Travison Thomas G, O'Donnell Amy B, Araujo Andre B, Matsumoto Alvin M, McKinlay John B
New England Research Institutes, Watertown, MA 02472, USA.
Clin Endocrinol (Oxf). 2007 Jul;67(1):71-7. doi: 10.1111/j.1365-2265.2007.02837.x. Epub 2007 Apr 27.
Similarities in the symptomatic expressions of excess adiposity and hypercortisolaemic conditions suggest that elevated glucocorticoid exposure may influence the pathogenesis of obesity. Circulating cortisol levels are not typically elevated in obese subjects, but data from large prospective samples are rare. We undertook an analysis to determine both cross-sectional and longitudinal associations between body composition and serum cortisol concentrations in a randomly chosen group of 999 community-dwelling men, aged 40-79 years.
Data were obtained from the two follow-up waves of the Massachusetts Male Ageing Study (T2: 1995-97; T3: 2002-04). Partial correlation and multivariate regression analyses were used to estimate cross-sectional (T2) and longitudinal associations between serum cortisol concentrations and a range of measures of subjects' body composition, including weight, body mass index (BMI), waist circumference (WC), waist-to-hip girth ratio (WHR), and percentage body fat (measured by bioelectrical impedance at T3); similar analyses were conducted to assess the association between change (T2 to T3) in serum cortisol and simultaneous change in body composition parameters.
We observed weak negative associations between cortisol concentrations and all body composition parameters, with the exception of percentage body fat. Longitudinal results demonstrated similar relationships but associations were of lesser magnitude. T2 cortisol concentrations were not associated with change in body composition over time, whereas T2 body size was positively associated with longitudinal changes in cortisol concentrations, providing limited evidence that weight change drives changes in cortisol concentrations, rather than vice versa. Results were unchanged when age and other covariate effects were controlled.
Circulating cortisol concentrations are somewhat lower in obese than in nonobese community-dwelling men. There is some evidence that excess adiposity presages increases in cortisol concentrations, rather than the reverse. However, this observation should be greeted with caution, as age-related weight loss - and not gain - was associated with simultaneous increases in serum cortisol concentrations.
肥胖症和高皮质醇血症的症状表现相似，这表明糖皮质激素暴露增加可能会影响肥胖症的发病机制。肥胖受试者的循环皮质醇水平通常不会升高，但来自大型前瞻性样本的数据很少。我们进行了一项分析，以确定999名年龄在40 - 79岁之间、随机选取的社区居住男性的身体成分与血清皮质醇浓度之间的横断面和纵向关联。
数据来自马萨诸塞州男性衰老研究的两次随访（T2：1995 - 1997年；T3：2002 - 2004年）。采用偏相关和多元回归分析来估计血清皮质醇浓度与一系列身体成分测量指标之间的横断面（T2）和纵向关联，这些指标包括体重、体重指数（BMI）、腰围（WC）、腰臀比（WHR）和体脂百分比（在T3时通过生物电阻抗测量）；进行了类似的分析以评估血清皮质醇的变化（T2至T3）与身体成分参数的同时变化之间的关联。
我们观察到皮质醇浓度与除体脂百分比外的所有身体成分参数之间存在弱负相关。纵向结果显示了类似的关系，但关联程度较小。T2时的皮质醇浓度与随时间变化的身体成分无关，而T2时的身体大小与皮质醇浓度的纵向变化呈正相关，这提供了有限的证据表明体重变化驱动皮质醇浓度变化，而不是相反。在控制年龄和其他协变量影响后，结果不变。
肥胖的社区居住男性的循环皮质醇浓度略低于非肥胖男性。有一些证据表明，肥胖预示着皮质醇浓度会升高，而不是相反。然而，并不能轻易接受这一观察结果，因为与年龄相关的体重减轻（而非体重增加）与血清皮质醇浓度的同时升高有关。
