Negative associations of morning serum cortisol levels with obesity: the Henan rural cohort study

2021 ◽  
Author(s):  
K. Fan ◽  
D. Wei ◽  
X. Liu ◽  
Y. He ◽  
H. Tian ◽  
...  
Keyword(s):  
Cohort Study ◽  
Serum Cortisol ◽  
Morning Serum Cortisol ◽  
Cortisol Levels

scholarly journals Ambient air pollutants are associated with morning serum cortisol in overweight and obese Latino youth in Los Angeles

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
C. M. Toledo-Corral ◽  
T. L. Alderete ◽  
M. M. Herting ◽  
R. Habre ◽  
A. K. Peterson ◽  
...  
Keyword(s):  
Hpa Axis ◽  
Air Pollutants ◽  
Latino Youth ◽  
Serum Cortisol ◽  
Ambient Air ◽  
Pubertal Status ◽  
Ambient Air Pollutants ◽  
Morning Cortisol ◽  
Morning Serum Cortisol ◽  
Cortisol Levels

Abstract Background Hypothalamic-pituitary-adrenal (HPA)-axis dysfunction has been associated with a variety of mental health and cardio-metabolic disorders. While causal models of HPA-axis dysregulation have been largely focused on either pre-existing health conditions or psychosocial stress factors, recent evidence suggests a possible role for central nervous system activation via air pollutants, such as nitrogen dioxide (NO2), ozone (O3) and particulate matter (PM). Therefore, in an observational study of Latino youth, we investigated if monthly ambient NO2, O3, and PM with aerodynamic diameter ≤ 2.5 (PM2.5) exposure were associated with morning serum cortisol levels. Methods In this cross-sectional study, morning serum cortisol level was assessed after a supervised overnight fast in 203 overweight and obese Latino children and adolescents (female/male: 88/115; mean age: 11.1 ± 1.7 years; pre-pubertal/pubertal/post-pubertal: 85/101/17; BMI z-score: 2.1 ± 0.4). Cumulative concentrations of NO2, O3 and PM2.5 were spatially interpolated at the residential addresses based on measurements from community monitors up to 12 months prior to testing. Single and multi-pollutant linear effects models were used to test the cumulative monthly lag effects of NO2, O3, and PM2.5 on morning serum cortisol levels after adjusting for age, sex, seasonality, social position, pubertal status, and body fat percent by DEXA. Results Single and multi-pollutant models showed that higher O3 exposure (derived from maximum 8-h exposure windows) in the prior 1–7 months was associated with higher serum morning cortisol (p < 0.05) and longer term PM2.5 exposure (4–10 months) was associated with lower serum morning cortisol levels (p < 0.05). Stratification by pubertal status showed associations in pre-pubertal children compared to pubertal and post-pubertal children. Single, but not multi-pollutant, models showed that higher NO2 over the 4–10 month exposure period associated with lower morning serum cortisol (p < 0.05). Conclusions Chronic ambient NO2, O3 and PM2.5 differentially associate with HPA-axis dysfunction, a mechanism that may serve as an explanatory pathway in the relationship between ambient air pollution and metabolic health of youth living in polluted urban environments. Further research that uncovers how ambient air pollutants may differentially contribute to HPA-axis dysfunction are warranted.

scholarly journals Low Morning Serum Cortisol Levels in Children with Tonsillar Hypertrophy and Moderate-to-Severe OSA

SLEEP ◽  
2013 ◽  
Vol 36 (9) ◽  
pp. 1349-1354 ◽  
Author(s):  
Georgia Malakasioti ◽  
Emmanouel I. Alexopoulos ◽  
Vasiliki Varlami ◽  
Konstantinos Chaidas ◽  
Nikolaos Liakos ◽  
...  
Keyword(s):  
Serum Cortisol ◽  
Tonsillar Hypertrophy ◽  
Morning Serum Cortisol ◽  
Cortisol Levels

scholarly journals Sex Differences in the Genetic Basis of Morning Serum Cortisol Levels: Genome-Wide Screen Identifies Two Novel Loci Specific to Women

2005 ◽  
Vol 90 (8) ◽  
pp. 4747-4752 ◽  
Author(s):  
Lianne M. Kurina ◽  
Lauren A. Weiss ◽  
Steven W. Graves ◽  
Rodney Parry ◽  
Gordon H. Williams ◽  
...  
Keyword(s):  
Sex Differences ◽  
Genetic Basis ◽  
Serum Cortisol ◽  
Genome Wide ◽  
Morning Serum Cortisol ◽  
Cortisol Levels

Sugar-sweetened beverage consumption is associated with visceral fat in children

2020 ◽  
pp. 1-9
Author(s):  
Claire Gallagher ◽  
George Moschonis ◽  
Katrina A. Lambert ◽  
Eva Karaglani ◽  
Christina Mavrogianni ◽  
...  
Keyword(s):  
Visceral Fat ◽  
Disease Risk ◽  
Serum Cortisol ◽  
Concomitant Disease ◽  
Linear Regression Models ◽  
Significant Positive Association ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverage ◽  
Morning Serum Cortisol ◽  
Cortisol Levels

