psychological stress and MetS or the other three risk factors (overweight or obesity, hyperglycemia, and dyslipidemia) in cross-sectional and MR analyses. Conclusion Although we did not observe an association between psychological stress and MetS, we found associations between psychological stress and hypertension both in cross-sectional and MR studies, which may have implications for targeting hypertension-related factors in interventions to improve mental and metabolic health. Further study is needed to confirm our findings.
Collapse
Affiliation(s)
- Cancan Li
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Tianqi Tao
- Department of Geriatrics, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yanyan Tang
- Department of Geriatrics, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Huimin Lu
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Hongfeng Zhang
- Department of Geriatrics, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Huixin Li
- Department of Geriatrics, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xiuhua Liu
- Department of Geriatrics, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Weiping Guan
- Department of Geriatrics, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yixuan Niu
- Department of Geriatrics, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
3
|
Gan L, Li N, Heizhati M, Li M, Yao L, Hong J, Wu T, Wang H, Liu M, Maitituersun A. Diurnal Cortisol Features and Type 2 Diabetes Risk in Patients With Hypertension and Obstructive Sleep Apnea: A Cohort Study. J Clin Endocrinol Metab 2023; 108:e679-e686. [PMID: 37022782 DOI: 10.1210/clinem/dgad184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/20/2023] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
CONTEXT The hypothalamic-pituitary-adrenal (HPA) axis may be associated with type 2 diabetes (T2D); however, whether HPA axis dysfunction is associated with incident T2D remains unclear in patients with hypertension and obstructive sleep apnea (OSA). OBJECTIVE To investigate the relationship between the diurnal cortisol features and the risk of incident T2D in patients with hypertension and OSA. METHODS Participants with cortisol rhythm test at baseline in the Urumqi Research on Sleep Apnea and Hypertension cohort were enrolled. The Cox regression model was used to evaluate the relationship between ln-transformed diurnal cortisol features and T2D risk. Stratified and sensitivity analyses were also performed. RESULTS A total of 1478 patients with hypertension and OSA were enrolled in this study. During a median follow-up of 7.0 years, 196 participants developed T2D. Overall, a steep diurnal cortisol slope (DCS) was significantly associated with decreased T2D risk (per SD increase, HR 0.88, 95% CI 0.79-0.97, P = .014). Midnight cortisol was positively associated with increased T2D risk (per SD increase, HR 1.25, 95% CI 1.08-1.45, P = .003). Sensitivity analyses showed similar results. Neither DCS nor midnight cortisol was associated with incident T2D in the women's subgroup or participants with mild OSA. CONCLUSION Steeper DCS and higher midnight cortisol levels are associated with lower and higher T2D risks in patients with hypertension and OSA, respectively, at least in men or participants with moderate to severe OSA. Diurnal cortisol features may represent an early prevention target for diabetes in this population.
Collapse
Affiliation(s)
- Lin Gan
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Ling Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Ting Wu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Hui Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Miaomiao Liu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Adalaiti Maitituersun
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| |
Collapse
|
4
|
Toledo-Corral CM, Ding L, Morales JC, Chapman TM, Romero MB, Weigensberg MJ. Morning Serum Cortisol Is Uniquely Associated with Cardiometabolic Risk Independent of Body Composition in Latino Adolescents. Metab Syndr Relat Disord 2023; 21:214-221. [PMID: 37042653 PMCID: PMC10181798 DOI: 10.1089/met.2022.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
Background: Alterations in morning serum cortisol (MSC) have been associated with higher cardiometabolic risk. This finding has been documented primarily in populations with overweight or obesity; however, it has not been clearly established if obesity plays a requisite role in this relationship. This study seeks to extend earlier findings by examining whether body composition measures alter the relationship between MSC with glucose and insulin markers, blood pressure, and lipid parameters in Latino youth in middle adolescence. Methods: This cross-sectional study included 196 healthy adolescents (130F/66M; mean age: 16.4 ± 0.6 years; 95% Latino; mean body mass index, BMI: 24.3 ± 5.7) from Los Angeles, California. Morning cortisol, glucose, insulin, glycated hemoglobin, and lipids (triglycerides and high-density lipoprotein cholesterol) were assessed from a fasting blood sample. Sitting systolic and diastolic blood pressure was averaged from duplicate measures. Body composition measures included BMI and waist circumference, which were used as proxies for total body and abdominal adiposity, respectively. Triplicate measurements of weight and height were averaged for calculation of BMI; age- and sex-specific BMI z-score was used to classify into normal BMI or overweight/obese BMI status. Waist circumference was measured in duplicate and the average was used to classify participants into two strata: normal/healthy waist circumference (<90th percentile for age, sex, and ethnicity) and high waist circumference (≥90th percentile). Results: The primary findings were that higher MSC was associated with higher fasting glucose and systolic blood pressure after adjusting for age, sex, and BMI z-score (and/or waist circumference). BMI status or waist circumference status did not alter these relationships. Main Conclusion: Our results suggest that the relationships between hypothalamic-pituitary-adrenal axis function and certain cardiometabolic risk factors may be independent of adiposity. Future research is warranted to discover the contributors and underlying mechanisms of these relationships in adolescent populations. ClinicalTrials.gov identifier: NCT02088294.
Collapse
Affiliation(s)
- Claudia M. Toledo-Corral
- Department of Health Sciences & Health Equity and Research Education (HERE) Center, California State University Northridge, Northridge, California, USA
| | - Li Ding
- Department of Population and Public Health Sciences and University of Southern California, Los Angeles, California, USA
| | - Jeremy C. Morales
- Department of Population and Public Health Sciences and University of Southern California, Los Angeles, California, USA
| | - Tiffany M. Chapman
- Department of Population and Public Health Sciences and University of Southern California, Los Angeles, California, USA
| | - Melyssa B. Romero
- Department of Population and Public Health Sciences and University of Southern California, Los Angeles, California, USA
| | - Marc J. Weigensberg
- Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
5
|
Ostinelli G, Scovronec A, Iceta S, Ouellette AS, Lemieux S, Biertho L, Bégin C, Michaud A, Tchernof A. Deciphering the Association Between Hypothalamus-Pituitary-Adrenal Axis Activity and Obesity: A Meta-Analysis. Obesity (Silver Spring) 2021; 29:846-858. [PMID: 33783120 DOI: 10.1002/oby.23125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/17/2020] [Accepted: 12/31/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Both the cortisol awakening response (CAR; corresponding to the state measurement) and hair cortisol concentration (HCC; corresponding to the trait measurement) are considered reliable markers of hypothalamus-pituitary-adrenal axis activity. Because cortisol has long been associated with adiposity, this systematic review and meta-analysis aims to summarize and compare the literature around CAR and HCC and their association with obesity or fat distribution indices. METHODS The PubMed, Web of Science (Web of Science Core Collection and Medline), EBSCO Information Services, Embase, and PsycNET databases were searched, and full-text articles investigating the association between CAR or HCC and markers of adiposity in humans were included. Meta-analyses were then performed to compare studies associating CAR or HCC with BMI (a marker of general adiposity) and waist circumference (a marker of fat distribution). RESULTS The results of this review highlight inconsistencies in cortisol sampling and CAR computation, which makes comparisons between studies difficult. It was found that adiposity indices are not associated with CAR but that they correlate significantly and positively with HCC. The subgroup analysis hinted to possible age differences in the magnitude of the association between HCC and BMI. CONCLUSIONS Trait rather than state measurement of the hypothalamus-pituitary-adrenal axis activity is associated with increased general and abdominal adiposity in humans.
