title: Serum Cortisol-to-Cortisone Ratio and Blood Pressure in Severe Obesity before and after Weight Loss.
abstract: OBJECTIVE
  The pathogenesis of obesity-associated hypertension is poorly understood. Serum cortisol-to-cortisone ratio (F/E ratio) is a marker of cortisol metabolism. Our objective was to determine whether the serum F/E ratio is associated with blood pressure (BP) in patients after significant weight loss (≥15% from baseline weight).
  
  
  METHODS
  Sera from 43 nondiabetic, severely obese males participating in a weight management program were assayed for F and E by mass spectrometry. We assessed whether changes in the F/E ratio accompanying weight loss correlate with changes in the systolic (SBP) and diastolic BP (DBP). Linear regression was used to evaluate change in the F/E ratio as a predictor of change in BP.
  
  
  RESULTS
  The body mass index decreased from 40.8 ± 5.6 to 33.7 ± 4.8 (p < 0.001); also, SBP (133.2 ± 13.8 vs. 124.1 ± 14.3 mm Hg; p < 0.001) and DBP (69.8 ± 8.0 vs. 66.6 ± 9.4 mm Hg; p = 0.026) decreased during the study. The baseline F/E ratio tended to associate with baseline DBP (Spearman's r = -0.29, p = 0.06), and change in the serum F/E ratio correlated with change in DBP (Spearman's r = -0.32, p = 0.036). Change in the F/E ratio also tended to associate with change in SBP (Spearman's r = -0.27, p = 0.08). A multiple linear regression model adjusted for change in the F/E ratio and age explained 22% of the variance in SBP change (R(2) = 0.22, p = 0.007). Change in the F/E ratio independently predicted change in SBP (p = 0.036).
  
  
  CONCLUSIONS
  In our sample of nondiabetic, severely obese males, change in the serum F/E ratio was associated with change in BP after weight loss.
authors.affiliation: Division of Cardiovascular Medicine, Mich., USA.
authors.forename: James B
authors.initials: JB
authors.lastname: Byrd
authors.affiliation: Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, Mich., USA; Division of Weight Management Program, Mich., USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Rothberg
authors.affiliation: Division of Metabolomics Core, Mich., USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Chomic
authors.affiliation: Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, Mich., USA; Division of Weight Management Program, Mich., USA; Division of Metabolomics Core, Mich., USA; Department of Molecular and Integrative Physiology, Mich., USA.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Burant
authors.affiliation: Division of Cardiovascular Medicine, Mich., USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Brook
authors.affiliation: Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, Mich., USA; Division of Metabolomics Core, Mich., USA; Division of Pharmacology, University of Michigan, Ann Arbor, Mich., USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Auchus
keywords: Adrenal steroids; Cortisol; Cortisone; Hypertension; Obesity