Cortisol Secretion in Obesity Revisited: Lower Basal Serum and Salivary Cortisol with Diminished Cortisol Response to the Low Dose ACTH Challenge

被引：0
作者：
Sofer, Yael [1 ,2 ]
Osher, Esther [1 ,2 ]
Abu Ahmad, Wiessam [3 ]
Greenman, Yona [1 ,2 ]
Moshe, Yaffa [1 ]
Shaklai, Sigal [1 ,2 ]
Yaron, Marianna [1 ]
Serebro, Merav [1 ,2 ]
Tordjman, Karen [1 ,2 ]
Stern, Naftali [1 ,2 ]
机构：
[1] Sourasky Med Ctr, Inst Endocrinol Metab & Hypertens, Tel Aviv, Israel
[2] Tel Aviv Univ, Fac Med, Tel Aviv, Israel
[3] Hebrew Univ Jerusalem Hadassah Hosp & Med Sch, Braun Sch Publ Hlth & Community Med, Jerusalem, Israel
来源：
OBESITY FACTS | 2025年
关键词：
Cortisol; Serum free cortisol; Obesity; Low dose ACTH test; PITUITARY-ADRENAL AXIS; 1; MU-G; ABDOMINAL OBESITY; INSULIN-RESISTANCE; METABOLIC SYNDROME; FAT DISTRIBUTION; WOMEN; STIMULATION; STRESS; MEN;
D O I：
10.1159/000543449
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Introduction:Some clinical resemblance may exist betweenobesity, particularly abdominal obesity, and Cushing's syn-drome. This has stimulated ongoing interest in the role ofcortisol's secretion pattern, control, and metabolism inobesity.Goals:The aim of the study was to investigatewhether basal and stimulated levels of cortisol differ be-tween healthy people with obesity and individuals withnormal weight.Methods:Total, free, and salivary cortisolwas tested at baseline state and after 1 mu g ACTH stimulationin 60 healthy subjects with obesity and 54 healthy leancontrols.Results:Baseline total cortisol was lower in subjectswith obesity compared to lean controls (347 [265-452]nmol/L vs. 422 [328-493] nmol/L, respectively;p<0.05).Similarly, basal salivary cortisol was significantly lower insubjects with obesity (7.5 [5.2-9.7] nmol/L vs. 10.7 [7.5-17.6]nmol/L;p<0.05). Upon challenge with ACTH, total peakserum and salivary peak cortisol responses were significantlylower in people with obesity than in lean subjects (665.16 +/- 151.8 vs. 728.64 +/- 124.2 nmol/L;p<0.05 and 31.66[19-38.64] vs. 40.05 [31.46-46.64] nmol/L;p<0.05, re-spectively). Additionally, baseline total cortisol and salivarycortisol were inversely related to BMI (r=-0.24,r=-0.27;p<0.05 for both) and waist circumference (r=-0.27,r=-0.34;p<0.05 for both).Conclusion:Baseline as well as peakstimulated total serum and salivary cortisol were signifi-cantly lower in subjects with obesity. It thus appears thatobesity is not associated with enhanced basal or ACTH-stimulated cortisol.(c) 2025 The Author(s).Published by S. Karger AG, Basel
引用
收藏
页数：9
相关论文
共 44 条
  • [21] Beishuizen A., Van Lijf J.H., Lekkerkerker J.F., Vermes I., The low dose (1 microg) ACTH stimulation test for assessment of the hypothalamo-pituitary-adrenal axis, Neth J Med., 56, 3, pp. 91-99, (2000)
  • [22] Birtolo M.F., Antonini S., Saladino A., Zampetti B., Lavezzi E., Chiodini I., Et al., ACTH stimulation test for the diagnosis of secondary adrenal insufficiency: Light and shadow, Biomedicines., 11, 3, (2023)
  • [23] Tordjman K., Jaffe A., Trostanetsky Y., Greenman Y., Limor R., Stern N., Low-dose (1 microgram) adrenocorticotrophin (ACTH) stimulation as a screening test for impaired hypothalamo-pituitary-adrenal axis function: Sensitivity, specificity and accuracy in comparison with the high-dose (250 microgram) test, Clin Endocrinol., 52, 5, pp. 633-640, (2000)
  • [24] Dickstein G., Spigel D., Arad E., Shechner C., One microgram is the lowest ACTH dose to cause a maximal cortisol response. There is no diurnal variation of cortisol response to submaximal ACTH stimulation, Eur J Endocrinol., 137, 2, pp. 172-175, (1997)
  • [25] Marcus-Perlman Y., Tordjman K., Greenman Y., Limor R., Shenkerman G., Osher E., Et al., Low-dose ACTH (1 microg) salivary test: A potential alternative to the classical blood test, Clin Endocrinol., 64, 2, pp. 215-218, (2006)
  • [26] Limor R., Tordjman K., Marcus Y., Greenman Y., Osher E., Sofer Y., Et al., Serum free cortisol as an ancillary tool in the interpretation of the low-dose 1-μg ACTH test, Clin Endocrinol., 75, 3, pp. 294-300, (2011)
  • [27] Sofer Y., Osher E., Limor R., Shefer G., Marcus Y., Shapira I., Et al., Gender determines serum free cortisol: Higher levels in men, Endocr Pract., 22, 12, pp. 1415-1421, (2016)
  • [28] Stamou M.I., Colling C., Dichtel L.E., Adrenal aging and its effects on the stress response and immunosenescence, Maturitas., 168, pp. 13-19, (2023)
  • [29] Stern N., Sowers J.R., Taylor I.L., Golub M., Dopaminergic modulation of mealstimulated and circadian secretion of pancreatic polypeptide in man, J Clin Endocrinol Metab., 56, 2, pp. 300-304, (1983)
  • [30] Mancillas-Adame L.G., Sanchez-Garcia A., Rodriguez-Gutierrez R., Gonzalez-Velazquez C., Lavalle-Gonzalez F.J., Zuniga-Hernandez J.A., Et al., Low-dose ACTH stimulation test in obesity: A randomized dose assessment, Int J Endocrinol., 2022, (2022)
12345