Collapse
Affiliation(s)
- Giada Ostinelli
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| | - Anaïs Scovronec
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| | - Sylvain Iceta
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| | | | - Simone Lemieux
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| | - Laurent Biertho
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
| | - Catherine Bégin
- School of Psychology, Université Laval, Québec City, Québec, Canada
| | - Andréanne Michaud
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| | - André Tchernof
- Québec Heart and Lung Institute Research Center, Québec City, Québec, Canada
- School of Nutrition, Université Laval, Québec City, Québec, Canada
| |
Collapse
|
6
|
Impact of cortisol on blood pressure and hypertension-mediated organ damage in hypertensive patients. J Hypertens 2021; 39:1412-1420. [PMID: 33534343 DOI: 10.1097/hjh.0000000000002801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Patients with overt and subclinical Cushing's syndrome frequently develop hypertension, metabolism disorders, and atherosclerotic lesions. The aim of the present study was to test the association between cortisol and blood pressure (BP), organ damage, and metabolic parameters in hypertensive patients without hypercortisolism. METHODS After exclusion of patients treated with corticosteroids or with Cushing's syndrome, the cohort included 623 hypertensive patients (mean ± SD age 50.3 ± 15.4 years, 50.9% men, median 24-h BP 146/88 mmHg) with an extended work-up (lipid profile, hypertension-mediated organ damage). Cortisol secretion was assessed by plasma cortisol at 0800 and 1600 h, and by 24-h urinary free cortisol (24 h UFC) normalized if required to urine creatinine (UFC/U creat). RESULTS Plasma cortisol at 1600 h, 24 h-UFC, and UFC/U creat were significantly and positively correlated with daytime, night-time, and 24-h SBP; plasma cortisol at 0800 h was not associated with BP. The strongest correlations were observed in the subgroup of aged more than 50 years (correlation coefficients between 0.23 and 0.28). These correlations remained after adjustment on plasma aldosterone. Metabolic parameters were weakly associated with cortisol. Arterial stiffness (central pulse pressure and pulse wave velocity), plasma NT-proBNP, and microalbuminuria were significantly correlated with 24 h UFC, UFC/U creat, and plasma cortisol at 1600 h. CONCLUSION Cortisol influences weakly the level of BP independently from plasma aldosterone in hypertensive patients, particularly in older patients, and that there was weak association with HMOD. It may, therefore, be of interest to test specific treatments targeting cortisol excess in selected hypertensive patients.
Collapse
|
7
|
Behavioural characteristics and abdominal obesity among Brazilian shift working women. Public Health Nutr 2020; 24:253-259. [PMID: 32972472 DOI: 10.1017/s1368980020003377] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To explore the association between behavioural characteristics with the prevalence of abdominal obesity (AO) among a population of Southern Brazilian shift working women. DESIGN A cross-sectional study was conducted. AO was estimated using waist circumference (WC), and it was used to classify women as having AO (WC ≥ 88 cm). Prevalence ratios were estimated using Poisson regression with robust variance. SETTING A large plastic utensils company in Southern Brazil. PARTICIPANTS 450 female shift workers. RESULTS The prevalence of the AO in the women shift workers was 44·5 % (95 % CI 40·0, 49·2 %). In night shift workers, the prevalence of AO was 56·1 % compared with 40·9 % among hybrid shift workers. After adjustments for covariates, women who were current smokers had a decrease in the prevalence of AO compared with those who never smoked. Women who had three or fewer meals per day had a 46 % increase in the AO prevalence compared with those eating more frequent meals. Night shift work was associated with increase in AO prevalence compared with hybrid shift (PR 1·33; 95 % CI: 1·08, 1·64). CONCLUSIONS Our findings indicate that behavioural characteristics are associated with a high prevalence of AO in female shift workers, thus suggesting that behavioural modifications among women working shifts, such as increase in meal frequency and physical activity, may reduce AO.
Collapse
|
8
|
Lehrer HM, Steinhardt MA, Dubois SK, Laudenslager ML. Perceived stress, psychological resilience, hair cortisol concentration, and metabolic syndrome severity: A moderated mediation model. Psychoneuroendocrinology 2020; 113:104510. [PMID: 31911349 PMCID: PMC7769194 DOI: 10.1016/j.psyneuen.2019.104510] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 09/22/2019] [Accepted: 11/07/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Psychological resilience is considered to protect against detrimental effects of perceived stress on cardiovascular and metabolic health, but few studies have tested biological mechanisms underlying these relationships. PURPOSE This study examined whether psychological resilience moderated the indirect association of perceived stress with Metabolic Syndrome (MetS) severity via hair cortisol concentration (HCC), a retrospective index of hypothalamic pituitary adrenal (HPA) axis activity. METHOD Participants included 228 adults (73 White, 86 Hispanic, 69 African American; mean age 45.29 years; 68% females). Participants completed questionnaires assessing perceived stress (Perceived Stress Scale) and resilience (Brief Resilience Scale). The first 3 cm of scalp-near hair were analyzed for cortisol concentration using enzyme-linked immunoassay analysis. Cardiometabolic risk factors including blood glucose, lipids, blood pressure, and waist circumference were assessed, from which a sex- and race/ethnicity-specific continuous MetS severity score was calculated. A moderated mediation model was tested using path analysis. RESULTS Psychological resilience moderated the association of perceived stress with HCC (R2 change for interaction = 0.014, p = 0.043), such that the association of perceived stress and HCC decreased as resilience scores increased. Resilience also moderated the indirect association of perceived stress with MetS severity via HCC (b = -0.039, 95% CI [-0.001; -0.100]), such that HCC mediated the association of greater perceived stress with greater MetS severity only for individuals reporting Brief Resilience Scale scores 3 or below (range: 1.17-5.00). Psychological resilience was also associated with lower MetS severity (β = -0.227, p = 0.014) independent of perceived stress and HCC. CONCLUSION Findings suggest that psychological resilience may serve as both a stress buffer and as a direct determinant of cardiometabolic health. These results extend literature on psychological resilience to measures of retrospective HPA axis function and MetS severity in a diverse sample.
Collapse
Affiliation(s)
- H. Matthew Lehrer
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Mary A. Steinhardt
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Susan K. Dubois
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA,Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Mark L. Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| |
Collapse
|
9
|
Ferguson D, Hutson I, Tycksen E, Pietka TA, Bauerle K, Harris CA. Role of Mineralocorticoid Receptor in Adipogenesis and Obesity in Male Mice. Endocrinology 2020; 161:bqz010. [PMID: 32036385 PMCID: PMC7007880 DOI: 10.1210/endocr/bqz010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 10/30/2019] [Indexed: 02/07/2023]
Abstract
Increased visceral adiposity and hyperglycemia, 2 characteristics of metabolic syndrome, are also present in conditions of excess glucocorticoids (GCs). GCs are hormones thought to act primarily via the glucocorticoid receptor (GR). GCs are commonly prescribed for inflammatory disorders, yet their use is limited due to many adverse metabolic side effects. In addition to GR, GCs also bind the mineralocorticoid receptor (MR), but there are many conflicting studies about the exact role of MR in metabolic disease. Using MR knockout mice (MRKO), we find that both white and brown adipose depots form normally when compared with wild-type mice at P5. We created mice with adipocyte-specific deletion of MR (FMRKO) to better understand the role of MR in metabolic dysfunction. Treatment of mice with excess GCs for 4 weeks, via corticosterone in drinking water, induced increased fat mass and glucose intolerance to similar levels in FMRKO and floxed control mice. Separately, when fed a high-fat diet for 16 weeks, FMRKO mice had reduced body weight, fat mass, and hepatic steatosis, relative to floxed control mice. Decreased adiposity likely resulted from increased energy expenditure since food intake was not different. RNA sequencing analysis revealed decreased enrichment of genes associated with adipogenesis in inguinal white adipose of FMRKO mice. Differentiation of mouse embryonic fibroblasts (MEFs) showed modestly impaired adipogenesis in MRKO MEFs compared with wild type, but this was rescued upon the addition of peroxisome proliferator-activated receptor gamma (PPARγ) agonist or PPARγ overexpression. Collectively, these studies provide further evidence supporting the potential value of MR as a therapeutic target for conditions associated with metabolic syndrome.
