[The hypothalamic-hypophyseal-adrenal axis in obesity]

The HHA axis was assessed in 26 women with essential obesity using a CRF test, insulin hypoglycemia and oral glucose load. Basal values of ACTH and cortisol were similar in obese subjects and controls, whereas peak ACTH values following CRF administration were significantly lower in obese subjects. The net integrated areas under ACTH and cortisol curves after CRF injection were lower in obese subjects but not statistically significant. Glucose inhibited cortisol levels in controls but not in obese subjects. Insulin hypoglycemia provoked a ACTH and cortisol response in obese women which was significantly higher than that provoked by CRF. The lesser response of ACTH to CRF in obesity might be the result of an altered hypophyseal response to CRF mediated by other factors; in addition, the increased ACTH and cortisol response to the insulin stimulus compared to CRF observed in obese subjects leads to suppose that the metabolic stimulus involves the release of other factors.