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Published on: July 24, 2013
The relation between long-term cortisol levels and the metabolic syndrome in HIV-infected patients
Thomas Langerak1,2, Lennert W J van den Dries3, Vincent L Wester1,2
1Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Objective:
Patients infected with the human immunodeficiency virus (HIV) have an increased risk of metabolic complications such as dyslipidaemia, insulin resistance and hypertension; symptoms that are also associated with an excess of the hormone cortisol. We studied the relationship between long-term cortisol levels and metabolic syndrome (MetS) in HIV-infected patients.
Design:
Cross-sectional study performed at the outpatient clinic of infectious diseases of the Erasmus MC, University Medical Center Rotterdam, the Netherlands.
Methods:
Fasting blood samples and anthropometric data were collected in 126 HIV-infected patients. An ELISA-based technique was used to determine long-term cortisol levels in scalp hair. Cortisol levels were compared to 191 healthy controls.
Results:
A higher risk of MetS was observed in HIV patients with a low hair cortisol (odds ratio lower vs upper tertile 4·23, P = 0·04). Hair cortisol levels were not significantly different between HIV patients and healthy controls (16·4 pg/mg vs 13·5 pg/mg; P = 0·14).
Conclusion:
The risk of MetS was significantly higher in HIV-infected patients in the lowest hair cortisol group compared with patients in the highest hair cortisol group. This finding contrasts with results from studies in uninfected individuals where a high cortisol level in hair is associated with metabolic syndrome. The results of this study suggest that these metabolic complications might be related to relative cortisol hypersensitivity in HIV patients.
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