Abstract Sugar-sweetened beverage (SSB) consumption has been associated with visceral fat partitioning in adults; however, the underlying mechanisms in childhood remain unclear and warrant exploration. This cross-sectional study aimed to investigate the association between SSB consumption and body fat in children aged 9–13 years and the potential modifying effect of children’s sex and serum cortisol levels. A sample of 2665 Greek schoolchildren participated in the ‘Healthy Growth Study’, and anthropometric, body composition, dietary intake and serum cortisol data were assessed. SSB consumption was defined as low (<1 serving/d), medium (1–2 servings/d) or high (>2 servings/d). We used linear regression models to assess the association between SSB consumption and measures of adiposity and to assess effect modification; models were stratified by sex and tertiles of morning serum cortisol. A significant positive association was observed between high SSB consumption and visceral adipose tissue (VAT) (β = 1·4, 95 % CI 0·4, 2·3, P = 0·01) but not BMI or BMI z-score. When stratified by sex, the association was observed in boys (β = 1·8, 95 % CI 0·3, 3·4, P = 0·02) but not in girls. When stratified by cortisol levels, SSB consumption was associated with VAT in children with cortisol levels in the lowest tertile (β = 2·8, 95 % CI 1·0, 4·6, P < 0·01). These results indicate that increased SSB consumption is associated with visceral adiposity in schoolchildren and this association may be modified by sex and morning serum cortisol. To prevent VAT accumulation and concomitant disease risk, dietary interventions should target SSB consumption during childhood.

scholarly journals Morning Serum Cortisol May Be Less Accurate for Diagnosing Adrenal Insufficiency in Hospitalized Patients, Particularly Those on Opioids

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A89-A90
Author(s):  
Caitlin Ann Colling ◽  
Lisa B Nachtigall ◽  
Beverly M K Biller ◽  
Karen Klahr Miller
Keyword(s):  
Positive Predictive Value ◽  
Adrenal Insufficiency ◽  
Predictive Value ◽  
Serum Cortisol ◽  
Hospitalized Patients ◽  
Opioid Use ◽  
Morning Cortisol ◽  
Morning Serum Cortisol ◽  
Cortisol Levels ◽  
The Impact

Abstract Introduction: The positive predictive value of a low morning serum cortisol to diagnose adrenal insufficiency (AI) is reported to be &gt;90%, which is the basis for guidelines recommending morning cortisol as the first-line test for central AI. A level &lt;3 µg/dL is considered diagnostic. However, studies that established this cut-off were conducted primarily in outpatients, not hospitalized patients in whom diurnal variation may be disrupted. Studies suggest that opioids suppress cortisol levels acutely, may disrupt diurnal cortisol rhythm, and cause adrenal insufficiency in 8–50% of chronically-exposed patients. The impact of hospitalization, particularly in the setting of opioid use, on the accuracy of diagnostics for AI is unknown. We hypothesized that low morning cortisol values in hospitalized patients, especially those prescribed opioids, do not accurately diagnose adrenal insufficiency, as determined by corticotropin stimulation test (CST) peak cortisol &lt;18 µg/dL. Methods: We performed a retrospective analysis of CSTs in hospitalized patients in the Mass General Brigham health system from 5/2015 to 9/2020. Opioid-exposed adults who underwent CST were included if they had a morning cortisol (5–9 AM) result. Control patients were matched by age, gender and race and had no opioid prescriptions within 30 days of testing. Patients were excluded if tested in the outpatient or ICU setting, had a history of cirrhosis or pituitary disease, had an elevated ACTH, were prescribed oral estrogen, or received oral, IV or intraarticular glucocorticoids within 30 days. Results: The analysis included 124 opioid-exposed and 322 control patients, mean (±SD) age 60.8±14.4 and 63.8±15.3y, and 55.6% and 45.0% female, respectively. Twenty-two (17.7%) opioid-exposed and 33 (10.2%) control patients were diagnosed with AI by CST (p=0.031). Nineteen opioid-exposed (15.3%) and 22 control (6.8%) patients had morning cortisol of &lt;3 µg/dL (p=0.005). A morning cortisol &lt;3 µg/dL had a positive predictive value of 36.8% (CI 19.1–59.0%) for AI in opioid-exposed and 50.0% (CI 30.7–69.3%) in control patients. In opioid-exposed patients with low morning cortisol levels, mean daily morphine milligram equivalent and duration of opioid exposure did not differ between those with AI confirmed by CST and those with normal CST (p=0.13 and 0.38, respectively). Conclusion: Among hospitalized patients with suspected AI, those prescribed opioids have a higher prevalence of central AI than controls. Serum morning cortisol &lt;3 µg/dL is not an accurate test for AI in hospitalized patients, including those prescribed opioids in whom low morning cortisol is more prevalent than in controls. Given the risks associated with misdiagnosis of AI, caution should be exercised in relying on morning cortisol values for the diagnosis of AI in hospitalized patients.

