Oo Wei Jet, Lim Chooi Ling, Goh Mun Hon, Koh Rhun Yian
Division of Applied Biomedical Science and Biotechnology, School of Health Sciences, IMU University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
Laboratory and Blood Services Department, National Heart Institute, 145, Jalan Tun Razak, 50400, Kuala Lumpur, Malaysia.
Curr Cardiol Rev. 2025;21(3):e1573403X328499. doi: 10.2174/011573403X328499241106064553.
Cardiovascular disease (CVD), the leading cause of death globally, poses a significant burden on the healthcare sector. Its association with stress and Cushing's Syndrome has driven cortisol, the 'stress hormone,' to be a potential candidate in determining CVD risk. Cortisol synthesis and release through the hypothalamic-pituitary-adrenal (HPA) axis are regulated by several hormones and receptors involved in the pathological cascade towards CVD. Evidence suggests that metabolic syndrome plays a major role in cortisol-mediated CVD risk. On the other hand, non-metabolic features are also implicated when the association between cortisol and CVD risk remains significant upon normalisation of metabolic parameters. Correspondingly, the treatment for hypercortisolism is often found effective in lowering CVD risk. Despite available evidence, several factors continue to hinder the clinical use of cortisol as a risk biomarker for CVD. This review provides an insight into the role of serum cortisol in CVD progression and risk, with emphasis on the mechanistic features and parameters.
心血管疾病（CVD）是全球主要的死亡原因，给医疗保健部门带来了巨大负担。它与压力和库欣综合征的关联，使得“应激激素”皮质醇成为确定CVD风险的潜在候选因素。通过下丘脑-垂体-肾上腺（HPA）轴进行的皮质醇合成和释放，受到参与CVD病理级联反应的多种激素和受体的调节。有证据表明，代谢综合征在皮质醇介导的CVD风险中起主要作用。另一方面，当代谢参数正常化后，皮质醇与CVD风险之间的关联仍然显著时，非代谢特征也与之相关。相应地，高皮质醇血症的治疗通常被发现可有效降低CVD风险。尽管有现有证据，但仍有几个因素继续阻碍皮质醇作为CVD风险生物标志物的临床应用。本综述深入探讨了血清皮质醇在CVD进展和风险中的作用，重点关注其机制特征和参数。