Collapse
Affiliation(s)
- Daniel Ferguson
- Department of Medicine, Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, Missouri
| | - Irina Hutson
- Department of Medicine, Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, Missouri
| | - Eric Tycksen
- Genome Technology Access Center, McDonnell Genome Institute, Washington University School of Medicine, St. Louis, Missouri
| | - Terri A Pietka
- Nutrition and Geriatrics Division, Washington University School of Medicine, St. Louis, Missouri
| | - Kevin Bauerle
- Department of Medicine, Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, Missouri
| | - Charles A Harris
- Department of Medicine, Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine, St. Louis, Missouri
- Department of Medicine, Veterans Affairs St Louis Healthcare System, John Cochran Division, St. Louis, Missouri
| |
Collapse
|
10
|
Garcez A, Leite HM, Weiderpass E, Paniz VMV, Watte G, Canuto R, Olinto MTA. Basal cortisol levels and metabolic syndrome: A systematic review and meta-analysis of observational studies. Psychoneuroendocrinology 2018; 95:50-62. [PMID: 29800780 DOI: 10.1016/j.psyneuen.2018.05.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/06/2018] [Accepted: 05/15/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To perform a qualitative synthesis (systematic review) and quantitative analysis (meta-analysis) to summarize the evidence regarding the relationship between basal cortisol levels and metabolic syndrome (MetS) in adults. METHODS A systematic search was performed in the PubMed, Embase, and PsycINFO databases for observational studies on the association between basal cortisol levels and MetS. The quality of individual studies was assessed by the Newcastle-Ottawa score. A random effects model was used to report pooled quantitative results and the I2 statistic was used to assess heterogeneity. Egger's and Begg's tests were used to evaluate publication bias. RESULTS Twenty-six studies (19 cross-sectional and seven case-control) met the inclusion criteria for the systematic review. The majority was classified as having a low risk of bias and used established criteria for the diagnosis of MetS. Twenty-one studies provided data on basal cortisol levels as continuous values and were included in the meta-analysis; they comprised 35 analyses and 11,808 subjects. Pooled results showed no significant difference in basal cortisol levels between subjects with and without MetS (standardized mean difference [SMD] = 0.02, 95% confidence interval [CI]=-0.11 to 0.14). There was high heterogeneity between the studies when all comparisons were considered (I2 = 83.1%;p < 0.001). Paradoxically, meta-analysis of studies evaluating saliva samples showed no significantly lower basal cortisol levels among subjects with MetS (SMD=-0.18, 95% CI=-0.37 to 0.01), whereas those studies that evaluated serum samples (SMD = 0.11, 95% CI=-0.02 to 0.24) and urine samples (SMD = 0.73, 95% CI=-0.40 to 1.86) showed no significantly higher basal cortisol levels among subjects with MetS. In the subgroup and meta-regression analyses, a significant difference in basal cortisol levels was observed according to study design, population base, age, gender, cortisol level assessment method, and study quality. CONCLUSION This systematic review and meta-analysis does not reveal any association between basal cortisol levels and MetS based on results of observational studies. The results of a random-effect meta-analysis showed no significant difference in basal cortisol levels between subjects with and without MetS. The present findings should be considered in order to help future studies.
Collapse
Affiliation(s)
- Anderson Garcez
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil
| | - Heloísa Marquardt Leite
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Cancer Registry of Norway, Institute of Population-based Cancer Research, Department of Research, Oslo, Norway; Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, Tromsø, Norway; University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Vera Maria Vieira Paniz
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil
| | - Guilherme Watte
- Department of Respiratory Medicine and Thoracic Surgery, Pavilhão Pereira Filho, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Raquel Canuto
- Department of Nutrition, Federal University of Rio Grande do Sul State (UFRGS), Porto Alegre, RS, Brazil
| | - Maria Teresa Anselmo Olinto
- Post-graduate Program in Collective Health, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil; Department of Nutrition, Federal University of Health Science of Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
| |
Collapse
|
11
|
Garbellotto GI, Reis FJ, Feoli AMP, Piovesan CH, Gustavo ADS, Oliveira MDS, Macagnan FE, Ferreira CAS, Bauer ME, Wietzycoski CR. SALIVARY CORTISOL AND METABOLIC SYNDROME COMPONENT'S ASSOCIATION. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2018; 31:e1351. [PMID: 29947685 PMCID: PMC6049990 DOI: 10.1590/0102-672020180001e1351] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/23/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Actually the lifestyle exposes the population to several risk factors related to alimentary habits and less physical activity that contributes to chronic diseases appearance worldwide. AIM To analyze the association between salivary cortisol and the components of metabolic syndrome. METHODS This is a cross-sectional study. As part of it, 28 individuals aged 30-59 years presenting three or more of the following findings: CA: ≥88 cm for women and ≥102 cm for men; SBP>130 mmHg and DBP>85 mmHg; GL>100 mg/dl; TG>150 mg/dl; HDL<40 mg/dl for men and <50 mg/dl for women. Was performed analysis of salivary cortisol (by radioimmunoassay) from 25 salivary samples collected throughout the day, for evaluating changes in the circadian rhythm of this hormone (8AM, noon and 8PM). RESULTS 28 evaluated individuals had a mean age of 51.9±7.5 years, mostly women (64.3%) and a mean of BMI 33.6±3.2 kg/m². The cortisol level from the 8AM averaged 18.7±4.8 ng/dlL. Individuals with FPG>110mg/dl, have significantly lower average levels of cortisol than ones with FPG <110 (12.8±5,2 vs. 17.3±4.2). Significant correlations were HOMA vs. WC (r=0,465; p˂0,005) and TG (r=0,473; p˂0,005), WC vs. FG (r=0,446; p˂0,005) and BMI (r=0,730; p˂0.0001); TG vs. HDL (r=0,441 p˂0,005) and FG (r=0,440; p˂0,005). CONCLUSION Morning salivary cortisol in subjects with chronically elevated blood glucose can represent a downregulation of the hypothalamic-pituitary adrenal axis. This is an important finding not yet well investigated.
Collapse
Affiliation(s)
| | - Fernanda Jardim Reis
- Faculty of Nursing, Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul
| | - Ana Maria Pandolfo Feoli
- Faculty of Nursing, Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul
| | - Carla Haas Piovesan
- Faculty of Nursing, Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul
| | - Andréia da Silva Gustavo
- Faculty of Nursing, Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul
| | | | - Fabrício Edler Macagnan
- Faculty of Nursing, Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul
| | | | - Moisés Evandro Bauer
- Post-graduate Programa in Molecular and Cellular Biology, Biosciences Faculty, PUCRS, Porto Alegre, RS, Brazil
| | - Cácio Ricardo Wietzycoski
- Faculty of Nursing, Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul
| |
Collapse
|
12
|
Cardel MI, Min YI, Sims M, Musani SK, Dulin-Keita A, DeBoer MD, Gurka MJ. Association of psychosocial stressors with metabolic syndrome severity among African Americans in the Jackson Heart Study. Psychoneuroendocrinology 2018; 90:141-147. [PMID: 29494952 PMCID: PMC5864559 DOI: 10.1016/j.psyneuen.2018.02.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/08/2018] [Accepted: 02/14/2018] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Using Jackson Heart Study (JHS) data, we assessed the association between perceived psychosocial stressors and metabolic syndrome (MetS) severity in African American adults. METHODS Participants included 3870 African American JHS participants aged 21-95 years (63.1% women; mean age 53.8 ± 13.0). Psychosocial stressors assessed included: major life events (MLEs); global stress; and weekly stress inventory. Each stress measure was classified into tertiles (low, medium, and high). Associations of psychosocial stressors with a sex- and race/ethnic-specific MetS severity Z-score were examined after adjustment for demographics and MetS risk factors (i.e., nutrition, physical activity, smoking status, and alcohol consumption). RESULTS Independent of lifestyle factors, participants who reported high (versus low) perceived global stress and MLEs had significantly greater MetS severity (p = .0207 and p = .0105, respectively). Weekly stress was not associated with MetS severity. Compared to men, women reported significantly higher global stress and MLEs (p < 0.0001). A significant interaction between sex and MLEs (p = .0456) demonstrated men significantly increased their MetS severity at medium levels of stress, whereas women's MetS severity was significantly increased at high levels of MLEs. CONCLUSIONS In the total sample, higher reported global stress and MLEs were associated with increased risk of MetS severity, while weekly stress was not. Men's and women's stress responses to MLEs were differentially associated with MetS severity, with male MetS severity increasing significantly at lower levels of MLEs relative to women's MetS severity. These data may have implications for targeting stress-related factors in interventions to improve cardiometabolic health in African American adults.
Collapse
Affiliation(s)
- Michelle I. Cardel
- Department of Health Outcomes and Policy, University of Florida, PO Box 100177, Gainesville, Florida, 32610-0177, USA
| | - Yuan-I Min
- Department of Medicine, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS, 39216, USA.
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS, 39216, USA.
| | - Solomon K. Musani
- Department of Medicine, University of Mississippi Medical Center, 2500 N. State St., Jackson, Mississippi, 39216, USA
| | - Akilah Dulin-Keita
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G-S121-4, 121 S. Main St., Providence, RI, 02912, USA.
| | - Mark D. DeBoer
- Department of Pediatrics, PO Box 800386, University of Virginia Health System, Charlottesville, Virginia, 22908-0386, USA
| | - Matthew J. Gurka
- Department of Health Outcomes and Policy, University of Florida, PO Box 100177, Gainesville, Florida, 32610-0177, USA
| |
Collapse
|
13
|
Simultaneous measurement of salivary cortisol and alpha-amylase: Application and recommendations. Neurosci Biobehav Rev 2017; 83:657-677. [DOI: 10.1016/j.neubiorev.2017.08.015] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/16/2017] [Accepted: 08/21/2017] [Indexed: 01/20/2023]
|
14
|
Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Ann N Y Acad Sci 2017; 1391:20-34. [PMID: 27750377 PMCID: PMC5334212 DOI: 10.1111/nyas.13217] [Citation(s) in RCA: 321] [Impact Index Per Article: 45.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Controversy exists over the role of stress and depression in the pathophysiology of type 2 diabetes mellitus. Depression has been shown to increase the risk for progressive insulin resistance and incident type 2 diabetes mellitus in multiple studies, whereas the association of stress with diabetes is less clear, owing to differences in study designs and in forms and ascertainment of stress. The biological systems involved in adaptation that mediate the link between stress and physiological functions include the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous and immune systems. The HPA axis is a tightly regulated system that represents one of the body's mechanisms for responding to acute and chronic stress. Depression is associated with cross-sectional and longitudinal alterations in the diurnal cortisol curve, including a blunted cortisol awakening response and flattening of the diurnal cortisol curve. Flattening of the diurnal cortisol curve is also associated with insulin resistance and type 2 diabetes mellitus. In this article, we review and summarize the evidence supporting HPA axis dysregulation as an important biological link between stress, depression, and type 2 diabetes mellitus.
Collapse
Affiliation(s)
- Joshua J Joseph
- Division of Endocrinology, Diabetes, and Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sherita H Golden
- Division of Endocrinology, Diabetes, and Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
15
|
Joseph JJ, Wang X, Diez Roux AV, Sanchez BN, Seeman TE, Needham BL, Golden SH. Antecedent longitudinal changes in body mass index are associated with diurnal cortisol curve features: The multi-ethnic study of atherosclerosis. Metabolism 2017; 68:95-107. [PMID: 28183457 PMCID: PMC5312946 DOI: 10.1016/j.metabol.2016.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 11/15/2016] [Accepted: 12/05/2016] [Indexed: 01/05/2023]
Abstract
CONTEXT Prior studies have shown a cross-sectional association between body mass index (BMI) and salivary diurnal cortisol profile features (cortisol features); however, to our knowledge prior population-based studies have not examined the longitudinal association of body-mass index (BMI) with cortisol features. OBJECTIVE To examine the association of (1) prior annual BMI percent change over 7years with cortisol features, (2) baseline cortisol features with subsequent change in BMI over 6years and (3) the association of change in cortisol features with change in BMI over 6years. DESIGN Longitudinal study. SETTING Multi-Ethnic Study of Atherosclerosis (MESA) Stress I & II Studies (2004-2006 & 2010-2012). PARTICIPANTS 1685 ethnically diverse men and women attended either MESA Stress exam (mean age 65±10years at MESA Stress I; mean age 69±9years at MESA Stress II). OUTCOME MEASURES Log-transformed cortisol features including wake-up cortisol, cortisol awakening response, early decline slope (30min to 2h post-awakening), late decline slope (2h post-awakening to bedtime), bedtime, and total area under the curve (AUC) cortisol. RESULTS Over 7years, following multivariable adjustment, (1) a 1% higher prior annual BMI % increase was associated with a 2.9% (95% CI: -5.0%, -0.8%) and 3.0% (95% CI: -4.7%, -1.4%) lower current wake-up and total AUC cortisol, respectively; (2) there was no significant association between baseline cortisol features and subsequent change in BMI and (3) among participants with BMI≥30kg/m2, flattening of the late decline slope was associated with increases in BMI (every 1-unit increase late decline slope were associated with a 12.9% increase (95%CI: -1%, 26.8%) in BMI, respectively). CONCLUSIONS We found a significant association between prior annual BMI % change and cortisol features, but no significant association between baseline cortisol features and subsequent change in BMI. In participants with obesity increases in BMI were associated with less pronounced declined. Collectively, our results suggest that greater adiposity may lead to a blunted diurnal cortisol profile.
Collapse
Affiliation(s)
- Joshua J Joseph
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
| | - Xu Wang
- School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Ana V Diez Roux
- School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Brisa N Sanchez
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Teresa E Seeman
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Belinda L Needham
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Sherita Hill Golden
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, United States
| |
Collapse
|
16
|
Maripuu M, Wikgren M, Karling P, Adolfsson R, Norrback KF. Relative hypocortisolism is associated with obesity and the metabolic syndrome in recurrent affective disorders. J Affect Disord 2016; 204:187-96. [PMID: 27367307 DOI: 10.1016/j.jad.2016.06.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/08/2016] [Accepted: 06/12/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is one of the main causes of excess deaths in affective disorders. Affective disorders are associated with increased frequencies of CVD risk-factors such as obesity, dyslipidemia, and metabolic syndrome. Stress-induced chronic cortisol excess has been suggested to promote obesity and metabolic syndrome. Chronic stress with frequent or persisting hypothalamic-pituitary-adrenal-axis (HPA-axis) hyperactivity may, over time, lead to a state of low HPA-axis activity, also denoted hypocortisolism. A low-dose weight-adjusted dexamethasone-suppression-test (DST) is considered to be a sensitive measure of hypocortisolism. METHODS 245 patients with recurrent depression or bipolar disorder and 258 controls participated in a low-dose DST and were also examined with regard to metabolic status. RESULTS Patients with hypocortisolism (low post-DST cortisol) compared with patients without hypocortisolism (normal or high post-DST cortisol) exhibited increased odds ratios (OR) for obesity (OR=4.0), overweight (OR=4.0), large waist (OR=2.7), high LDL (OR=4.2), low HDL (OR=2.4), high LDL/HDL ratio (OR=3.3), high TC/HDL ratio (OR=3.4) and metabolic syndrome (OR=2.0). A similar pattern but less pronounced was also found in the control sample. LIMITATIONS The cross sectional study design and absence of analyses addressing lifestyle factors. CONCLUSIONS Our findings suggest that a substantial portion of the metabolic disorders and cardiovascular risk factors seen in recurrent affective disorders are found among individuals exhibiting hypocortisolism. This might indicate that long-term stress is a central contributor to metabolic abnormalities and CVD mortality in recurrent affective disorders.
Collapse
Affiliation(s)
- Martin Maripuu
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden.
| | - Mikael Wikgren
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Pontus Karling
- Division of Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Rolf Adolfsson
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Karl-Fredrik Norrback
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| |
Collapse
|
17
|
Pulopulos MM, Hidalgo V, Puig-Perez S, Salvador A. Cortisol awakening response and cognitive performance in hypertensive and normotensive older people. Horm Behav 2016; 83:75-82. [PMID: 27208824 DOI: 10.1016/j.yhbeh.2016.05.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 02/28/2016] [Accepted: 05/16/2016] [Indexed: 01/22/2023]
Abstract
Healthy older people with a cortisol awakening response (CAR) of decreased magnitude show worse frontal cortex-related cognitive performance. Systemic hypertension has been related to a CAR of decreased magnitude. Additionally, worse executive function and processing speed have been observed in older people with systemic hypertension. This is the first study to examine the relationship between the CAR (measured with six saliva samples at home on two consecutive weekdays) and cognitive performance, in both hypertensive (n=26) and normotensive (n=28) older people (from 56 to 78years old). Hypertensive participants showed lower morning cortisol secretion, and they also woke up earlier. No differences in CAR were observed. A CAR of decreased magnitude was related to worse executive function in both hypertensive and normotensive participants, but to slower processing speed only in normotensive participants. Being treated with antihypertensive for a longer period of time was related to a CAR of increased magnitude and better performance on executive function. Our findings suggest that earlier awakening time in hypertensive older people might underlie the lower overall morning cortisol secretion observed in previous studies. Additionally, this study confirms that a dysregulation of the CAR is related to worse executive function, and it extends this association to hypertensive older people. Finally, it is worth noting that hypertension may moderate the relationship between CAR and processing speed.
