Effect of hyperinsulinaemia on the function of the pituitary‐adrenal axis in healthy man

Walker, Mark; Berrish, T. S.; James, Andrew; Alberti, K. G. M. M.

doi:10.1111/j.1365-2265.1994.tb02488.x

Cited by 13 publications

(10 citation statements)

References 21 publications

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“…In the patient group, maximal cortisol levels also varied (from 334 to 718 nmol/L) and in some cases responses could be considered suboptimal (11). Obesity and hyperinsulinemia may attenuate the adrenocortical response to CRH (19); however, these factors are not present in these patients and the exact reason for the individual sub-responsiveness is not clear. Patients with DTC receive treatment with thyroxine in suppressive doses as part of their therapy (20) and consequently are subclinically or even clinically hyperthyroid.…”

Section: Discussionmentioning

confidence: 96%

The Hypothalamic–Pituitary–Adrenal Axis in Women with Differentiated Thyroid Cancer

Chrisoulidou¹,

Pazaitou‐Panayiotou²,

Georgiou³

et al. 2010

Endocrine Research

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Section: Discussionmentioning

confidence: 96%

The Hypothalamic–Pituitary–Adrenal Axis in Women with Differentiated Thyroid Cancer

Chrisoulidou¹,

Pazaitou‐Panayiotou²,

Georgiou³

et al. 2010

Endocrine Research

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“…Two studies investigated the role of mild to moderate hyperinsulinemia in the regulation of the HPA axis in vivo using the euglycemic hyperinsulinemic clamp technique (34,35). They reported disparate results, however, with one study demonstrating a diminished cortisol response to CRH in conditions of moderate hyperinsulinemia (34) and the other reporting an increase of ACTH and cortisol blood levels with increasing insulin levels during the clamp study, therefore suggesting a stimulatory effect of insulin on the HPA axis secretory capacity. No studies have investigated this issue in obese subjects.…”

Section: Discussionmentioning

confidence: 96%

Response of the Hypothalamic-Pituitary-Adrenocortical Axis to High-Protein/Fat and High-Carbohydrate Meals in Women with Different Obesity Phenotypes

Vicennati

Ceroni

Gagliardi

et al. 2002

The Journal of Clinical Endocrinology &Amp; Metabolism

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Subjects with abdominal obesity are characterized by hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis. Food intake, particularly at noon, is a well-known inducer of HPA axis activation. Whether obese subjects present an abnormal response to meals containing different macronutrient proportions is at present unknown. Therefore, this study was carried out to investigate the effect of a high-lipid/protein meal (HLP-meal) and a high-carbohydrate meal (HCHO-meal) on the HPA axis activity in women with different obesity phenotypes. Nondepressed, noncomplicated obese (body mass index greater than 28 kg/m(2)) women with abdominal (A-BFD) (n = 10) and peripheral body fat distribution (P-BFD) (n = 9) and a group of 11 normal-weight controls were investigated in the follicular phase of the menstrual cycle. They were randomly given an 800-kcal HCHO-meal (containing 89% carbohydrates, 11% proteins, 0% lipids), and an 800-kcal HLP-meal (containing 53% lipids, 43% proteins, 4% carbohydrates), which were eaten within 15 min at noon, with an interval of 2 d between each meal. Blood samples for ACTH, cortisol, glucose, and insulin were obtained at 15-min intervals before and after each meal. Baseline hormone and glucose concentrations in the three groups were similar. After the HLP-meal, ACTH tended to similarly but insignificantly increase in all groups, whereas cortisol increased significantly (P < 0.05) in the P-BFD group and insignificantly in the other groups. Conversely, both ACTH and cortisol significantly (P < 0.05) increased only in the A-BFD group, without any significant changes in both controls and P-BFD women. The analysis of the interaction between meals and groups clearly indicated that the cortisol response to the HLP-meal and the HCHO-meal was significantly different (P < 0.025) between the two obese groups, the A-BFD group being characterized by a significantly lower response to the HLP-meal and a significantly higher response to the HCHO-meal, compared with the P-BFD group. Considering all groups together and after adjusting for body mass index, a highly significant relationship was found between cortisol-area under the curve and ACTH-area under the curve after each meal test. However, no relationships were found between changes in ACTH and cortisol and those of glucose, insulin, and the glucose:insulin ratio after each meal. Therefore, our data demonstrate that the response of the HPA axis to meals containing different macronutrient proportions may depend on the pattern of body fat distribution. We also suggest that the activation of the HPA axis following the ingestion of large amounts of carbohydrates may have some pathophysiological relevance, specifically in women with the abdominal obesity phenotype.

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“…Short‐term studies using euglycaemic clamps have shown that hyperinsulinaemia causes activation of the HPA axis (Fruehwald‐Schultes et al ., , ). However, cortisol response to corticotrophin‐releasing hormone (CRH) is lower in those with higher circulating insulin levels (Walker et al ., ). Patients with insulinoma (who have persistent hyperinsulinaemia) also have poor cortisol response to hypoglycaemia (Grimaldi et al ., ; Chang et al ., ).…”

Section: Introductionmentioning

confidence: 97%

Plasma testosterone in adult normoglycaemic men: impact of hyperinsulinaemia

et al. 2012

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This study analysed the relationship of plasma testosterone with β-cell secretion, insulin sensitivity and other pituitary-target gland hormones in normoglycaemic adult men. The sample frame was the 'Offspring of individuals with diabetes study' database. A total of 358 offspring of individuals with type-2 diabetes (T2DM) and 287 individuals without known family history of T2DM were recruited for the study. Normoglycaemic men aged ≥18 years (maximum 55) were selected for this analysis. All participants underwent 75 g oral glucose tolerance test (OGTT); blood samples were collected at 0, 30, 60 and 120 min for plasma insulin and C-peptide. Total testosterone, cortisol, adrenocorticotropic hormone, thyroid stimulating hormone and thyroxine (T4) were measured in the fasting sample. A total of 164 men (age 28 ± 7.7 years) were included in analysis. Testosterone correlated negatively with BMI, waist to hip ratio (WHR), area under curve (AUC) of C-peptide and insulin (during OGTT) and was positively correlated with insulin sensitivity (r ~ 0.4). Cortisol and T4 positively correlated (weak) with testosterone (r ~ 0.2). In multivariate analysis, AUC C-peptide, BMI, WHR (negatively) and cortisol (positively) were related to testosterone. Concluding, testosterone correlated negatively with BMI and β-cell secretion. There was a positive association of testosterone with insulin sensitivity, cortisol and T4.

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Effect of hyperinsulinaemia on the function of the pituitary‐adrenal axis in healthy man

Abstract: The peak cortisol response to CRH was diminished at the higher circulating insulin levels. This was not dependent upon concurrent hypoglycaemia and did not appear to be mediated at the level of the pituitary gland.

Cited by 13 publications

References 21 publications

The Hypothalamic–Pituitary–Adrenal Axis in Women with Differentiated Thyroid Cancer

The Hypothalamic–Pituitary–Adrenal Axis in Women with Differentiated Thyroid Cancer

Response of the Hypothalamic-Pituitary-Adrenocortical Axis to High-Protein/Fat and High-Carbohydrate Meals in Women with Different Obesity Phenotypes

Plasma testosterone in adult normoglycaemic men: impact of hyperinsulinaemia

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