Abstract
BackgroundObesity is one of the major public health challenges worldwide. It involves numerous endocrine disorders as etiological factors or as complications. Previous studies strongly suggested the involvement of the hypothalamic-pituitary-adrenal (HPA) axis activity in obesity, however, to date, no consistent trend in obesity-associated alterations of the HPA axis has been identified. Aging has been demonstrated to aggravate obesity and to induce abnormalities of the HPA axis. Thus, the question arises whether obesity is correlated with peripheral indicators of HPA function in adult populations.ObjectivesWe aimed to meta-analyze literature data on peripheral cortisol levels as indicators of HPA activity in obesity during aging, in order to identify possible explanations for previous contradictory findings and to suggest new approaches for future clinical studies.Data Sources3,596 records were identified through searching of PubMed, Embase and Cochrane Library Database. Altogether 26 articles were suitable for analyses.Study Eligibility CriteriaEmpirical research papers were eligible provided that they reported data of healthy adult individuals, included body mass index (BMI) and measured at least one relevant peripheral cortisol parameter (i.e., either morning blood cortisol or 24-h urinary free cortisol).Statistical MethodsWe used random effect models in each of the meta-analyses calculating with the DerSimonian and Laird weighting methods. I-squared indicator and Q test were performed to assess heterogeneity. Meta-regression was applied to explore the effect of BMI and age on morning blood and urinary free cortisol levels. To assess publication bias Egger’s test was used.ResultsObesity did not show any correlation with the studied peripheral cortisol values. On the other hand, peripheral cortisol levels declined with aging within the obese, but not in the non-obese groups.ConclusionsOur analysis demonstrated that obesity or healthy aging does not lead to enhanced HPA axis activity, peripheral cortisol levels rather decline with aging.
Highlights
Obesity, one of the major public health challenges of the world involves a great variety of endocrine disorders as etiological factors or as complications [1]
Peripheral cortisol levels declined with aging within the obese, but not in the nonobese groups
Our analysis demonstrated that obesity or healthy aging does not lead to enhanced HPA axis activity, peripheral cortisol levels rather decline with aging
Summary
One of the major public health challenges of the world involves a great variety of endocrine disorders as etiological factors or as complications [1]. The potential involvement of glucocorticoids in obesity is supported by numerous factors (for review see [2, 3]) Among other actions, they induce gluconeogenesis leading to hyperglycemia and hyperinsulinemia promoting fat deposition in case of enhanced caloric intake, they promote the differentiation and proliferation of human adipocytes [8], and they play a role in the development of metabolic syndrome associated with visceral obesity [9]. Obesity is one of the major public health challenges worldwide It involves numerous endocrine disorders as etiological factors or as complications. The question arises whether obesity is correlated with peripheral indicators of HPA function in adult populations
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