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Hypothalamic-pituitary-adrenal axis function: relative contributions of perceived stress and obesity in women.
J Womens Health (Larchmt) 2008; 17(10):1647-55JW

Abstract

OBJECTIVE

A range of behavioral and psychosocial factors may contribute to a chronically stimulated hypothalamic-pituitary-adrenal (HPA) axis and subsequently altered diurnal patterns. The goal of this cross-sectional study was to examine associations among diurnal cortisol levels, perceived stress, and obesity patterns.

METHODS

Seventy-eight women (aged 24-72 years) employed in a rural public school system completed the perceived stress scale, collected diurnal saliva samples, and underwent anthropometric assessments. Reduced peak-to-nadir cortisol values across the day were considered a sign of impairment in HPA function. A series of linear regression models determined the best predictors of diurnal cortisol variation.

RESULTS

There was a marginal linear trend in stress levels across body mass index (BMI) categories, with obese women reporting the highest levels of stress (p = 0.07). Perceived stress was the only significant predictor of the degree of flattening of the diurnal cortisol curve in the sample as a whole (beta = -0.042, R(2) = 0.11, F = 8.6, p = 0.005), indicating reduction in the normal diurnal pattern. Among overweight women (BMI = 25-29.9 kg/m(2)), stress and waist circumference combined predicted 35% of the variability in diurnal cortisol. In contrast, among obese women (BMI > or = 30 kg/m(2)), BMI predicted 31% of the variability in diurnal cortisol (F = 13.8, p = 0.001), but stress was no longer significantly related to diurnal cortisol.

CONCLUSIONS

Psychological stress predicts a significant portion of HPA axis functioning. In overweight women, perceived stress and waist circumference were of approximately equal importance in predicting adrenal cortisol secretion. However, among obese women, a major portion of the diurnal cortisol variation was predicted by BMI alone, not stress or waist circumference. This may help elucidate the mechanisms linking obesity to increased risk of cardiovascular disease (CVD).

Authors+Show Affiliations

University of Oklahoma Prevention Research Center, Oklahoma City, Oklahoma, USA. noha-farag@ouhsc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19049359

Citation

Farag, Noha H., et al. "Hypothalamic-pituitary-adrenal Axis Function: Relative Contributions of Perceived Stress and Obesity in Women." Journal of Women's Health (2002), vol. 17, no. 10, 2008, pp. 1647-55.
Farag NH, Moore WE, Lovallo WR, et al. Hypothalamic-pituitary-adrenal axis function: relative contributions of perceived stress and obesity in women. J Womens Health (Larchmt). 2008;17(10):1647-55.
Farag, N. H., Moore, W. E., Lovallo, W. R., Mills, P. J., Khandrika, S., & Eichner, J. E. (2008). Hypothalamic-pituitary-adrenal axis function: relative contributions of perceived stress and obesity in women. Journal of Women's Health (2002), 17(10), pp. 1647-55. doi:10.1089/jwh.2008.0866.
Farag NH, et al. Hypothalamic-pituitary-adrenal Axis Function: Relative Contributions of Perceived Stress and Obesity in Women. J Womens Health (Larchmt). 2008;17(10):1647-55. PubMed PMID: 19049359.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hypothalamic-pituitary-adrenal axis function: relative contributions of perceived stress and obesity in women. AU - Farag,Noha H, AU - Moore,William E, AU - Lovallo,William R, AU - Mills,Paul J, AU - Khandrika,Srikrishna, AU - Eichner,June E, PY - 2008/12/4/pubmed PY - 2009/3/10/medline PY - 2008/12/4/entrez SP - 1647 EP - 55 JF - Journal of women's health (2002) JO - J Womens Health (Larchmt) VL - 17 IS - 10 N2 - OBJECTIVE: A range of behavioral and psychosocial factors may contribute to a chronically stimulated hypothalamic-pituitary-adrenal (HPA) axis and subsequently altered diurnal patterns. The goal of this cross-sectional study was to examine associations among diurnal cortisol levels, perceived stress, and obesity patterns. METHODS: Seventy-eight women (aged 24-72 years) employed in a rural public school system completed the perceived stress scale, collected diurnal saliva samples, and underwent anthropometric assessments. Reduced peak-to-nadir cortisol values across the day were considered a sign of impairment in HPA function. A series of linear regression models determined the best predictors of diurnal cortisol variation. RESULTS: There was a marginal linear trend in stress levels across body mass index (BMI) categories, with obese women reporting the highest levels of stress (p = 0.07). Perceived stress was the only significant predictor of the degree of flattening of the diurnal cortisol curve in the sample as a whole (beta = -0.042, R(2) = 0.11, F = 8.6, p = 0.005), indicating reduction in the normal diurnal pattern. Among overweight women (BMI = 25-29.9 kg/m(2)), stress and waist circumference combined predicted 35% of the variability in diurnal cortisol. In contrast, among obese women (BMI > or = 30 kg/m(2)), BMI predicted 31% of the variability in diurnal cortisol (F = 13.8, p = 0.001), but stress was no longer significantly related to diurnal cortisol. CONCLUSIONS: Psychological stress predicts a significant portion of HPA axis functioning. In overweight women, perceived stress and waist circumference were of approximately equal importance in predicting adrenal cortisol secretion. However, among obese women, a major portion of the diurnal cortisol variation was predicted by BMI alone, not stress or waist circumference. This may help elucidate the mechanisms linking obesity to increased risk of cardiovascular disease (CVD). SN - 1931-843X UR - https://www.unboundmedicine.com/medline/citation/19049359/Hypothalamic_pituitary_adrenal_axis_function:_relative_contributions_of_perceived_stress_and_obesity_in_women_ L2 - https://www.liebertpub.com/doi/full/10.1089/jwh.2008.0866?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -