Antecedent longitudinal changes in body mass index are associated with diurnal cortisol curve features: The multi-ethnic study of atherosclerosis.
BACKGROUND
Prior studies have shown a cross-sectional association between body mass index (BMI) and salivary diurnal cortisol profile features (cortisol features); however, to our knowledge prior population-based studies have not examined the longitudinal association of body-mass index (BMI) with cortisol features.


OBJECTIVE
To examine the association of (1) prior annual BMI percent change over 7years with cortisol features, (2) baseline cortisol features with subsequent change in BMI over 6years and (3) the association of change in cortisol features with change in BMI over 6years.


METHODS
Longitudinal study.


METHODS
Multi-Ethnic Study of Atherosclerosis (MESA) Stress I & II Studies (2004-2006 & 2010-2012).


METHODS
1685 ethnically diverse men and women attended either MESA Stress exam (mean age 65±10years at MESA Stress I; mean age 69±9years at MESA Stress II).


METHODS
Log-transformed cortisol features including wake-up cortisol, cortisol awakening response, early decline slope (30min to 2h post-awakening), late decline slope (2h post-awakening to bedtime), bedtime, and total area under the curve (AUC) cortisol.


RESULTS
Over 7years, following multivariable adjustment, (1) a 1% higher prior annual BMI % increase was associated with a 2.9% (95% CI: -5.0%, -0.8%) and 3.0% (95% CI: -4.7%, -1.4%) lower current wake-up and total AUC cortisol, respectively; (2) there was no significant association between baseline cortisol features and subsequent change in BMI and (3) among participants with BMI≥30kg/m2, flattening of the late decline slope was associated with increases in BMI (every 1-unit increase late decline slope were associated with a 12.9% increase (95%CI: -1%, 26.8%) in BMI, respectively).


CONCLUSIONS
We found a significant association between prior annual BMI % change and cortisol features, but no significant association between baseline cortisol features and subsequent change in BMI. In participants with obesity increases in BMI were associated with less pronounced declined. Collectively, our results suggest that greater adiposity may lead to a blunted diurnal cortisol profile.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States. Electronic address: joseph.117@osu.edu.
Joshua J
JJ
Joseph
School of Public Health, Drexel University, Philadelphia, PA, United States.
Xu
X
Wang
School of Public Health, Drexel University, Philadelphia, PA, United States.
Ana V
AV
Diez Roux
Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States.
Brisa N
BN
Sanchez
Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
Teresa E
TE
Seeman
Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States.
Belinda L
BL
Needham
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, United States.
Sherita Hill
SH
Golden
D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D050197:Atherosclerosis / Q000097:blood* / Q000453:epidemiology; D015992:Body Mass Index; D002940:Circadian Rhythm / Q000502:physiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D014481:United States; D055105:Waist Circumference
D006854:Hydrocortisone
Body mass index; Cortisol; Hypothalamic–Pituitary–Adrenal axis; Obesity; Waist circumference