Associations between pituitary-adrenocortical function and abdominal obesity, hyperinsulinaemia and dyslipidaemia in normotensive males.
OBJECTIVE
To examine the relationships between pituitary-adrenal cortical (PA) function, abdominal obesity, hyperinsulinaemia, and dyslipidaemia.


METHODS
A prospective study.


METHODS
Helsinki University Central Hospital, Finland.


METHODS
Seventy-one healthy males aged 30-55 years.


METHODS
Insulin sensitivity was assessed by the oral glucose tolerance test (OGTT). Basal PA activity was examined by measuring urinary and serum concentrations of hormones, followed by dexamethasone suppression and corticotrophin (ACTH) stimulation tests to determine functional PA activity.


RESULTS
The means of waist-to-hip ratio (WHR), body-mass index (BMI), HDL-cholesterol and triglyceride levels, and insulin and C-peptide measurements during the OGTT were significantly different across the tertiles for insulin:glucose ratio. The ratio of 12-h urinary cortisol excretion to BMI, preceding the OGTT, and the mean basal cortisol level during the OGTT were decreased, while the net increments of cortisol and 17-hydroxyprogesterone (17-OHP) from 0 to 60 min, as well as the ratio of net 17-OHP to 11-deoxycortisol increments, after ACTH, were elevated in the upper compared with the lower tertile. The mean cortisol during the OGTT, and the ratio of urinary cortisol to BMI were negatively related, while absolute DHEA and cortisol responses to ACTH were positively related to fasting and mean insulin levels. Hormonal variables, WHR, insulin, and triglycerides were successfully integrated into a tentative mathematical model by the use of covariance structure (path) analyses.


CONCLUSIONS
Several alterations in the PA function, suggestive of decreased 21-hydroxylase activity, mild cortisol deficiency and slight adrenal hyperplasia, are associated with abdominal obesity which, in turn, appears to be an important prelude to insulin resistance and dyslipidaemia.
Hautanen
A
A
Department of Clinical Chemistry, University of Helsinki, Finland. aarno.hautanen@sll.fimnet.fi
Räikkönen
K
K
Adlercreutz
H
H
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood; D000005:Abdomen; D000302:Adrenal Cortex / Q000378:metabolism*; D000328:Adult; D001824:Body Constitution; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003687:Dehydroepiandrosterone / Q000097:blood; D005951:Glucose Tolerance Test; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D006946:Hyperinsulinism / Q000097:blood / Q000378:metabolism*; D006949:Hyperlipidemias / Q000097:blood / Q000378:metabolism*; D007328:Insulin / Q000097:blood; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000378:metabolism*; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D002096:C-Peptide; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides; D003687:Dehydroepiandrosterone; D019326:17-alpha-Hydroxyprogesterone; D006854:Hydrocortisone