Variations in Morning Serum Cortisol Levels Based on Sex and Pubertal Status

2019 ◽  
Vol 92 (3) ◽  
pp. 162-168
Author(s):  
Sarah A. Jacob ◽  
David D. Williams ◽  
Jennifer Boyd ◽  
Kavitha Dileepan ◽  
Sarah L. Tsai
Keyword(s):  
Serum Cortisol ◽  
Pubertal Status ◽  
Morning Serum Cortisol ◽  
Cortisol Levels

Diabetes, Active Disease, and Afternoon Serum Cortisol Levels Predict Cushing’s Disease Mortality: A Cohort Study

2020 ◽  
Vol 106 (1) ◽  
pp. e103-e111
Author(s):  
Paola Roldán-Sarmiento ◽  
César Ernesto Lam-Chung ◽  
José Miguel Hinojosa-Amaya ◽  
Mariana Morales-García ◽  
María Fernanda Guillén-Placencia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Cushing’S Disease ◽  
Cox Regression ◽  
Serum Cortisol ◽  
Cushing's Disease ◽  
Cortisol Levels ◽  
Active Disease

Abstract Context Cushing’s disease (CD) is a life-threating disease, with increased mortality in comparison with the general population. Objective This study aimed to evaluate standardized mortality ratios (SMRs) in CD patients. We also analyzed independent risk factors related to increased mortality. Design We conducted a longitudinal cohort study in a 3rd level specialty center, from 1979 to 2018, in patients with CD. Results From 1375 cases with a pathology diagnosis of pituitary adenoma, 191 cases had the confirmed diagnosis of CD (14%). A total of 172 patients completed follow-up, with a mean age at diagnosis of 33 ± 11 years, female predominance (n = 154, 89.5%), majority of them with microadenoma (n = 136, 79%), and a median follow-up of 7.5 years (2.4–15). Eighteen patients (10.5%) died, 8 of them (44%) were with active CD, 8 (44%) were under remission, and 2 (11%) were under disease control. Estimated all-cause SMR = 3.1, 95% confidence interval (CI) 1.9–4.8, P &lt; 0.001. Cardiovascular disease was the main cause of death (SMR = 4.2, 1.5–9.3, P = 0.01). Multivariate Cox regression models adjusted for potential cofounders showed that diabetes (HR = 5.2, IC 95% 1.8–15.4, P = 0.002), high cortisol levels after 1600 hours at diagnosis (3.4, 2.3–7.0, P = 0.02), and active CD (7.5, 3.8–17.3, P = 0.003) significantly increased the risk of mortality. Conclusions Main cause of CD mortality was cardiovascular disease. Main risk factors for mortality were uncontrolled diabetes, persistently high cortisol levels after 1600 hours at diagnosis, and active disease at last follow-up.

431: Genome-Wide Screen Identifies Two Novel Loci Associated with Morning Serum Cortisol Levels in Women

2005 ◽  
Vol 161 (Supplement_1) ◽  
pp. S108-S108
Author(s):  
L M Kurina ◽  
L A Weiss ◽  
S W Graves ◽  
R Parry ◽  
G H Williams ◽  
...  
Keyword(s):  
Serum Cortisol ◽  
Genome Wide ◽  
Morning Serum Cortisol ◽  
Cortisol Levels

scholarly journals Functional Adrenal Insufficiency among Tuberculosis-Human Immunodeficiency Virus co-infected patients: A Cross-section study in Uganda

2020 ◽  
Author(s):  
Agnes Bwanika Bwanika Naggirinya ◽  
Andrew Mujugira ◽  
David B. Meya ◽  
Irene Andia Biraro ◽  
Ezekiel Mupere ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Serum Cortisol ◽  
Early Morning ◽  
Serum Cortisol Level ◽  
Drug Resistant ◽  
Morning Serum Cortisol ◽  
Cortisol Levels ◽  
Clinical Signs And Symptoms

Abstract Objective: Tuberculosis (TB) is the leading cause of adrenal insufficiency in resource-limited settings. The adrenal gland is the most commonly affected endocrine organ in TB infection. We assessed factors associated with functional adrenal insufficiency (FAI) among TB-HIV patients with and without drug-resistance in Uganda. Patients with drug-sensitive and drug-resistant TB were enrolled and examined for clinical signs and symptoms of FAI with an early morning serum cortisol level obtained. FAI was defined as early morning serum cortisol <414 nmol//L. Associations with FAI were modeled using multivariable logistic regression.Results: We screened 311 TB patients and enrolled 272. Of these, 117 (43%) had drug-resistant TB. Median age was 32 years (IQR 18-66) and 66% were men. The proportion with FAI was 59.8%. Mean cortisol levels were lower in participants with drug-resistant than susceptible TB (317.4 versus 488.5 nmol/L; p<0.001). In multivariable analyses, drug-resistant TB (aOR 4.61; 95% CI: 2.3-9.1; p<0.001), treatment duration > 1 month (aOR 2.86; 95% CI: 1.4-5.5; p=0.002) and abdominal pain (aOR 2.06; 95% CI: 1.04-4.09; p=0.038) were significantly associated with FAI. Early morning serum cortisol levels should be quantified in TB-HIV co-infected patients with drug-resistant TB.

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