Hair cortisol, obesity and the immune system: Results from a 3 year longitudinal study

Valk, Eline S van der; Voorn, Bibian van der; Iyer, Anand M.; Mohseni, Mostafa; Leenen, Pieter J.M.; Dik, Willem A.; Berg, Sjoerd A.A. van den; Rijke, Yolanda B. de; Akker, Erica L T van den; Penninx, Brenda W. J. H.; Rossum, Elisabeth F.C. van

doi:10.1016/j.psyneuen.2021.105422

Cited by 14 publications

(10 citation statements)

References 34 publications

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“…Intriguingly, the relationship between HairGC and MetS may not be linear, as indicated by studies reporting significantly higher odds of having MetS only in the highest, but not middle, ranges of HairGC levels when compared to the group with the lowest levels [29, 32, 34]. Moreover, two of these studies suggest an equally strong, or even stronger, association of HairE with MetS than was seen for HairF [29, 32], which is in line with studies regarding BMI and waist circumference [54, 55], as well as studies regarding CVD [18, 21]. Mechanistically, it has been speculated that cortisone may represent a more stable marker for the long‐term systemic reservoir of available glucocorticoids in the body.…”

Section: Discussionsupporting

confidence: 62%

Long‐term glucocorticoids in relation to the metabolic syndrome and cardiovascular disease: A systematic review and meta‐analysis

Kuckuck,

Lengton,

Boon

et al. 2023

J Intern Med

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The striking link of Cushing's syndrome with the metabolic syndrome (MetS) and cardiovascular disease (CVD) suggests that long‐term exposure to extremely high cortisol levels catalyzes cardiometabolic deterioration. However, it remained unclear whether the findings from the extreme glucocorticoid overabundance observed in Cushing's syndrome could be translated into more subtle variations in long‐term glucocorticoid levels among the general population, for example, due to chronic stress. Here, we performed a systematic review (PROSPERO: CRD42023425541) of evidence regarding the role of subtle variations in long‐term biological stress, measured as levels of scalp hair cortisol (HairF) and cortisone (HairE), in the context of MetS and CVD in adults. We also performed a meta‐analysis on the cross‐sectional difference in HairF levels between individuals with versus without CVD. Seven studies were included regarding MetS, sixteen regarding CVD, and one regarding both. Most articles indicated a strong, consistent cross‐sectional association of higher HairF and HairE levels with CVD, which was confirmed by our meta‐analysis for HairF (eight studies, SMD = 0.48, 95% confidence intervals [CIs]: 0.16–0.79, p = 0.0095). Moreover, these relationships appear largely independent of standard risk factors. Age seems relevant as the effect seems stronger in younger individuals. Results regarding the associations of HairF and HairE with MetS were inconsistent. Altogether, long‐term biological stress, measured as HairF and HairE, is associated with the presence of CVD, and less consistently with MetS. Prospective studies need to evaluate the directionality of this relationship and determine whether HairF and HairE can be used in addition to standard risk factors in predicting future cardiometabolic deterioration.

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Section: Discussionsupporting

confidence: 62%

Long‐term glucocorticoids in relation to the metabolic syndrome and cardiovascular disease: A systematic review and meta‐analysis

Kuckuck,

Lengton,

Boon

et al. 2023

J Intern Med

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“…However, around 20% of the association between ln(HCC) and CAD is not explained by SMuRFs. Therefore, future studies might also focus on the relation between HCC and atherosclerosis or inflammation ( 20 ). Finally, even though studies suggest that increased cortisol levels cause obesity and metabolic dysregulation ( 8 , 9 , 20 ), future longitudinal studies could investigate the cause-and-effect relationship between increased HCC, SMuRFs, and CAD even further.…”

Section: Discussionmentioning

confidence: 99%

“…High hair cortisol concentrations (HCCs) have also been shown among patients with the SMuRFs diabetes ( 15 – 17 ), hypertension ( 18 ), and smoking ( 15 ), as well as other cardiovascular risk factors including abdominal obesity ( 19 ), low high-density lipoprotein (HDL)-cholesterol levels ( 19 ), and a history of cardiovascular disease ( 17 ). Importantly, longitudinal data suggest that higher HCC is associated with an increased weight gain over 3 years ( 20 ). Thus, it may be suggested that increased circulating cortisol levels, either due to Cushing's syndrome ( 8 ), glucocorticoid treatment ( 9 ), or other more subtle derangements of the hypothalamic-pituitary-adrenal (HPA) axis reflected by increased HCC ( 20 ), is a cause rather than a consequence of obesity and SMuRFs.…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, longitudinal data suggest that higher HCC is associated with an increased weight gain over 3 years ( 20 ). Thus, it may be suggested that increased circulating cortisol levels, either due to Cushing's syndrome ( 8 ), glucocorticoid treatment ( 9 ), or other more subtle derangements of the hypothalamic-pituitary-adrenal (HPA) axis reflected by increased HCC ( 20 ), is a cause rather than a consequence of obesity and SMuRFs.…”

Section: Introductionmentioning

confidence: 99%

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Standard Modifiable Cardiovascular Risk Factors Mediate the Association Between Elevated Hair Cortisol Concentrations and Coronary Artery Disease

Stomby

Strömberg

Theodorsson

et al. 2022

Front. Cardiovasc. Med.

