Sofer Yael, Osher Esther, Ahmad Wiessam Abu, Greenman Yona, Moshe Yaffa, Shaklai Sigal, Yaron Marianna, Serebro Merav, Tordjman Karen, Stern Naftali
Institute of Endocrinology, Metabolism and Hypertension, Sourasky Medical Center, Tel Aviv, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Obes Facts. 2025;18(2):178-186. doi: 10.1159/000543449. Epub 2025 Jan 8.
Some clinical resemblance may exist between obesity, particularly abdominal obesity, and Cushing's syndrome. This has stimulated ongoing interest in the role of cortisol's secretion pattern, control, and metabolism in obesity.
The aim of the study was to investigate whether basal and stimulated levels of cortisol differ between healthy people with obesity and individuals with normal weight.
Total, free, and salivary cortisol was tested at baseline state and after 1 μg ACTH stimulation in 60 healthy subjects with obesity and 54 healthy lean controls.
Baseline total cortisol was lower in subjects with obesity compared to lean controls (347 [265-452] nmol/L vs. 422 [328-493] nmol/L, respectively; p < 0.05). Similarly, basal salivary cortisol was significantly lower in subjects with obesity (7.5 [5.2-9.7] nmol/L vs. 10.7 [7.5-17.6] nmol/L; p < 0.05). Upon challenge with ACTH, total peak serum and salivary peak cortisol responses were significantly lower in people with obesity than in lean subjects (665.16 ± 151.8 vs. 728.64 ± 124.2 nmol/L; p < 0.05 and 31.66 [19-38.64] vs. 40.05 [31.46-46.64] nmol/L; p < 0.05, respectively). Additionally, baseline total cortisol and salivary cortisol were inversely related to BMI (r = -0.24, r = -0.27; p < 0.05 for both) and waist circumference (r = -0.27, r = -0.34; p < 0.05 for both).
Baseline as well as peak stimulated total serum and salivary cortisol were significantly lower in subjects with obesity. It thus appears that obesity is not associated with enhanced basal or ACTH-stimulated cortisol.
肥胖，尤其是腹型肥胖，与库欣综合征之间可能存在一些临床相似之处。这激发了人们对皮质醇分泌模式、控制及代谢在肥胖中的作用的持续关注。
本研究旨在调查肥胖健康人群与正常体重个体的基础皮质醇水平和刺激后皮质醇水平是否存在差异。
对60名肥胖健康受试者和54名体重正常的健康对照者在基线状态及1μg促肾上腺皮质激素（ACTH）刺激后检测总皮质醇、游离皮质醇和唾液皮质醇。
肥胖受试者的基线总皮质醇低于瘦对照者（分别为347[265 - 452]nmol/L和422[328 - 493]nmol/L；p < 0.05）。同样，肥胖受试者的基础唾液皮质醇也显著较低（7.5[5.2 - 9.7]nmol/L对10.7[7.5 - 17.6]nmol/L；p < 0.05）。在ACTH刺激后，肥胖人群的血清总峰值皮质醇和唾液峰值皮质醇反应显著低于瘦受试者（665.16 ± 151.8对728.64 ± 124.2 nmol/L；p < 0.05以及31.66[19 - 38.64]对40.05[31.46 - 46.64]nmol/L；p < 0.05）。此外，基线总皮质醇和唾液皮质醇与体重指数（r = -0.24，r = -0.27；两者p < 0.05）和腰围（r = -0.27，r = -0.34；两者p < 0.05）呈负相关。
肥胖受试者的基线以及刺激后的血清总峰值皮质醇和唾液皮质醇均显著较低。因此，肥胖似乎与基础或ACTH刺激的皮质醇升高无关。
