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Hypothalamic–Pituitary–Adrenal (HPA) axis functioning in relation to body fat distribution
Author(s) -
Rutters Femke,
Nieuwenhuizen Arie G.,
Lemmens Sofie G. T.,
Born Jurriaan M.,
WesterterpPlantenga Margriet S.
Publication year - 2010
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2009.03712.x
Subject(s) - endocrinology , medicine , dexamethasone , glucocorticoid , waist–hip ratio , body mass index , hydrocortisone , anthropometry , dexamethasone suppression test , hypothalamic–pituitary–adrenal axis , waist , hormone
Summary Objective To relate hypothalamic–pituitary–adrenal (HPA) axis functioning and HPA feedback functioning to body fat distribution in normal weight to obese subjects. Patients 91 men and 103 women [age 18–45 years, BMI 19–35 kg/m 2 , waist‐to‐hip ratio (WHR) 0·6–1·1] Measurements Anthropometry, body composition using hydrodensitometry and deuterium dilution method, cortisol variability by measuring 5‐h cortisol concentrations, HPA axis feedback functioning using a dexamethasone suppression test, and HPA axis functioning under a challenged condition consisting of a standardized high‐intensity test with ingestion of 4 mg dexamethasone. Results In men, an inverse relationship was observed between 5‐h cortisol exposure (nmol/ml) and fat mass index (FMI) (kg/m 2 ) ( r = −0·55, P < 0·001). In women, relationships were observed between 5‐h cortisol exposure (nmol/ml.min) and WHR ( r = −0·49, P < 0·001), maximal workload ( r = 0·32, P < 0·001) as well as oral contraceptive use ( r = 0·38, P < 0·001). Similarly, in men, an inverse relationship was observed between negative feedback expressed as baseline concentrations minus post dexamethasone cortisol concentrations (nmol/ml) and FMI ( r = −0·53, P < 0·001). In women, relationships were observed between negative feedback expressed as baseline concentrations minus post dexamethasone cortisol concentrations (nmol/ml) and WHR ( r = −0·43, P < 0·001), maximal workload ( r = 0·30, P < 0·001) as well as oral contraceptive use ( r = 0·43, P < 0·001) in women. Moreover, an inverse relationship was observed between HPA axis functioning in a challenged condition expressed as percentage increase of cortisol concentrations after standardized high‐intensity test with ingestion of 4 mg dexamethasone (%) and waist circumference ( r = −0·21, P < 0·10) in men and WHR ( r = −0·21, P < 0·05) in women. In men, strong positive relationships were observed between FMI and waist circumference ( r = 0·85, P < 0·001), as well as waist‐to‐hip ratio ( r = 0·70, P < 0·001). Conclusion Disturbance of HPA axis functioning under basal and challenged conditions is related to visceral fat accumulation.