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Deciphering the Association Between Hypothalamus‐Pituitary‐Adrenal Axis Activity and Obesity: A Meta‐Analysis
Author(s) -
Ostinelli Giada,
Scovronec Anaïs,
Iceta Sylvain,
Ouellette Anne-Sophie,
Lemieux Simone,
Biertho Laurent,
Bégin Catherine,
Michaud Andréanne,
Tchernof André
Publication year - 2021
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.23125
Subject(s) - waist , medicine , obesity , meta analysis , hypothalamus , endocrinology , cochrane library , body mass index , abdominal obesity , medline , biology , biochemistry
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.