Al-Safi Zain A, Polotsky Alex, Chosich Justin, Roth Lauren, Allshouse Amanda A, Bradford Andrew P, Santoro Nanette
a Department of Obstetrics and Gynecology , University of Colorado School of Medicine , Aurora , CO , USA.
b Department of Biostatistics and Informatics , Colorado School of Public Health , Aurora , CO , USA.
Gynecol Endocrinol. 2018 Apr;34(4):336-340. doi: 10.1080/09513590.2017.1393511. Epub 2017 Oct 25.
Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis may play a role in the pathogenesis of comorbidities encountered in obesity, including the relative hypogonadotropic hypogonadism that we and others have observed. We sought to examine serum cortisol profiles throughout the day and evening in a sample of normal weight women and women with obesity. In this cross-sectional study, regularly cycling obese (n = 12) and normal weight (n = 10) women were recruited. Mean serum cortisol was measured by frequent blood sampling for 16 h (8am-midnight) in the luteal phase of the menstrual cycle. Women with obesity had significantly higher overall cortisol levels when compared to normal weight women (6.2 [4.3, 6.6] vs. 4.7 [3.7, 5.5] ug/dl, p = .04). Over the two-hour postprandial period, obese women displayed an almost two-fold greater (7.2 [6.5, 8.6] ug/dl) rise in cortisol than normal weight controls (4.4 [3.7, 6.2] ug/dl, p < .01). In addition, obese women demonstrated a sustained evening cortisol elevation compared to normal weight women, who displayed the typical decline in cortisol (3.2 [2.3, 4] vs. 2 [1.5, 3.2] ug/dl, p < .05). Changes in the HPA axis in the setting of obesity may be related to risks of obesity-associated metabolic comorbidities and reproductive dysfunction often seen in these women.
下丘脑-垂体-肾上腺（HPA）轴功能亢进可能在肥胖相关合并症的发病机制中起作用，包括我们和其他人所观察到的相对性低促性腺激素性性腺功能减退。我们试图在正常体重女性和肥胖女性样本中检测全天及夜间的血清皮质醇水平。在这项横断面研究中，招募了月经周期规律的肥胖女性（n = 12）和正常体重女性（n = 10）。在月经周期的黄体期，通过频繁采血16小时（上午8点至午夜）测量平均血清皮质醇。与正常体重女性相比，肥胖女性的总体皮质醇水平显著更高（6.2 [4.3, 6.6] 对 4.7 [3.7, 5.5] μg/dl，p = 0.04）。在餐后两小时内，肥胖女性的皮质醇升高幅度几乎是正常体重对照组的两倍（7.2 [6.5, 8.6] μg/dl），而正常体重对照组为4.4 [3.7, 6.2] μg/dl，p < 0.01）。此外，与正常体重女性相比，肥胖女性夜间皮质醇持续升高，而正常体重女性皮质醇呈现典型下降（3.2 [2.3, 4] 对 2 [1.5, 3.2] μg/dl，p < 0.05）。肥胖情况下HPA轴的变化可能与这些女性中常见的肥胖相关代谢合并症及生殖功能障碍风险有关。