Collapse
Affiliation(s)
- Matias M Pulopulos
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Spain.
| | - Vanesa Hidalgo
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Spain
| | - Sara Puig-Perez
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Spain
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Spain
| |
Collapse
|
18
|
Konishi S, O'Connor KA. Salivary but not blood cortisol excretion is associated with metabolic biomarkers in healthy young women. Am J Hum Biol 2016; 28:539-44. [PMID: 26779782 DOI: 10.1002/ajhb.22827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 11/21/2015] [Accepted: 12/22/2015] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Elevated and suppressed concentrations of cortisol have been linked with less favorable metabolic biomarkers, such as elevated lipids and glycosylated hemoglobin (HbA1c). Based on recent work reporting that some individuals secrete more cortisol into saliva (high saliva-to-blood cortisol ratio; high secretors) than others after correcting for blood cortisol concentrations, our objectives were to examine (1) whether lipids and glycosylated hemoglobin varied across cortisol and salivary secretor status; and (2) if blood and saliva provide the same results with respect to metabolic markers. METHODS Matched saliva and dried blood spot (DBS) specimens collected once a week for four weeks (N = 48 healthy women, 192 specimens) were assayed for cortisol. Fasting blood specimens collected once from each woman were quantified for cholesterol (total, HDL, LDL), triglycerides and HbA1c. RESULTS Low salivary cortisol secretors showed significantly higher triglyceride and HbA1c compared to high-secretors (P<0.05; t-test). The only significant correlation with mean blood or salivary cortisol concentration was a negative correlation between salivary cortisol and HbA1c (P = 0.021, r = -0.333). CONCLUSIONS Triglycerides, HDL, and especially HbA1c were associated with salivary cortisol secretor status but not with DBS cortisol concentrations. These results suggest that blood and saliva cortisol measures might provide different health outcome information, and that salivary cortisol secretor status may provide additional information on health status. Am. J. Hum. Biol. 28:539-544, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Shoko Konishi
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan.,Department of Anthropology, University of Washington, Seattle, Washington, 98195
| | - Kathleen A O'Connor
- Department of Anthropology, University of Washington, Seattle, Washington, 98195.,Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington, 98195
| |
Collapse
|
19
|
Joseph JJ, Wang X, Spanakis E, Seeman T, Wand G, Needham B, Golden SH. Diurnal salivary cortisol, glycemia and insulin resistance: The multi-ethnic study of atherosclerosis. Psychoneuroendocrinology 2015; 62:327-35. [PMID: 26356041 PMCID: PMC4637243 DOI: 10.1016/j.psyneuen.2015.08.021] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 08/25/2015] [Accepted: 08/25/2015] [Indexed: 10/23/2022]
Abstract
Hypercortisolism is associated with insulin resistance (IR) and diabetes mellitus (DM); however, to our knowledge prior studies have not examined the association of diurnal cortisol curve features with measures of glycemia or IR in a population-based setting. Using log-transformed salivary cortisol data on 850 ethnically diverse men and women from the Multi-Ethnic Study of Atherosclerosis, we investigated the cross-sectional association of cortisol curve features with (1) glycemia in those with and without DM and (2) IR, in non-diabetic subjects. The log-transformed salivary cortisol curve features included wake-up cortisol, cortisol awakening response (CAR), early decline slope (30min to 2h post-awakening), late decline slope (2h post-awakening to bedtime), overall decline slope (0min to bedtime, excluding 30min cortisol), bedtime cortisol and total area under the curve (AUC). Overall, following multivariable adjustment, among those with diabetes mellitus (DM), early decline slope, overall decline slope, bedtime cortisol, and AUC were significantly and positively associated with a 5.4% (95% CI: 1.3, 9.7), 54.7% (95% CI: 12.4, 112.9), 4.0% (95% CI: 1.6,6.4), and 6.8% (95% CI: 3.3,10.4) higher HbA1c per 1 unit increase in log cortisol feature, respectively. Cortisol curve features were not associated with HbA1c among non-diabetic participants; however, wake-up cortisol and AUC were associated with a 8.2% lower (95% CI: -13.3,-2.7) and 7.9% lower (95% CI: -14.6, -0.6) log HOMA-IR, respectively. This was attenuated by adjustment for waist circumference. Among participants with DM, cortisol curve parameters suggestive of higher hypothalamic-pituitary-adrenal (HPA) axis activity and dysfunction were associated with higher HbA1c. In non-diabetic participants, greater HPA activity was paradoxically associated with lower insulin resistance.
Collapse
Affiliation(s)
- Joshua J. Joseph
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Xu Wang
- School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Elias Spanakis
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Teresa Seeman
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Gary Wand
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Belinda Needham
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Sherita Hill Golden
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, United States.
| |
Collapse
|
20
|
An K, Salyer J, Brown RE, Kao HFS, Starkweather A, Shim I. Salivary Biomarkers of Chronic Psychosocial Stress and CVD Risks. Biol Res Nurs 2015; 18:241-63. [DOI: 10.1177/1099800415604437] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The use of salivary biomarkers in stress research is increasing, and the precision and accuracy with which researchers are able to measure these biomarkers have dramatically improved. Chronic psychosocial stress is often linked to the pathogenesis of cardiovascular disease (CVD). Salivary biomarkers represent a noninvasive biological method of characterizing the stress phenomenon that may help to more fully describe the mechanism by which stress contributes to the pathogenesis and outcomes of CVD. Objectives: We conducted a systematic review of 40 research articles to identify the salivary biomarkers researchers have most commonly used to help describe the biological impact of chronic psychosocial stress and explore its associations with CVD risk. We address strengths and weaknesses of specimen collection and measurement. Methods: We used PubMed, CINAHL, EBSCO host, Web of Science, BIOSIS Previews, Biological Sciences (ProQuest), and Dissertations/Theses (ProQuest) to retrieve 387 initial articles. Once we applied our inclusion/exclusion criteria to specifically target adult human studies dealing with chronic stress rather than acute/laboratory-induced stress, 40 studies remained, which we synthesized using Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Results: Cortisol was the biomarker used most frequently. Sources of psychosocial stress included job strain, low socioeconomic status, and environmental factors. Overall, psychosocial stress was associated with CVD risks such as vascular pathology (hypertension, blood pressure fluctuation, and carotid artery plaque) as well as metabolic factors such as abnormal blood glucose, dyslipidemia, and elevated cardiac enzymes. Conclusion: Diverse salivary biomarkers have been useful in stress research, particularly when linked to CVD risks.
Collapse
Affiliation(s)
- Kyungeh An
- School of Nursing, Virginia Commonwealth University, Richmond VA, USA
| | - Jeanne Salyer
- School of Nursing, Virginia Commonwealth University, Richmond VA, USA
| | - Roy E. Brown
- School of Nursing, Virginia Commonwealth University, Richmond VA, USA
| | | | | | | |
Collapse
|
21
|
Ratliff S, Mezuk B. Depressive symptoms, psychiatric medication use, and risk of type 2 diabetes: results from the Health and Retirement Study. Gen Hosp Psychiatry 2015; 37:420-6. [PMID: 26094130 PMCID: PMC4558325 DOI: 10.1016/j.genhosppsych.2015.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 05/15/2015] [Accepted: 05/22/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This prospective study investigates the relationships between depressive symptoms, psychiatric medication use, and their interaction on risk of developing type 2 diabetes. METHOD Data come from the 1998-2010 waves of the Health and Retirement Study, a US nationally representative cohort of adults aged 51 years and older. Analysis is restricted to participants <65 years old who did not have diabetes in 1998 (N=8704). Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies-Depression Scale. Risk of diabetes over the 12-year follow-up period was assessed using Cox proportional hazard models with time-varying covariates. RESULTS After adjusting for covariates, both depressive symptoms [hazard ratio (HR): 1.06, 95% confidence interval (CI): 1.02-1.09] and psychiatric medication use (HR: 1.57, 95% CI: 1.25-1.96) were associated with development of diabetes. The interaction between depressive symptoms and medication use was significant (beta=-0.240, P=.049), indicating that the association between elevated depressive symptoms and diabetes was higher among respondents not taking medications. The associations between depressive symptoms and medication use were also attenuated by increasing body mass index. CONCLUSION Findings highlight the complex relationship between depressive symptoms and psychiatric medications on diabetes risk and the need for a nuanced understanding of these factors.
