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Obesity and cortisol status.

M Salehi1, A Ferenczi, B Zumoff

  • 1Division of Endocrinology and Metabolism, Department of Medicine, Beth Israel Medical Center and Albert Einstein College of Medicine, New York, NY 10003, USA.

Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|June 14, 2005
PubMed
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Obesity does not cause systemic hypercortisolism (excess cortisol). Instead, obese individuals show reduced hypothalamic-pituitary-adrenal (HPA) axis function. Tissue hypercortisolism in obesity remains unclear.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Hormone Physiology

Background:

  • Obesity is a common feature of hypercortisolism (Cushing's syndrome).
  • The reverse relationship, where hypercortisolism is a feature of obesity, has been investigated.
  • Hypercortisolism can manifest as systemic (overall excess) or tissue (intracellular excess) forms.

Purpose of the Study:

  • To review literature on the relationship between obesity and hypercortisolism.
  • To clarify the status of systemic and tissue cortisol in obesity.
  • To evaluate the hypothalamic-pituitary-adrenal (HPA) axis function in obese individuals.

Main Methods:

  • Literature review of studies on obesity and hypercortisolism over 50 years.
  • Analysis of systemic hypercortisolism parameters: cortisol production rate (CPR) corrected for urinary creatinine and 24-hour mean plasma cortisol concentration.

Related Experiment Videos

  • Review of studies on tissue hypercortisolism, specifically the enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD-1).

    • Main Results:

    • Corrected CPR is normal in obese individuals.
    • 24-hour mean plasma cortisol concentrations are slightly subnormal in obesity.
    • Findings suggest diminished stimulability of the HPA axis in obesity.
    • Evidence for tissue hypercortisolism via 11beta-HSD-1 in obesity is inconsistent and causality is unclear.

    Conclusions:

    • Obesity is not associated with systemic hypercortisolism.
    • Obesity is linked to a diminished HPA axis response.
    • The role of tissue hypercortisolism in obesity requires further investigation.