title: Salivary cortisol levels are associated with outcomes of weight reduction therapy in obese Japanese patients.
abstract: Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis can increase the risk of cardiovascular disease (CVD). However, the detailed relationships of HPA axis activity with weight reduction and CVD risk factors in obese patients have not been examined. This study was designed to elucidate the associations of salivary cortisol levels with weight reduction and CVD risk factors in obese patients. As a marker of HPA axis activity, we measured the morning salivary cortisol levels of 83 obese Japanese outpatients. We also examined metabolic parameters, inflammatory markers, and indicators of arterial stiffness, that is, the pulse wave velocity and cardio-ankle vascular index. All 83 obese patients underwent 3-month weight reduction therapy with lifestyle modification. At the baseline, multivariate regression analysis revealed that only logarithmic transformation of C-reactive protein (β = 0.258, P < .05) and cardio-ankle vascular index (β = 0.233, P < .05) were independent determinants of the salivary cortisol levels. However, other metabolic parameters were not significantly associated with the salivary cortisol levels. In addition, lower salivary cortisol levels and higher body weight at the baseline were the only independent determinants of successful weight loss through the weight reduction therapy (P < .01). The present study demonstrates that the baseline morning salivary cortisol levels are significantly associated with the levels of an inflammatory marker, arterial stiffness, and successful weight reduction in obese patients. Therefore, salivary cortisol could be a useful marker for assessing and managing body weight and CVD risk factors in obese patients.
authors.affiliation: Clinical Research Institute, National Hospital Organization, Kyoto Medical Center, 1-1 Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Himeno
authors.forename: Noriko
authors.initials: N
authors.lastname: Satoh-Asahara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Usui
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Wada
authors.forename: Mayu
authors.initials: M
authors.lastname: Tochiya
authors.forename: Shigeo
authors.initials: S
authors.lastname: Kono
authors.forename: Nobuko
authors.initials: N
authors.lastname: Yamada-Goto
authors.forename: Goro
authors.initials: G
authors.lastname: Katsuura
authors.forename: Koji
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Kazuwa
authors.initials: K
authors.lastname: Nakao
authors.forename: Akira
authors.initials: A
authors.lastname: Shimatsu
mesh_terms: D000328:Adult; D044466:Asian People; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000208:ethnology / Q000378:metabolism / Q000628:therapy*; D011379:Prognosis; D040242:Risk Reduction Behavior; D012463:Saliva / Q000737:chemistry / Q000378:metabolism; D016896:Treatment Outcome; D061217:Weight Reduction Programs / Q000379:methods
chemical_list: D006854:Hydrocortisone