Collapse
Affiliation(s)
- Scott Ratliff
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA 23298, USA.
| | - Briana Mezuk
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA 23298, USA; Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Richmond, VA 23219, USA; Research Center for Group Dynamics, Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48106, USA.
| |
Collapse
|
22
|
Cash E, Sephton SE, Chagpar AB, Spiegel D, Rebholz WN, Zimmaro LA, Tillie JM, Dhabhar FS. Circadian disruption and biomarkers of tumor progression in breast cancer patients awaiting surgery. Brain Behav Immun 2015; 48:102-14. [PMID: 25728235 DOI: 10.1016/j.bbi.2015.02.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 02/09/2015] [Accepted: 02/20/2015] [Indexed: 02/08/2023] Open
Abstract
Psychological distress, which can begin with cancer diagnosis and continue with treatment, is linked with circadian and endocrine disruption. In turn, circadian/endocrine factors are potent modulators of cancer progression. We hypothesized that circadian rest-activity rhythm disruption, distress, and diurnal cortisol rhythms would be associated with biomarkers of tumor progression in the peripheral blood of women awaiting breast cancer surgery. Breast cancer patients (n=43) provided actigraphic data on rest-activity rhythm, cancer-specific distress (IES, POMS), saliva samples for assessment of diurnal cortisol rhythm, cortisol awakening response (CAR), and diurnal mean. Ten potential markers of tumor progression were quantified in serum samples and grouped by exploratory factor analysis. Analyses yielded three factors, which appear to include biomarkers reflecting different aspects of tumor progression. Elevated factor scores indicate both high levels and strong clustering among serum signals. Factor 1 included VEGF, MMP-9, and TGF-β; suggesting tumor invasion/immunosuppression. Factor 2 included IL-1β, TNF-α, IL-6R, MCP-1; suggesting inflammation/chemotaxis. Factor 3 included IL-6, IL-12, IFN-γ; suggesting inflammation/TH1-type immunity. Hierarchical regressions adjusting age, stage and socioeconomic status examined associations of circadian, distress, and endocrine variables with these three factor scores. Patients with poor circadian coordination as measured by rest-activity rhythms had higher Factor 1 scores (R(2)=.160, p=.038). Patients with elevated CAR also had higher Factor 1 scores (R(2)=.293, p=.020). These relationships appeared to be driven largely by VEGF concentrations. Distress was not related to tumor-relevant biomarkers, and no other significant relationships emerged. Women with strong circadian activity rhythms showed less evidence of tumor promotion and/or progression as indicated by peripheral blood biomarkers. The study was not equipped to discern the cause of these associations. Circadian/endocrine aberrations may be a manifestation of systemic effects of aggressive tumors. Alternatively, these results raise the possibility that, among patients with active breast tumors, disruption of circadian activity rhythms and elevated CAR may facilitate tumor promotion and progression.
Collapse
Affiliation(s)
- E Cash
- Department of Surgery, Division of Otolaryngology-HNS, University of Louisville School of Medicine, Louisville, KY, United States; Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, United States; James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States
| | - S E Sephton
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, United States; James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States.
| | - A B Chagpar
- The Breast Center - Smilow Cancer Hospital at Yale-New Haven, Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - D Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - W N Rebholz
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, United States
| | - L A Zimmaro
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, United States
| | - J M Tillie
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - F S Dhabhar
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, United States; Institute for Immunity, Transplantation, and Infection, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, United States.
| |
Collapse
|
23
|
Baughman P, Andrew ME, Burchfiel CM, Fekedulegn D, Hartley TA, Violanti JM, Miller DB. High-protein meal challenge reveals the association between the salivary cortisol response and metabolic syndrome in police officers. Am J Hum Biol 2015; 28:138-44. [PMID: 26088798 DOI: 10.1002/ajhb.22748] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 05/13/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Policing is considered a high-stress occupation and officers have elevated cardiovascular morbidity and mortality. To investigate a potential connection, we evaluated the association between salivary cortisol response to a high-protein meal challenge and the metabolic syndrome (MetSyn), a subclinical disorder associated with increased cardiovascular risk. METHODS Cross-sectional data were from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study (2004-2009). MetSyn was defined as having ≥3 components: abdominal obesity, hypertension, elevated triglycerides, reduced high-density lipoprotein cholesterol, and glucose intolerance. Officers provided five saliva samples for cortisol analysis, one before challenge (high-protein shake) and four at 15-min intervals thereafter, where the usual response is increase. Regression models were used to examine trends in mean number of MetSyn components across quartiles of area under the curve (AUC) salivary cortisol. Patterns of mean cortisol response were assessed by MetSyn status using repeated-measures analysis of covariance. RESULTS Prevalence of MetSyn was 25.7% among 373 officers (74.0% male). The mean count of MetSyn components decreased (1.89, 1.75, 1.55, 1.37; P < 0.01) across increasing quartiles of AUC salivary cortisol. Mean salivary cortisol decreased from baseline (5.55, 4.58, 4.47, 4.79, 4.75 nmol/l) in officers with MetSyn and increased (5.08, 5.82, 5.92, 5.82, 5.60 nmol/l) in their counterparts. The test for interaction between MetSyn status and time of saliva collection was statistically significant (P < 0.001). CONCLUSIONS Reduced cortisol response to a high-protein meal challenge may be associated with MetSyn. Future longitudinal studies could provide useful evidence for planning intervention studies on cardiovascular risk among police officers.
Collapse
Affiliation(s)
- Penelope Baughman
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia.,Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michael E Andrew
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Cecil M Burchfiel
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Desta Fekedulegn
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Tara A Hartley
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - John M Violanti
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York, University at Buffalo, Buffalo, New York
| | - Diane B Miller
- Toxicology and Molecular Biology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| |
Collapse
|
24
|
He Z, Payne EK, Mukherjee B, Lee S, Smith JA, Ware EB, Sánchez BN, Seeman TE, Kardia SLR, Diez Roux AV. Association between Stress Response Genes and Features of Diurnal Cortisol Curves in the Multi-Ethnic Study of Atherosclerosis: A New Multi-Phenotype Approach for Gene-Based Association Tests. PLoS One 2015; 10:e0126637. [PMID: 25993632 PMCID: PMC4439141 DOI: 10.1371/journal.pone.0126637] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 04/05/2015] [Indexed: 11/18/2022] Open
Abstract
The hormone cortisol is likely to be a key mediator of the stress response that influences multiple physiologic systems that are involved in common chronic disease, including the cardiovascular system, the immune system, and metabolism. In this paper, a candidate gene approach was used to investigate genetic contributions to variability in multiple correlated features of the daily cortisol profile in a sample of European Americans, African Americans, and Hispanic Americans from the Multi-Ethnic Study of Atherosclerosis (MESA). We proposed and applied a new gene-level multiple-phenotype analysis and carried out a meta-analysis to combine the ethnicity specific results. This new analysis, instead of a more routine single marker-single phenotype approach identified a significant association between one gene (ADRB2) and cortisol features (meta-analysis p-value=0.0025), which was not identified by three other commonly used existing analytic strategies: 1. Single marker association tests involving each single cortisol feature separately; 2. Single marker association tests jointly testing for multiple cortisol features; 3. Gene-level association tests separately carried out for each single cortisol feature. The analytic strategies presented consider different hypotheses regarding genotype-phenotype association and imply different costs of multiple testing. The proposed gene-level analysis integrating multiple cortisol features across multiple ethnic groups provides new insights into the gene-cortisol association.
