Altered adrenocorticotropin and Cortisol secretion in abdominal obesity: implications for the insulin resistance syndrome

Hautanen, Aarno; Adlercreutz, Herman

doi:10.1111/j.1365-2796.1993.tb00779.x

Cited by 84 publications

(58 citation statements)

References 32 publications

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“…[17][18][19] This is further supported by evidences showing that the HPA axis responsiveness to stimuli such as acute stress, CRH/AVP, 20 adrenergic manipulations, 21 hypoglycemia, or a standard meal 22,23 is enhanced in idiopathic obesity, particularly in visceral obesity. 21 The mild increase in glucocorticoid production and exaggerated cortisol responses in obesity can be explained by increased forward drive to the HPA axis, 24 and/or by reduced sensitivity to HPA axis feedback.…”

Section: Glucocorticoids and Neuropeptide Ymentioning

confidence: 70%

Role of glucocorticoids in the physiopathology of excessive fat deposition and insulin resistance

2004

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Glucocorticoids are important hormones in the regulation of metabolic homeostasis. We infused normal rats with dexamethasone given intracerebroventricularly (i.c.v.) for 3 days. This resulted in hyperphagia, hyperinsulinemia, and marked insulin resistance. Similar metabolic defects were observed following i.c.v. infusion of neuropeptide Y (NPY) in normal rats. As central dexamethasone infusion enhanced NPY content in the arcuate nucleus, it suggested that its metabolic effects are mediated by NPY. Moreover, due to the lack of effects observed in vagotomized animals, activation of the parasympathetic nervous system by central dexamethasone infusion is proposed. Glucocorticoid action is known to involve prereceptor metabolism by enzymes such as 11b-HSD-1 that converts inactive into active glucocorticoids. Mice overexpressing 11b-HSD-1 in adipose tissue were shown to be obese and insulin resistant. We recently observed that adipose tissue 11b-HSD-1 mRNA expression is increased at the onset of high-fat diet-induced obesity and positively correlated with the degree of hyperglycemia. In human obesity, increased adipose tissue 11b-HSD-1 expression and activity were also reported. Resistin is a new adipose tissue-secreted hormone shown to play a role in glucose homeostasis by increasing hepatic glucose production and inhibiting muscle and adipose tissue glucose utilization. We observed increased adipose tissue resistin expression in the early phase of highfat diet-induced obesity as well as decreased resistin expression in response to leptin. A positive correlation between glycemia and adipose tissue resistin expression further suggested a role of this hormone in the development of insulin resistance. The melanocortin system is another important player in the regulation of energy balance. Peripheral administration of a melanocortin agonist decreased food intake and body weight and favored lipid oxidation, effects that were more marked in obese than in lean rats. It is proposed that both resistin and melanocortin agonists may influence adipose tissue 11b-HSD-1, thereby decreasing or enhancing glucose metabolism.

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Section: Glucocorticoids and Neuropeptide Ymentioning

confidence: 70%

Role of glucocorticoids in the physiopathology of excessive fat deposition and insulin resistance

2004

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“…In a study of 66 adult males aged 30 to 55 years, Hautanen et al reported a correlation between the cortisol response to IV ACTH and the subject's waist-hip ratio (51). It has been suggested that adrenal secretion of cortisol in response to ACTH may be blunted due to hyperinsulinemia (124).…”

Section: Ivacthmentioning

confidence: 99%

The Hypothalamic‐Pituitary‐Adrenal Axis in Obesity

1995

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“…Some authors have observed central adrenal insufficiency with concurrent disorders of insulin and lipoprotein metabolism in this group [9]. Others have reported that both ACTH and cortisol concentration may be increased [10,11].…”

Section: Discussionmentioning

confidence: 99%

Etomidate, but not thiopental, decreases serum cortisol concentration in morbidly obese patients. A randomized controlled trial

Możański

Tomaszewski²,

Rybicki³

et al. 2016

Anaesthesiol Intensive Ther

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Background: The effect of etomidate administration on the adrenal cortex in obese patients is still unclear. The objective of the study was to determine the influence of a single dose of etomidate on cortisol secretion in the morbidly obese. Methods: 127 healthy patients were enrolled into the study. Data from 82 patients scheduled for elective laparoscopic surgery were analyzed. 62 of them were morbidly obese, while 20 had normal body mass. The participants were divided equally into etomidate and thiopental groups, depending on the kind of intravenous anaesthetic used for the induction of anaesthesia. Each patient's serum cortisol concentration was measured five times: on the day before surgery (sample A), two hours after the induction of anaesthesia (sample B), after a short tetracosactide test (sample C), 24 hours after the induction of anaesthesia (sample D), and after a second short stimulation test (sample E). Results:The mean cortisol concentration in obese patients in the etomidate group was lower two hours after the induction of anaesthesia (sample B, P < 0.001), and 30 minutes after the first tetracosactide test (sample C, P < 0.001) compared to obese patients in the thiopental group. There were no differences between the groups in sample A (P = 0.833), D (P = 0.614) and E (P = 0.769). We found no changes in haemodynamic parameters between both groups. Conclusions: Etomidate decreased serum cortisol concentration and decreased reactivity to tetracosactide both in morbidly obese and in normal weight patients. This effect was reversible within 24 hours.

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Altered adrenocorticotropin and Cortisol secretion in abdominal obesity: implications for the insulin resistance syndrome

Abstract: Abdominal obesity may be associated with subtle central adrenal insufficiency, which might also affect insulin and lipoprotein metabolism.

Cited by 84 publications

References 32 publications

Role of glucocorticoids in the physiopathology of excessive fat deposition and insulin resistance

Role of glucocorticoids in the physiopathology of excessive fat deposition and insulin resistance

The Hypothalamic‐Pituitary‐Adrenal Axis in Obesity

Etomidate, but not thiopental, decreases serum cortisol concentration in morbidly obese patients. A randomized controlled trial

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