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Updated: Dec 3, 2025

Collecting Hair Samples for Hair Cortisol Analysis in African Americans
Published on: June 10, 2018
Associations of Hair Cortisol Concentrations with General and Organ Fat Measures in Childhood
Florianne O L Vehmeijer1,2, Susana Santos1,2, Romy Gaillard1,2
1The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Insights
Childhood stress, measured by hair cortisol concentration (HCC), is linked to increased body fat and nonalcoholic fatty liver disease (NAFLD) risk by age 10. These associations, particularly for liver fat, persist independently of early adiposity.
Area of Science:
- Pediatric endocrinology
- Metabolic health
- Stress physiology
Background:
- Childhood stress can negatively impact body fat distribution.
- Early life stress may influence long-term metabolic health outcomes.
- Understanding stress biomarkers in children is crucial for public health.
Purpose of the Study:
- To investigate the association between hair cortisol concentration (HCC) at age 6 and body fat measures at age 10.
- To examine the link between HCC and overweight risk and nonalcoholic fatty liver disease (NAFLD) at age 10.
- To determine if these associations are independent of adiposity at age 6.
Main Methods:
- Longitudinal cohort study (Generation R) with 2042 children.
- Hair cortisol concentration (HCC) measured at age 6.
- Body mass index (BMI), fat mass index, visceral and pericardial fat indices, and liver fat fraction assessed at age 10 using DXA and MRI.
- NAFLD risk and overweight status evaluated at age 10.
Main Results:
- Higher HCC at age 6 correlated with higher BMI and fat mass index at age 10, explained by baseline adiposity.
- Elevated HCC at age 6 was independently associated with a higher liver fat fraction and increased NAFLD risk at age 10.
- No significant association was found between HCC and visceral or pericardial fat indices.
Conclusions:
- Childhood stress, indicated by HCC, is associated with adverse body composition and metabolic health.
- Hair cortisol concentration at age 6 predicts higher liver fat and NAFLD risk at age 10, independent of early adiposity.
- These findings highlight the long-term impact of early life stress on metabolic health in children.
Context:
Stress may lead to an adverse body fat distribution from childhood onwards.
Objective:
To examine the associations of hair cortisol concentration (HCC) at 6 years with general and organ fat measures, risk of overweight, and nonalcoholic fatty liver disease (NAFLD) at 10 years and to assess whether these were independent of adiposity measures at 6 years.
Design, Setting And Participants:
HCCs were measured in hair of 6-year-old children (n = 2042) participating in the Generation R Study, a population-based prospective cohort study.
Main Outcome Measures:
Body mass index (BMI), fat mass index measured by dual-energy X-ray absorptiometry scan, and visceral fat index, pericardial fat index, liver fat fraction measured by magnetic resonance imaging and risk of overweight and NAFLD were obtained at 10 years.
Results:
The associations of higher HCC at 6 years, with higher BMI, fat mass index, and increased risk of overweight at age 10 years are explained by the relationships observed at 6 years. HCCs at 6 years were associated with a higher liver fat fraction (difference 0.11 liver fat fraction standard deviation score; 95% confidence interval [CI] 0.03, 0.18) and a higher risk of NAFLD at 10 years (odds ratio 1.95; 95% CI 1.06, 3.56), independent of fat mass index at 6 years. HCCs were not associated with pericardial or visceral fat indices.
Conclusions:
Higher HCCs at 6 years were associated with higher BMI, fat mass index, liver fat fraction, and higher risks of overweight and NAFLD at 10 years. Only the associations for liver fat fraction and NAFLD were independent of fat mass index at 6 years.
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