Serum Cortisol-to-Cortisone Ratio and Blood Pressure in Severe Obesity before and after Weight Loss

Abstract

Background/Aims: The pathogenesis of obesity-associated hypertension is poorly understood. Serum cortisol-to-cortisone ratio (F/E ratio) is a marker of cortisol metabolism. Our objective was to determine whether the serum F/E ratio is associated with blood pressure (BP) in patients after significant weight loss ( ≥ 15% from baseline weight). Methods: Sera from 43 nondiabetic, severely obese males participating in a weight management program were assayed for F and E by mass spectrometry. We assessed whether changes in the F/E ratio accompanying weight loss correlate with changes in the systolic (SBP) and diastolic BP (DBP). Linear regression was used to evaluate change in the F/E ratio as a predictor of change in BP. Results: The body mass index decreased from 40.8 ± 5.6 to 33.7 ± 4.8 (p < 0.001); also, SBP (133.2 ± 13.8 vs. 124.1 ± 14.3 mm Hg; p < 0.001) and DBP (69.8 ± 8.0 vs. 66.6 ± 9.4 mm Hg; p = 0.026) decreased during the study. The baseline F/E ratio tended to associate with baseline DBP (Spearman's r = -0.29, p = 0.06), and change in the serum F/E ratio correlated with change in DBP (Spearman's r = -0.32, p = 0.036). Change in the F/E ratio also tended to associate with change in SBP (Spearman's r = -0.27, p = 0.08). A multiple linear regression model adjusted for change in the F/E ratio and age explained 22% of the variance in SBP change (R 2 = 0.22, p = 0.007). Change in the F/E ratio independently predicted change in SBP (p = 0.036). Conclusion: In our sample of nondiabetic, severely obese males, change in the serum F/E ratio was associated with change in BP after weight loss.

The Association of Cortisol Excretion with Weight and Metabolic Parameters in Nondiabetic Patients with Morbid Obesity

“…The negative correlation of DBP and urinary cortisol levels was even part of the multivariable analysis for the prediction of urinary cortisol excretion. Our data are in line with a study on the association of cortisol/cortisone ratio and blood pressure in 43 men before and after weight loss [37]. Despite the much lower sample size, the authors could show a trend toward a negative correlation of basal serum cortisol and DBP in obese men (r = −0.29; p = 0.06) [37].…”

“…Our data are in line with a study on the association of cortisol/cortisone ratio and blood pressure in 43 men before and after weight loss [37]. Despite the much lower sample size, the authors could show a trend toward a negative correlation of basal serum cortisol and DBP in obese men (r = −0.29; p = 0.06) [37].…”

Gender-Specific Independent and Combined Effects of the Cortisol-to-Cortisone Ratio and 11-Deoxycortisol on Prediabetes and Type 2 Diabetes Mellitus: From the Henan Rural Cohort Study

“…Concentration of cortisol, cortisone, and 11-deoxycortisol was measured using liquid chromatography-tandem mass spectrometry on a Waters XEVO TQ-S system (Waters, Milford, MA, USA) [24, 28]. Glucocorticoid was quantitated using the internal reference in the positive ion mode with multiple reaction monitoring.…”

“…Moreover, a few animal experiments have shown that GCs can inhibit insulin secretion in vitro [22, 23]. Meanwhile, there are epidemiological studies investigating the relationship between F/E and T2DM and prediabetes [19, 24, 25]. Previous research has evidenced the impact of gender differences in the relationship between cortisol and diabetes [26].…”

An integrative review of the methods used for cortisol assessment in clinical studies investigating the association between Blood Pressure and Cortisol Hormone

“…36 Another study correlated serum cortisol with cortisone (F/E) and BP with severe obesity before and after weight loss and the alteration of the F/E serum ratio was associated with BP alteration after weight loss. 26 Patients with Human Immunodeficiency Virus (HIV) are at increased risk for metabolic complications (MetS) including SAH and excess cortisol. In this sense, a study was conducted in the Netherlands where they identified that the risk of MetS was higher in HIV-infected patients in the lower-level capillary cortisol group compared to patients with higher levels.…”