title: The relation between long-term cortisol levels and the metabolic syndrome in HIV-infected patients.
abstract: OBJECTIVE
  Patients infected with the human immunodeficiency virus (HIV) have an increased risk of metabolic complications such as dyslipidaemia, insulin resistance and hypertension; symptoms that are also associated with an excess of the hormone cortisol. We studied the relationship between long-term cortisol levels and metabolic syndrome (MetS) in HIV-infected patients.
  
  
  METHODS
  Cross-sectional study performed at the outpatient clinic of infectious diseases of the Erasmus MC, University Medical Center Rotterdam, the Netherlands.
  
  
  METHODS
  Fasting blood samples and anthropometric data were collected in 126 HIV-infected patients. An ELISA-based technique was used to determine long-term cortisol levels in scalp hair. Cortisol levels were compared to 191 healthy controls.
  
  
  RESULTS
  A higher risk of MetS was observed in HIV patients with a low hair cortisol (odds ratio lower vs upper tertile 4·23, P = 0·04). Hair cortisol levels were not significantly different between HIV patients and healthy controls (16·4 pg/mg vs 13·5 pg/mg; P = 0·14).
  
  
  CONCLUSIONS
  The risk of MetS was significantly higher in HIV-infected patients in the lowest hair cortisol group compared with patients in the highest hair cortisol group. This finding contrasts with results from studies in uninfected individuals where a high cortisol level in hair is associated with metabolic syndrome. The results of this study suggest that these metabolic complications might be related to relative cortisol hypersensitivity in HIV patients.
authors: Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.|Obesity Center CGG, Rotterdam, The Netherlands.
authors: Thomas
authors: T
authors: Langerak
authors: Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors: Lennert W J
authors: LW
authors: van den Dries
authors: Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.|Obesity Center CGG, Rotterdam, The Netherlands.
authors: Vincent L
authors: VL
authors: Wester
authors: Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.|Obesity Center CGG, Rotterdam, The Netherlands.
authors: Sabine M
authors: SM
authors: Staufenbiel
authors: Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors: Laura
authors: L
authors: Manenschijn
authors: Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.|Obesity Center CGG, Rotterdam, The Netherlands.
authors: Elisabeth F C
authors: EF
authors: van Rossum
authors: Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.|Division of Infectious Diseases, Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors: Eric C M
authors: EC
authors: van Gorp
mesh_terms: D000328:Adult; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D006973:Hypertension; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications; D008875:Middle Aged; D016017:Odds Ratio; D011965:Receptors, Glucocorticoid / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D011965:Receptors, Glucocorticoid; D006854:Hydrocortisone