title: Hair cortisol and cortisol awakening response are associated with criteria of the metabolic syndrome in opposite directions.
abstract: Findings on the association between hypothalamic-pituitary-adrenal (HPA) axis activity and metabolic risk are equivocal. Different methods of measuring HPA activity might indicate adverse vs. beneficial effects of HPA activity on metabolic risk thus contributing to heterogenous findings. In this study, we aimed to determine whether (1) the salivary cortisol awakening response (CAR) as a marker of awakening-induced activation of the HPA axis and (2) hair cortisol as a marker of long-term cortisol secretion are associated with criteria of the metabolic syndrome. Therefore, we recruited 41 healthy individuals (26 women, mean age: 41.2 years) and 44 patients with major depression (28 women, 41.4 years) and assessed CAR and hair cortisol values as well as all criteria of the metabolic syndrome (abdominal obesity, blood pressure, plasma glucose, triglycerides and high-density cholesterol levels) according to the International Diabetes Federation. CAR and hair cortisol values were divided into tertiles. Across groups, participants with hair cortisol or hair cortisone in the highest tertile showed significantly more criteria of the metabolic syndrome compared to participants in the medium or low tertile (F2,64=3.37, p=.04). These results were corroborated by significant positive correlations between mean hair cortisol values with waist circumference (r=.29, p=.03), triglycerides (r=.34, p=.01) and systolic blood pressure (r=.29, p=.04) and between mean hair cortisone and triglycerides (r=.46, p<.01). In contrast, mean CAR values correlated negatively with diastolic (r=-.29, p=.03) and systolic blood pressure (r=-.32, p=.02). Our results indicate that higher hair cortisol and hair cortisone levels but lower CAR values are associated with an unfavorable metabolic and cardiovascular risk profile.
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany. Electronic address: linn.kuehl@charite.de.
authors.forename: Linn K
authors.initials: LK
authors.lastname: Kuehl
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Kim
authors.initials: K
authors.lastname: Hinkelmann
authors.affiliation: Department of Psychosomatic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Muhtz
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Lucia
authors.initials: L
authors.lastname: Dettenborn
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Wingenfeld
authors.affiliation: Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Spitzer
authors.affiliation: Department of Psychology, Technical University of Dresden, Dresden, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Kirschbaum
authors.affiliation: Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Wiedemann
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Otte
mesh_terms: D000328:Adult; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006197:Hair / Q000737:chemistry; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012463:Saliva / Q000737:chemistry; D055105:Waist Circumference
chemical_list: D006854:Hydrocortisone
keywords: Cortisol awakening response; Hair cortisol; Hair cortisone; Metabolic syndrome