Increased Hair Cortisol Concentrations and BMI in Patients With Pituitary-Adrenal Disease on Hydrocortisone Replacement

Background Cortisol is the primary output of the hypothalamic-pituitary-adrenal (HPA) axis and is central to the biological stress response, with wide-ranging effects on psychiatric health. Despite well-studied biological pathways of glucocorticoid function, little attention has been paid to the role of genetic variation. Conventional salivary, urinary, and serum measures are influenced by diurnal variation and transient reactivity. Recently developed technology can be used to measure cortisol accumulation over several months in hair, thus indexing chronic HPA function. Methods In a socioeconomically diverse sample of 1,070 twins/multiples (ages 7.80–19.47 years), we estimated effects of sex, age, and socioeconomic status (SES) on hair concentrations of cortisol and its inactive metabolite, cortisone, along with their interactions with genetic and environmental factors. This is the first genetic study of hair neuroendocrine concentrations and the largest twin study of neuroendocrine concentrations in any tissue type. Results Glucocorticoid concentrations increased with age for females, but not males. Genetic factors accounted for approximately half of the variation in cortisol and cortisone. Shared environmental effects dissipated over adolescence. Higher SES was related to shallower increases in cortisol with age. SES was unrelated to cortisone, and did not significantly moderate genetic effects on either cortisol or cortisone. Conclusions Genetic factors account for sizable proportions of gluccocorticoid variation across the entire age range examined, whereas shared environmental influences are modest, and only apparent at earlier ages. Chronic glucocorticoid output appears to be more consistently related to biological sex, age, and genotype than to experiential factors that cluster within nuclear families.

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“…However, null associations between socioeconomic status and hair cortisol have also been reported (Bosma et al . 2015; Staufenbiel et al . 2015).…”

Section: Introductionmentioning

confidence: 99%

“…2014; Rippe et al . 2016; Staufenbiel et al . 2015 for other large-scale studies of hair cortisol in singletons).…”

Section: Introductionmentioning

confidence: 99%

Genetic influences on hormonal markers of chronic hypothalamic–pituitary–adrenal function in human hair

et al. 2017

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“…All studies reported higher mean HCC in hydrocortisone-treated patients compared to healthy individuals or non-AI controls. In the two studies performed in adult AI patients, (19,20), while in the other two studies, HCC correlated significantly with BMI but not with hydrocortisone dose (21,22). In the adrenocortical carcinoma patients, this can be explained by mitotane treatment, which alters the metabolism of hydrocortisone.…”

Section: Hydrocortisone Replacement Therapy Monitoringmentioning

confidence: 89%

“…Several published studies have investigated HCC in patients treated with hydrocortisone for AI. The studies included 132 adults with AI, 93 adults with AI, 54 children with AI and 15 adults who were treated with the adrenolytic drug mitotane for adrenocortical carcinoma (19,20,21,22). All studies reported higher mean HCC in hydrocortisone-treated patients compared to healthy individuals or non-AI controls.…”

Section: Hydrocortisone Replacement Therapy Monitoringmentioning

confidence: 99%

Clinical applications of cortisol measurements in hair

Wester

Rossum

2015

European Journal of Endocrinology

171

141

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Cortisol measurements in blood, saliva and urine are frequently used to examine the hypothalamus-pituitary-adrenal (HPA) axis in clinical practice and in research. However, cortisol levels are subject to variations due to acute stress, the diurnal rhythm and pulsatile secretion. Cortisol measurements in body fluids are not always a reflection of long-term cortisol exposure. The analysis of cortisol in scalp hair is a relatively novel method to measure cumulative cortisol exposure over months up to years. Over the past years, hair cortisol concentrations (HCC) have been examined in association with a large number of somatic and mental health conditions. HCC can be used to evaluate disturbances of the HPA axis, including Cushing's syndrome, and to evaluate hydrocortisone treatment. Using HCC, retrospective timelines of cortisol exposure can be created which can be of value in diagnosing cyclic hypercortisolism. HCC have also been shown to increase with psychological stressors, including major life events, as well as physical stressors, such as endurance exercise and shift work. Initial studies show that HCC may be increased in depression, but decreased in general anxiety disorder. In posttraumatic stress disorder, changes in HCC seem to be dependent on the type of traumatic experience and the time since traumatization. Increased hair cortisol is consistently linked to obesity, metabolic syndrome and cardiovascular disease. Potentially, HCC could form a future marker for cardiovascular risk stratification, as well as serve as a treatment target.

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“…The measurement of HCC may constitute an important, long term biomarker of stress [14]. Newer studies have established age and gender [15], season, hair characteristics, sociodemographic factors, health and body mass index [16, 17] as determinants of HCC to be included when studying HCC.…”

Section: Introductionmentioning

confidence: 99%

The Association between Hair Cortisol and Self-Reported Symptoms of Depression in Pregnant Women

Wikenius

Moe

Kjellevold³

et al. 2016

PLoS ONE

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Depression has been linked to an imbalance in cortisol. Until recently, cortisol has been studied by measuring concentrations at single time points in blood or saliva samples. Cortisol concentrations vary with circadian rhythm and experiences, from time point to time point. The measurement of hair cortisol concentration (HCC) is a new method of accessing mean, long-term cortisol concentrations. Recent studies show positive associations between depression and HCC, and prenatal maternal cortisol is thought to influence the developing fetus. We therefore examined the association between HCC and self-reported symptoms of depression in second trimester pregnant women. Participants were 181 women, recruited between September 2011 and October 2013 to the Little-in-Norway (LiN)-study. These women answered the Edinburgh Postnatal Depression Rating Scale (EPDS) on self-reported symptoms of depression, and one cm maternal scalp hair was collected and analyzed for cortisol concentrations. Multiple regression analyses did not show depressive symptoms as a predictor for HCC in our selection of pregnant women, while gestational age was significantly related. In conclusion, our study indicated that symptoms of depression during pregnancy did not predict HCC, but further studies of clinically depressed, pregnant women using gestational age as an adjustment variable are warranted.

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Increased Hair Cortisol Concentrations and BMI in Patients With Pituitary-Adrenal Disease on Hydrocortisone Replacement

Cited by 23 publications

References 27 publications

Genetic influences on hormonal markers of chronic hypothalamic–pituitary–adrenal function in human hair

Genetic influences on hormonal markers of chronic hypothalamic–pituitary–adrenal function in human hair

Clinical applications of cortisol measurements in hair

The Association between Hair Cortisol and Self-Reported Symptoms of Depression in Pregnant Women

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