Collapse
Affiliation(s)
- Zihuai He
- Department of Biostatistics, University of Michigan, Ann Arbor, United States of America
| | - Erin K. Payne
- Life Sciences Program, Northrop Grumman Health Division, McLean, Virginia, United States of America
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan, Ann Arbor, United States of America
- * E-mail:
| | - Seunggeun Lee
- Department of Biostatistics, University of Michigan, Ann Arbor, United States of America
| | - Jennifer A. Smith
- Department of Epidemiology, University of Michigan, Ann Arbor, United States of America
| | - Erin B. Ware
- Department of Epidemiology, University of Michigan, Ann Arbor, United States of America
| | - Brisa N. Sánchez
- Department of Biostatistics, University of Michigan, Ann Arbor, United States of America
| | - Teresa E. Seeman
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, United States of America
| | - Sharon L. R. Kardia
- Department of Epidemiology, University of Michigan, Ann Arbor, United States of America
| | - Ana V. Diez Roux
- Department of Epidemiology, Drexel University, Philadelphia, United States of America
| |
Collapse
|
25
|
Corey SM, Epel E, Schembri M, Pawlowsky SB, Cole RJ, Araneta MRG, Barrett-Connor E, Kanaya AM. Effect of restorative yoga vs. stretching on diurnal cortisol dynamics and psychosocial outcomes in individuals with the metabolic syndrome: the PRYSMS randomized controlled trial. Psychoneuroendocrinology 2014; 49:260-71. [PMID: 25127084 PMCID: PMC4174464 DOI: 10.1016/j.psyneuen.2014.07.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 07/11/2014] [Accepted: 07/12/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE Chronic stimulation and dysregulation of the neuroendocrine system by stress may cause metabolic abnormalities. We estimated how much cortisol and psychosocial outcomes improved with a restorative yoga (relaxation) versus a low impact stretching intervention for individuals with the metabolic syndrome. METHODS We conducted a 1-year multi-center randomized controlled trial (6-month intervention and 6-month maintenance phase) of restorative yoga vs. stretching. Participants completed surveys to assess depression, social support, positive affect, and stress at baseline, 6 months and 12 months. For each assessment, we collected saliva at four points daily for three days and collected response to dexamethasone on the fourth day for analysis of diurnal cortisol dynamics. We analyzed our data using multivariate regression models, controlling for study site, medications (antidepressants, hormone therapy), body mass index, and baseline cortisol values. RESULTS Psychosocial outcome measures were available for 171 study participants at baseline, 140 at 6 months, and 132 at 1 year. Complete cortisol data were available for 136 of 171 study participants (72 in restorative yoga and 64 in stretching) and were only available at baseline and 6 months. At 6 months, the stretching group had decreased cortisol at waking and bedtime compared to the restorative yoga group. The pattern of changes in stress mirrored this improvement, with the stretching group showing reductions in chronic stress severity and perseverative thoughts about their stress. Perceived stress decreased by 1.5 points (-0.4; 3.3, p=0.11) at 6 months, and by 2.0 points (0.1; 3.9, p=0.04) at 1 year in the stretching compared to restorative yoga groups. Post hoc analyses suggest that in the stretching group only, perceived increases in social support (particularly feelings of belonging), but not changes in stress were related to improved cortisol dynamics. CONCLUSIONS We found significant decreases in salivary cortisol, chronic stress severity, and stress perception in the stretching group compared to the restorative yoga group. Group support during the interactive stretch classes may have contributed to these changes.
Collapse
Affiliation(s)
- Sarah M Corey
- University of California, San Francisco, CA 94115, USA.
| | - Elissa Epel
- University of California, San Francisco, CA 94115, USA
| | | | | | - Roger J Cole
- Synchrony Applied Health Sciences, Del Mar, CA 92014, USA
| | | | | | - Alka M Kanaya
- University of California, San Francisco, CA 94115, USA
| |
Collapse
|
26
|
Reinehr T, Kulle A, Wolters B, Knop C, Lass N, Welzel M, Holterhus PM. Relationships between 24-hour urinary free cortisol concentrations and metabolic syndrome in obese children. J Clin Endocrinol Metab 2014; 99:2391-9. [PMID: 24670085 DOI: 10.1210/jc.2013-4398] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT Clinical features of Metabolic Syndrome (MetS) and Cushing's Syndrome are similar, suggesting a pathogenetic role of hypothalamus-pituitary-adrenal axis in MetS. OBJECTIVE The aim of the study was to determine whether MetS diagnosis and specific clusters of MetS components (waist circumference, dyslipidemia, hypertension, and impaired glucose metabolism) are associated with serum cortisol (SC) or 24-h urinary free cortisol (UFC) levels. DESIGN AND SETTING We conducted cross-sectional analyses of data from our obesity cohort. We studied 264 obese children (age, 11.0 ± 2.8 years; male, 48%; BMI, 28.2 ± 5.4 kg/m(2)). We examined UFC, SC, homeostasis model assessment (HOMA), and features of MetS (waist circumference, blood pressure, fasting lipids, and glucose). RESULTS Slightly increased UFC concentrations were measured in 30.7% of the children. Obese children with MetS had significantly (P = .003) higher UFC levels compared with obese children without MetS. Girls demonstrated significantly higher UFC concentrations compared with boys independent of pubertal stage. UFC and SC levels were significantly related to features of MetS, but the associations were stronger for UFC. In multivariate analyses adjusted for age, sex, and body mass index, none of the features of MetS but HOMA index was correlated with UFC, whereas SC demonstrated no significant association to any parameter of MetS or HOMA. CONCLUSIONS Our findings support the hypothesis that changes in the hypothalamus-pituitary-adrenal axis are related to MetS in obesity. UFC seems to be a suitable marker for this relationship. Norm values for UFC adapted to obese children may help to avoid unnecessary dexamethasone suppression tests.
Collapse
Affiliation(s)
- Thomas Reinehr
- Department of Pediatric Endocrinology (T.R., B.W., C.K., N.L.), Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Witten, Germany; Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics (A.K., M.W., P.-M.H.), University Hospital of Schleswig Holstein, Campus Kiel/Christian, Albrechts University of Kiel, Kiel, Germany
| | | | | | | | | | | | | |
Collapse
|
27
|
An K, Starkweather A, Sturgill JL, Kao HFS, Salyer J. State of the Science: Salivary Biomarker Utilization for Stress Research. ACTA ACUST UNITED AC 2014. [DOI: 10.16952/pns.2014.11.2.87] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Kyungeh An
- Associate Professor, School of Nursing, Virginia Commonwealth University, Richmond, USA
| | | | - Jamie L. Sturgill
- Assistant Professor, Virginia Commonwealth University, Richmond, USA
| | | | - Jeanne Salyer
- Associate Professor, Virginia Commonwealth University, Richmond, USA
| |
Collapse
|
28
|
Shabir I, Ganie MA, Praveen EP, Khurana ML, John J, Gupta N, Kumar G, Ammini AC. Morning plasma cortisol is low among obese women with polycystic ovary syndrome. Gynecol Endocrinol 2013; 29:1045-7. [PMID: 23957781 DOI: 10.3109/09513590.2013.829449] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common cause for androgen excess in women. It is associated with wide variety of metabolic disorders. The present study assessed morning plasma cortisol in women with PCOS. One hundred and ninety seven cases and 55 controls were enrolled for this study. The mean age of patients and controls were 23 ± 5.6 years and 25 ± 4.3 years. One hundred twelve (56%) women with PCOS had BMI >25. Serum cortisol levels were significantly higher in lean PCOS women compared to controls (13.4 ± 5.1 versus 11.3 ± 4.5, p < 0.01) and over-weight PCOS women group (13.4 ± 5.1 versus 9.3 ± 3.2, p < 0.01). There was a trend for less acne and hirsutism with increase in BMI. Morning plasma cortisol was lower among obese women with PCOS. Morning plasma cortisol correlated negatively with BMI in PCOS women with normal glucose tolerance.
Collapse
Affiliation(s)
- Iram Shabir
- Department of Endocrinology & Metabolism and
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Stalder T, Kirschbaum C, Alexander N, Bornstein SR, Gao W, Miller R, Stark S, Bosch JA, Fischer JE. Cortisol in hair and the metabolic syndrome. J Clin Endocrinol Metab 2013; 98:2573-80. [PMID: 23585660 DOI: 10.1210/jc.2013-1056] [Citation(s) in RCA: 156] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
CONTEXT Although exposure to supraphysiological levels of glucocorticoids is known to contribute to the development of the metabolic syndrome (MetS), the importance of physiological variation in basal cortisol secretion is less clear. This issue can be addressed by using hair cortisol analysis, which for the first time allows the assessment of long-term integrated hormone levels. OBJECTIVE AND DESIGN We used the analysis of cortisol in hair (hairF) to examine associations of long-term cortisol levels with prevalence of MetS and individual cardiometabolic parameters in a large occupational cohort. In additional exploratory analyses, we also studied cardiometabolic associations with hair cortisone levels. PARTICIPANTS Participants included 1258 employees of a large aerospace company (aged 16-64 years; 84.8% males) who partook in a voluntary health assessment. MAIN OUTCOME MEASURES The first 3 cm of scalp-near hair were analyzed for glucocorticoid concentrations using liquid chromatography tandem mass spectrometry. Relevant cardiometabolic risk factors were assessed and MetS was diagnosed (according to 2009 international task force criteria). RESULTS A higher prevalence of MetS was seen in individuals falling into the third (odds ratio 1.71, 95% confidence interval 1.08-2.69) or fourth hairF quartile (odds ratio 2.42, 95% confidence interval 1.55-3.75) compared with the first quartile, in fully adjusted analyses. HairF also showed positive associations with weight-related anthropometric measures (body mass index, waist to hip ratio, waist circumference) and glycated hemoglobin. The exploratory analysis of hair cortisone also indicated relevant associations with cardiometabolic parameters. CONCLUSION Normal physiological differences in long-term cortisol secretion, as assessed in hair, show relevant relationships with MetS and individual cardiometabolic parameters.
