Advances in the assessment of cortisol exposure and sensitivity.

Abstract

To review recent progress in the field of cortisol exposure and sensitivity, and its implications for research concerning obesity and related metabolic disturbances. In the past few years, scalp hair analysis had been successfully introduced as a marker for long-term cortisol exposure. With this relatively novel method, increased long-term cortisol levels have been linked to cardiovascular disease, metabolic syndrome, and stress-related measures. At the tissue level, the effect of cortisol is modulated by genetically determined glucocorticoid sensitivity. Polymorphisms in the glucocorticoid receptor gene that influence glucocorticoid sensitivity have been associated with differences in metabolic syndrome components. Hair analysis provides exciting new opportunities to study the influence of long-term cortisol exposure on a wide range of health outcomes, in both observational and interventional studies. We propose that addition of genetically determined glucocorticoid sensitivity to these studies may bring about a more thorough understanding of the long-term effects of cortisol.