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BackgroundIncreased cortisol exposure is a risk factor for coronary artery disease (CAD). It is not clear to what degree this risk is independent from the standard modifiable risk factors (SMuRFs) dyslipidemia, hypertension, and diabetes.AimTo use path analysis to test the direct and indirect association, mediated by SMuRFs, between long-term cortisol levels measured in hair cortisol concentration (HCC) and CAD.MethodsHair was sampled from patients admitted with acute myocardial infarction (n = 203) and a population-based sample without a diagnosis or symptoms of CAD (n = 3,134). The HCC was analyzed using radioimmunoassay and all the participants reported whether they were diagnosed with or treated for diabetes, hypertension, and hyperlipidemia. Path analysis was used to test to what degree the association between logarithmized (ln) HCC and CAD was direct or indirect, mediated by SMuRFs.ResultsParticipants with CAD had elevated HCC compared to those without elevated HCC [median interquartile range (IQR): 75.2 (167.1) vs. 23.6 (35.0) pg/mg, p < 0.0001]. Higher HCC was associated with diabetes, hypertension, and hyperlipidemia, which, in turn, were associated with CAD. In path models, 80% of the association between ln(HCC) and CAD were mediated by SMuRFs, while the direct path between ln(HCC) and CAD was not statistically significant.ConclusionThe SMuRFs diabetes, hyperlipidemia, and hypertension mediate the association between ln(HCC) and CAD. Some association between ln(HCC) and CAD did not operate via the SMuRFs considered and might have a pathway through atherosclerosis or inflammation.

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“…In this study, BMI positively predicted later cortisol metabolite excretion, and not vice versa ( 12 ). Conversely, data in adults demonstrated that hair glucocorticoid levels were positively associated with future gains in BMI and waist circumference ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Role of glucocorticoid metabolism in childhood obesity-associated hypertension

Finken

Wirix

Rosenstiel-Jadoul

et al. 2022

Endocrine Connections

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Objective: Childhood obesity is associated with alterations in hypothalamus-pituitary-adrenal axis activity. We tested the hypothesis that multiple alterations in the metabolism of glucocorticoids are required for the development of hypertension in children who become overweight. Methods: Spot urine for targeted gas chromatography-mass spectrometry steroid metabolome analysis was collected from (1) overweight/hypertensive children (n=38), (2) overweight/non-hypertensive children (n=83), and (3) non-overweight/non-hypertensive children (n=56). Results: The mean (±SD) age of participants was 10.4±3.4 years, and 53% of them were male. Group 1 and group 2 had higher excretion rates of cortisol and corticosterone metabolites than group 3 (869 (interquartile range: 631-1,352) vs. 839 (609-1,123) vs. 608 (439-834) μg/mmol creatinine x m2 body surface area, p<0.01, for the sum of cortisol metabolites), and group 1 had a higher excretion rate of naive cortisol than group 3. Furthermore, groups differed in cortisol metabolism, in particular in the activities of 11β-hydroxysteroid dehydrogenases, as assessed from the ratio of cortisol:cortisone metabolites (group 2 < group 3), 5α-reductase (group 1 > group 2 or 3), and CYP3A4 activity (group 1 < group 2 or 3). Discussion: The sequence of events leading to obesity-associated hypertension in children may involve an increase in the production of glucocorticoids, downregulation of 11β-hydroxysteroid dehydrogenase type 1 activity, and upregulation of 5α-reductase activity, along with a decrease in CYP3A4 activity and an increase in bioavailable cortisol.

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Hair cortisol, obesity and the immune system: Results from a 3 year longitudinal study

Cited by 14 publications

References 34 publications

Long‐term glucocorticoids in relation to the metabolic syndrome and cardiovascular disease: A systematic review and meta‐analysis

Long‐term glucocorticoids in relation to the metabolic syndrome and cardiovascular disease: A systematic review and meta‐analysis

Standard Modifiable Cardiovascular Risk Factors Mediate the Association Between Elevated Hair Cortisol Concentrations and Coronary Artery Disease

Role of glucocorticoid metabolism in childhood obesity-associated hypertension

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