title: Relative metabolic stability, but disrupted circadian cortisol secretion during the fasting month of Ramadan.
abstract: Chronic feeding and sleep schedule disturbances are stressors that exert damaging effects on the organism. Practicing Muslims in Saudi Arabia go through strict Ramadan fasting from dawn till sunset for one month yearly. Modern era Ramadan practices in Saudi Arabia are associated with disturbed feeding and sleep patterns, namely abstaining from food and water and increasing daytime sleep, and staying awake and receiving food and water till dawn.
  
  
  
  Strict Ramadan practices in Saudi Arabia may influence metabolism, sleep and circadian cortisol secretion.
  
  
  
  Young, male Ramadan practitioners were evaluated before and two weeks into the Ramadan. Blood samples were collected at 9.00 am and 9.00 pm for measurements of metabolic parameters and cortisol. Saliva was collected serially during the day for cortisol determinations.
  
  
  
  Ramadan practitioners had relative metabolic stability or changes expected by the pattern of feeding. However, the cortisol circadian rhythm was abolished and circulating insulin levels and HOMA index were increased during this period.
  
  
  
  The flattening of the cortisol rhythm is typical of conditions associated with chronic stress or endogenous hypercortisolism and associated with insulin resistance.
  
  
  
  Modern Ramadan practices in Saudi Arabia are associated with evening hypercortisolism and increased insulin resistance. These changes might contribute to the high prevalence of chronic stress-related conditions, such as central obesity, hypertension, metabolic syndrome and diabetes mellitus type 2, and their cardiovascular sequelae observed in the Kingdom.
authors: Department of ClinicalBiochemistry-Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors: Suhad
authors: S
authors: Bahijri
authors: Anwar
authors: A
authors: Borai
authors: Ghada
authors: G
authors: Ajabnoor
authors: Altaf
authors: A
authors: Abdul Khaliq
authors: Ibrahim
authors: I
authors: AlQassas
authors: Dhafer
authors: D
authors: Al-Shehri
authors: George
authors: G
authors: Chrousos
mesh_terms: D000293:Adolescent; D000328:Adult; D002940:Circadian Rhythm / Q000502:physiology*; D005215:Fasting / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D007514:Islam; D008297:Male; D012529:Saudi Arabia; D012890:Sleep / Q000502:physiology; D012892:Sleep Deprivation / Q000503:physiopathology
chemical_list: D007328:Insulin; D006854:Hydrocortisone
references: Aging (Albany NY). 2010 Dec 11;2(1):7-27
references: 20228939
references: Sleep Med Rev. 2007 Jun;11(3):163-78
references: 17442599
references: Ann Endocrinol (Paris). 2002 Dec;63(6 Pt 1):497-501
references: 12527850
references: J Allergy Clin Immunol. 2001 Jan;107(1):165-70
references: 11150007
references: Clin Chem. 1972 Jun;18(6):499-502
references: 4337382
references: Radiology. 2003 May;227(2):309-13
references: 12732691
references: Endocr Dev. 2011;20:116-126
references: 21164265
references: Prague Med Rep. 2008;109(4):275-85
references: 19537678
references: J Psychiatr Res. 2007 Dec;41(11):928-33
references: 17049559
references: Proc Natl Acad Sci U S A. 2009 Mar 17;106(11):4453-8
references: 19255424
references: Brain Res Rev. 2008 Mar;57(2):531-53
references: 17524488
references: Endocr J. 1996 Dec;43(6):645-55
references: 9075604
references: FASEB J. 2009 May;23(5):1572-83
references: 19141540
references: Nature. 2007 Dec 13;450(7172):1086-90
references: 18075593
references: Horm Res. 2007;67 Suppl 1:2-9
references: 17308390
references: PLoS One. 2011;6(9):e25612
references: 21980503
references: Cell. 2008 Jul 25;134(2):317-28
references: 18662546
references: Cell. 2008 Jul 25;134(2):329-40
references: 18662547
references: Sci STKE. 2005 Oct 04;2005(304):pe48
references: 16204701
references: Psychoneuroendocrinology. 2011 Jun;36(5):691-8
references: 21035272
references: Annu Rev Physiol. 2005;67:259-84
references: 15709959
references: Eur J Clin Nutr. 1988 Apr;42(4):359-62
references: 3396527
references: Metabolism. 2012 May;61(5):611-9
references: 22146091
references: Psychoneuroendocrinology. 2012 Apr;37(4):462-74
references: 21852051
references: Obesity (Silver Spring). 2008 Aug;16(8):1887-93
references: 18535539
references: Scand J Soc Med Suppl. 1989;44:1-36
references: 2683043
references: Diabetologia. 1985 Jul;28(7):412-9
references: 3899825
references: Trends Endocrinol Metab. 2010 May;21(5):277-86
references: 20106676