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Abstract-The effects of excess cortisol secretion on blood pressure and fat deposition are well documented, but the importance of this glucocorticoid in controlling these processes in normal individuals is less clear. We studied the relationship between cortisol excretion rate (tetrahydrocortisol [THF]ϩallo-THFϩtetrahydrocortisone [THE]) and a range of important cardiovascular risk factors in 439 normal subjects (238 male) sampled from the North of Glasgow (Scotland) population. There were marked gender differences: female subjects were lighter and had lower blood pressures and cortisol levels, whereas HDL cholesterol was higher. The pattern of cortisol metabolism was also different; the index of 11-hydroxysteroid dehydrogenase activity (THFϩallo-THF/THE) was lower and that of 5␣-reductase (allo-THF/THF) was higher. There was a strong correlation of blood pressure (positive), cholesterol (positive), and HDL cholesterol (negative in women, positive in men) with age. Cortisol excretion rate did not correlate with blood pressure but correlated strongly with parameters of body habitus (body mass index and waist and hip measurements [positive]) and HDL cholesterol (negative).With multiple regression analysis, there remained a significant association of cortisol excretion rate with HDL cholesterol in men and women and with body mass index in men. These results suggest that glucocorticoids regulate key components of cardiovascular risk. (Hypertension. 1999;33:1364-1368.)Key Words: glucocorticoids Ⅲ blood pressure Ⅲ body mass index Ⅲ cholesterol C linical 1 and experimental 2 cortisol excesses are associated with increases in blood pressure and profound alteration of intermediary metabolism, resulting in characteristic obesity, insulin resistance, and changes in lipid metabolism. In groups of subjects with essential hypertension, plasma 3 or urinary 4 cortisol levels may be mildly but significantly higher than those of matched normal subjects, and the efficiency of cortisol metabolism by 11-hydroxysteroid dehydrogenase (11-HSD) or 5␣-reductase may be abnormal. 5,6 Moreover, similar alterations in cortisol metabolism may contribute to obesity and to increased abdominal fat deposition in polycystic ovary disease. 7 However, in the general population, the contribution of cortisol to blood pressure and to relative obesity is less well established despite the fact that these are important predisposing factors to cardiovascular disease. A recent study of a small group of subjects concluded that differences in the level of cortisol and its metabolic disposal may be a contributory cause of obesity. 8 In the present study, we examined the association between cortisol and cardiovascular risk factors in a large sample of the middleaged population of an area with a high prevalence of cardiovascular disease. Methods PopulationA random sample of the North Glasgow, Scotland, population was selected as a stratified random sample of the patient lists of 30 general practitioners, randomly selected from all those practicing in North Gl...
Abstract-The effects of excess cortisol secretion on blood pressure and fat deposition are well documented, but the importance of this glucocorticoid in controlling these processes in normal individuals is less clear. We studied the relationship between cortisol excretion rate (tetrahydrocortisol [THF]ϩallo-THFϩtetrahydrocortisone [THE]) and a range of important cardiovascular risk factors in 439 normal subjects (238 male) sampled from the North of Glasgow (Scotland) population. There were marked gender differences: female subjects were lighter and had lower blood pressures and cortisol levels, whereas HDL cholesterol was higher. The pattern of cortisol metabolism was also different; the index of 11-hydroxysteroid dehydrogenase activity (THFϩallo-THF/THE) was lower and that of 5␣-reductase (allo-THF/THF) was higher. There was a strong correlation of blood pressure (positive), cholesterol (positive), and HDL cholesterol (negative in women, positive in men) with age. Cortisol excretion rate did not correlate with blood pressure but correlated strongly with parameters of body habitus (body mass index and waist and hip measurements [positive]) and HDL cholesterol (negative).With multiple regression analysis, there remained a significant association of cortisol excretion rate with HDL cholesterol in men and women and with body mass index in men. These results suggest that glucocorticoids regulate key components of cardiovascular risk. (Hypertension. 1999;33:1364-1368.)Key Words: glucocorticoids Ⅲ blood pressure Ⅲ body mass index Ⅲ cholesterol C linical 1 and experimental 2 cortisol excesses are associated with increases in blood pressure and profound alteration of intermediary metabolism, resulting in characteristic obesity, insulin resistance, and changes in lipid metabolism. In groups of subjects with essential hypertension, plasma 3 or urinary 4 cortisol levels may be mildly but significantly higher than those of matched normal subjects, and the efficiency of cortisol metabolism by 11-hydroxysteroid dehydrogenase (11-HSD) or 5␣-reductase may be abnormal. 5,6 Moreover, similar alterations in cortisol metabolism may contribute to obesity and to increased abdominal fat deposition in polycystic ovary disease. 7 However, in the general population, the contribution of cortisol to blood pressure and to relative obesity is less well established despite the fact that these are important predisposing factors to cardiovascular disease. A recent study of a small group of subjects concluded that differences in the level of cortisol and its metabolic disposal may be a contributory cause of obesity. 8 In the present study, we examined the association between cortisol and cardiovascular risk factors in a large sample of the middleaged population of an area with a high prevalence of cardiovascular disease. Methods PopulationA random sample of the North Glasgow, Scotland, population was selected as a stratified random sample of the patient lists of 30 general practitioners, randomly selected from all those practicing in North Gl...
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