Collapse
Affiliation(s)
- Tobias Stalder
- Technische Universität Dresden, Department of Psychology, Andreas-Schubert-Bau, Zellescher Weg 19, 01069 Dresden, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Roberts CK, Croymans DM, Aziz N, Butch AW, Lee CC. Resistance training increases SHBG in overweight/obese, young men. Metabolism 2013; 62:725-33. [PMID: 23318050 PMCID: PMC3845495 DOI: 10.1016/j.metabol.2012.12.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 12/03/2012] [Accepted: 12/04/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Evidence suggests that SHBG affects glycemic control, predicts both T2D and metabolic syndrome, and is low in obese subjects. We sought to determine if resistance exercise training (RT) can increase sex hormone-binding globulin (SHBG) and ameliorate levels of related steroid hormones in overweight/obese, sedentary young men. MATERIALS/METHODS 36 participants (BMI 31.4 kg/m(2), age 22 years) were randomized into an RT (12 weeks of training, 3/week) or control group (C, 12 weeks no training), and assessed for changes in SHBG, cortisol, testosterone, free testosterone (FT) and free androgen index (FAI). In addition, body composition and oral glucose tolerance testing was performed. RESULTS 12 weeks of RT increased SHBG (P=0.01) and decreased FAI (P<0.05) and cortisol (P<0.05) compared to C. FT decreased in RT (P=0.01). Total testosterone did not change in either group. These changes were noted without weight loss, and in concert with increases in lean body mass (P=0.0002 vs C) and decreases in glucose area under the curve (AUC) (P=0.004), insulin AUC (P=0.03), and total (P=0.002) and trunk (P=0.003) fat mass in RT. CONCLUSION In overweight/obese young men, RT increases SHBG and lowers FAI in obese young adult men.
Collapse
Affiliation(s)
- Christian K Roberts
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, UCLA School of Nursing, University of California, Los Angeles, CA, USA.
| | | | | | | | | |
Collapse
|
31
|
Manenschijn L, Schaap L, van Schoor NM, van der Pas S, Peeters GMEE, Lips P, Koper JW, van Rossum EFC. High long-term cortisol levels, measured in scalp hair, are associated with a history of cardiovascular disease. J Clin Endocrinol Metab 2013; 98:2078-83. [PMID: 23596141 DOI: 10.1210/jc.2012-3663] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Stress is associated with an increased incidence of cardiovascular disease. The impact of chronic stress on cardiovascular risk has been studied by measuring cortisol in serum and saliva, which are measurements of only 1 time point. These studies yielded inconclusive results. The measurement of cortisol in scalp hair is a novel method that provides the opportunity to measure long-term cortisol exposure. Our aim was to study whether long-term cortisol levels, measured in scalp hair, are associated with cardiovascular diseases. METHODS A group of 283 community-dwelling elderly participants were randomly selected from a large population-based cohort study (median age, 75 y; range, 65-85 y). Cortisol was measured in 3-cm hair segments, corresponding roughly with a period of 3 months. Self-reported data concerning coronary heart disease, stroke, peripheral arterial disease, diabetes mellitus, and other chronic noncardiovascular diseases were collected. RESULTS Hair cortisol levels were significantly lower in women than in men (21.0 vs 26.3 pg/mg hair; P < .001). High hair cortisol levels were associated with an increased cardiovascular risk (odds ratio, 2.7; P = .01) and an increased risk of type 2 diabetes mellitus (odds ratio, 3.2; P = .04). There were no associations between hair cortisol levels and noncardiovascular diseases. CONCLUSIONS Elevated long-term cortisol levels are associated with a history of cardiovascular disease. The increased cardiovascular risk we found is equivalent to the effect of traditional cardiovascular risk factors, suggesting that long-term elevated cortisol may be an important cardiovascular risk factor.
Collapse
Affiliation(s)
- L Manenschijn
- Department of Internal Medicine, Erasmus MC, Room Ee-542, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
|
33
|
Affiliation(s)
- In-Kyung Jeong
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| |
Collapse
|
34
|
Jang YM, Lee EJ, Kim DL, Kim SK, Song KH. The Association between Midnight Salivary Cortisol and Metabolic Syndrome in Korean Adults. Diabetes Metab J 2012; 36:245-50. [PMID: 22737665 PMCID: PMC3380129 DOI: 10.4093/dmj.2012.36.3.245] [Citation(s) in RCA: 6] [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: 10/17/2011] [Accepted: 02/16/2012] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The common characteristics of metabolic syndrome (MetS) and Cushing's syndrome suggest that excess cortisol may be involved in the pathogenesis of MetS. Salivary cortisol measurements are simple and can be surrogates for plasma free cortisol, which is the most biologically active form. We evaluated the association between levels of midnight salivary cortisol and MetS in Korean adults. METHODS A total of 46 subjects, aged 20 to 70 years, who visited the Health Care Center at Konkuk University Hospital from August 2008 to August 2009 were enrolled. We compared the levels of midnight salivary cortisol in subjects with MetS with those in subjects without MetS. We analyzed the associations between midnight salivary cortisol levels and components of MetS. RESULTS Midnight salivary cortisol levels were higher in the MetS group (70±42.4 ng/dL, n=12) than that in the group without MetS (48.1±36.8 ng/dL, n=34) (P=0.001). Positive correlations were observed between midnight salivary cortisol levels and waist circumference, fasting blood glucose, and homeostasis model assessment of insulin resistance. The risk for MetS was significantly higher in subjects with midnight salivary cortisol levels ≥100 ng/dL than in those with levels <50 ng/dL (odds ratio, 5.9; 95% confidence interval, 2.35 to 36.4). CONCLUSION The results showed a positive correlation between midnight salivary cortisol levels and MetS, suggesting that hypercortisolism may be related to MetS.
Collapse
Affiliation(s)
- Yun-Mi Jang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Eun Jung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Dong Lim Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Suk Kyeong Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Kee-Ho Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| |
Collapse
|
35
|
Praveen EP, Khurana ML, Kulshreshtha B, Dwivedi SN, Prabhakaran D, Khadgawat R, Gupta N, Kumar G, Ammini AC. Plasma testosterone in adult normoglycaemic men: impact of hyperinsulinaemia. Andrologia 2012; 44:293-8. [PMID: 22316062 DOI: 10.1111/j.1439-0272.2012.01278.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2011] [Indexed: 11/29/2022] Open
Abstract
This study analysed the relationship of plasma testosterone with β-cell secretion, insulin sensitivity and other pituitary-target gland hormones in normoglycaemic adult men. The sample frame was the 'Offspring of individuals with diabetes study' database. A total of 358 offspring of individuals with type-2 diabetes (T2DM) and 287 individuals without known family history of T2DM were recruited for the study. Normoglycaemic men aged ≥18 years (maximum 55) were selected for this analysis. All participants underwent 75 g oral glucose tolerance test (OGTT); blood samples were collected at 0, 30, 60 and 120 min for plasma insulin and C-peptide. Total testosterone, cortisol, adrenocorticotropic hormone, thyroid stimulating hormone and thyroxine (T4) were measured in the fasting sample. A total of 164 men (age 28 ± 7.7 years) were included in analysis. Testosterone correlated negatively with BMI, waist to hip ratio (WHR), area under curve (AUC) of C-peptide and insulin (during OGTT) and was positively correlated with insulin sensitivity (r ~ 0.4). Cortisol and T4 positively correlated (weak) with testosterone (r ~ 0.2). In multivariate analysis, AUC C-peptide, BMI, WHR (negatively) and cortisol (positively) were related to testosterone. Concluding, testosterone correlated negatively with BMI and β-cell secretion. There was a positive association of testosterone with insulin sensitivity, cortisol and T4.
Collapse
Affiliation(s)
- E P Praveen
- Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | | | | | | |
Collapse
|