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Titolo:
Fat distribution in obese women is associated with subtle alterations of the hypothalamic-pituitary-adrenal axis activity and sensitivity to glucocorticoids
Autore:
Duclos, M; Gatta, B; Corcuff, JB; Rashedi, M; Pehourcq, F; Roger, P;
Indirizzi:
Inst Francois Magendie, Lab Neurogenet & Stress, INSERM, U471, F-33076 Bordeaux, France Inst Francois Magendie Bordeaux France F-33076 F-33076 Bordeaux, France Hop Haut Leveque, CHU Bordeaux, Serv Endocrinol, Pessac, France Hop Haut Leveque Pessac France ordeaux, Serv Endocrinol, Pessac, France Hop Haut Leveque, CHU Bordeaux, Nucl Med Serv, Pessac, France Hop Haut Leveque Pessac France Bordeaux, Nucl Med Serv, Pessac, France Hop Pellegrin, CHU Bordeaux, Pharmacol Lab, F-33076 Bordeaux, France Hop Pellegrin Bordeaux France F-33076 acol Lab, F-33076 Bordeaux, France
Titolo Testata:
CLINICAL ENDOCRINOLOGY
fascicolo: 4, volume: 55, anno: 2001,
pagine: 447 - 454
SICI:
0300-0664(200110)55:4<447:FDIOWI>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORTICOSTEROID-BINDING GLOBULIN; CORTISOL SECRETION; ABDOMINAL OBESITY; ADIPOSE-TISSUE; DEXAMETHASONE SUPPRESSION; INSULIN-RESISTANCE; VASOPRESSIN TEST; PLASMA-CORTISOL; IN-VIVO; RESPONSES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
48
Recensione:
Indirizzi per estratti:
Indirizzo: Duclos, M Inst Francois Magendie, Lab Neurogenet & Stress, INSERM, U471, Rue CamilleSt Saens, F-33076 Bordeaux, France Inst Francois Magendie Rue Camille St Saens Bordeaux France F-33076
Citazione:
M. Duclos et al., "Fat distribution in obese women is associated with subtle alterations of the hypothalamic-pituitary-adrenal axis activity and sensitivity to glucocorticoids", CLIN ENDOCR, 55(4), 2001, pp. 447-454

Abstract

Objectives: Obesity with abdominal body fat distribution (A-BFD) and hypothalamic-pituitary-adrenal (HPA) axis activity are somehow linked, but the exact interactions still need clarification. Obese subjects display normal circulating plasma cortisol concentrations with normal circadian rhythms. However, when the HPA axis is pharmacologically challenged, body fat distribution matters and then A-BFD obese women differ from those with subcutaneousbody fat distribution (P-BFD). We hypothesized that lower dose provocativeand suppressive tests than those used to diagnose hypercortisolism of tumour origin or adrenal insufficiency would shed some light on the characteristics of the HPA axis activity in relation with body fat distribution. Patients and Methods: Fifty premenopausal obese women were grouped according to their body fat mass distribution. Their plasma cortisol responses to (i) two low doses of dexamethasone (0.25 and 0.5 mg) with (ii) low dose of the ACTH analogue tetracosactrin (1 mug) were assessed. Salivary cortisol was also determined during the ACTH test. Results A-BFD differed from P-BFD women in terms of HPA axis responsiveness. They had comparatively: (i) increased nocturnal cortisol excretion (9.38+/- 2.2 vs. 6.82 +/- 0.91 nmol/mu mol creatinine, A-BFD vs. P-BFD, respectively, P = 0.03); (ii) increased salivary cortisol response to ACTH stimulation (1 mug) [salivary cortisol peak: 33.4 (14.1-129) vs. 28.5 (13.2-42.8) nmol/l; salivary AUC: 825 (235-44738) vs. 537 (69-1420) nmol/min/l; A-BFD vs. P-BFD, P = 0.04 for both]; and (iii) increased pituitary sensitivity to dexamethasone testing [postdexamethasone (0.25 mg) plasma cortisol levels: 163 (26-472) vs. 318 (26-652) nmol/l and postdexamethasone (0.5 mg) plasma cortisol levels: 26 (26-79) vs. 33 (26-402) nmol/l; A-BFD vs. P-BFD, P = 0.01 for both]. Conclusions: These data demonstrate differences in the HPA axis activity and sensitivity to glucocorticoids between obese women differing in their body fat distribution, with both enhanced negative and positive feedback in those with abdominal obesity. Several mechanisms may explain these differences: central vs. peripheral hypotheses. Thus, abdominal obesity does not appear to be linked solely to one pathophysiological hypothesis.

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Documento generato il 06/07/20 alle ore 04:48:14