Cross‐sectional relation of long‐term glucocorticoids in hair with anthropometric measurements and their possible determinants: A systematic review and meta‐analysis

Abstract

Summary Background Long‐term glucocorticoids (HairGC) measured in scalp hair have been associated with body mass index (BMI), waist circumference (WC), and waist‐hip‐ratio (WHR) in several cross‐sectional studies. We aimed to investigate the magnitude, strength, and clinical relevance of these relations across all ages. Methods We performed a systematic review and meta‐analysis (PROSPERO registration CRD42020205187) searching for articles relating HairGC to measures of obesity. Main outcomes were bivariate correlation coefficients and unadjusted simple linear regression coefficients relating hair cortisol (HairF) and hair cortisone (HairE) to BMI, WC, and WHR. Results We included k = 146 cohorts (n = 34,342 individuals). HairGC were positively related to all anthropometric measurements. The strongest correlation and largest effect size were seen for HairE‐WC: pooled correlation 0.18 (95%CI 0.11–0.24; k = 7; n = 3,158; I2 = 45.7%) and pooled regression coefficient 11.0 cm increase in WC per point increase in 10‐log‐transformed HairE (pg/mg) on liquid‐chromatography‐(tandem) mass spectrometry (LC–MS) (95%CI 10.1–11.9 cm; k = 6; n = 3,102). Pooled correlation for HairF‐BMI was 0.10 (95%CI 0.08–0.13; k = 122; n = 26,527; I2 = 51.2%) and pooled regression coefficient 0.049 kg/m2 per point increase in 10‐log‐transformed HairF (pg/mg) on LC–MS (95%CI 0.045–0.054 kg/m2; k = 26; n = 11,635). Discussion There is a consistent positive association between HairGC and BMI, WC, and WHR, most prominently and clinically relevant for HairE‐WC. These findings overall suggest an altered setpoint of the hypothalamic–pituitary–adrenal axis with increasing central adiposity.

How energy balance-related behaviours, temperament, stress and overweight associate: a cross-sectional study of Finnish preschoolers

“…However, in our previous study, HCC did not associate with ST in preschoolers (23) , which may explain the lack of association between HCC and EBRB clusters. Moreover, our current study was unable to demonstrate a relationship between HCC and overweight, even though a recently conducted meta-analysis found a consistent positive association between HCC and BMI across age groups (21) . The lack of association between HCC and overweight in our study may possibly be explained by the smaller number of boys with HCC values (hair samples could not be taken from children with hair shorter than 2 cm, which were mostly boys) and the higher prevalence of overweight among boys.…”

“…The lack of association between HCC and overweight in our study may possibly be explained by the smaller number of boys with HCC values (hair samples could not be taken from children with hair shorter than 2 cm, which were mostly boys) and the higher prevalence of overweight among boys. Another explanation may be the choice of variables: we used HCC and BMI-based weight status, whereas the strongest correlations and largest effect sizes have been demonstrated using hair cortisone and waist circumference ( 21 ) .…”

“…Multiple individual- or family-level factors, such as the socio-economic status (SES) of families, personality traits or temperament and exposure to stress hormones, may also be involved in childhood overweight ( 20 , 21 ) . For instance, poor self-regulation (the ability to monitor and manage emotions and behaviours) and low negative affectivity (the tendency to experience negative emotions) have been shown to associate with higher BMI in preschoolers ( 20 ) .…”

Long‐term glucocorticoids in relation to the metabolic syndrome and cardiovascular disease: A systematic review and meta‐analysis

“…Intriguingly, the relationship between HairGC and MetS may not be linear, as indicated by studies reporting significantly higher odds of having MetS only in the highest, but not middle, ranges of HairGC levels when compared to the group with the lowest levels [29, 32, 34]. Moreover, two of these studies suggest an equally strong, or even stronger, association of HairE with MetS than was seen for HairF [29, 32], which is in line with studies regarding BMI and waist circumference [54, 55], as well as studies regarding CVD [18, 21]. Mechanistically, it has been speculated that cortisone may represent a more stable marker for the long‐term systemic reservoir of available glucocorticoids in the body.…”

Glucocorticoids, stress and eating: The mediating role of appetite‐regulating hormones

“… 16 , 20 , 21 , 22 Previous research suggests that this effect is at least partially mediated by glucocorticoid‐induced alterations in the levels and/or signaling of appetite‐regulating hormones. 16 , 19 , 23 Notably, many patients with obesity have cortisol levels in the high‐physiological range and/or use glucocorticoid medication, 24 , 25 indicating that there may be a large subgroup of patients suffering from glucocorticoid effects on appetite and metabolism.…”