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Altered adrenocorticotropin and cortisol secretion in abdominal obesity: implications for the insulin resistance syndrome.

Abstract：

OBJECTIVES:To investigate the relationship between the pituitary-adrenocortical function, abdominal obesity, and insulin resistance syndrome. DESIGN:A prospective study. SETTING:Helsinki University Hospital, Finland. SUBJECTS:Sixty-six healthy males aged 30-55 years. MAIN OUTCOME MEASURES:Insulin, C-peptide, cortisol and ACTH responses during the oral glucose tolerance test (OGTT), and the cortisol response to dexamethasone suppression and intravenous adrenocorticotrophic hormone (ACTH) stimulation. RESULTS:The subjects in the highest tertile of the waist-to-hip ratio (WHR) had lower high-density lipoprotein cholesterol (HDLC) (P < 0.05), but higher triglyceride (TG), insulin, and C-peptide levels, ACTH response to glucose at 2 h, and cortisol response to ACTH (P < 0.01) than those in the lowest tertile. The cortisol response to ACTH correlated positively, but cortisol levels during the OGTT correlated negatively with WHR. The ratio of these cortisol determinations correlated positively with the body-mass index (BMI) (r = 0.554; P < 0.001), WHR (r = 0.536; P < 0.001), TG (r = 0.397; P = 0.001), fasting insulin (r = 0.534; P < 0.001) and C-peptide (r = 0.458; P < 0.001), and negatively with HDLC (r = 0.353; P = 0.004). In multiple regression analyses, BMI and the 2-h ACTH response to glucose were significant predictors of WHR and, in addition, the cortisol ratio, WHR, and BMI of insulin. CONCLUSIONS:Abdominal obesity may be associated with subtle central adrenal insufficiency, which might also affect insulin and lipoprotein metabolism.

journal_name

J Intern Med

journal_title

Journal of internal medicine

authors

Hautanen A,Adlercreutz H

doi

10.1111/j.1365-2796.1993.tb00779.x

subject

Has Abstract

pub_date

1993-11-01 00:00:00

pages

461-9

issue

5

eissn

0954-6820

issn

1365-2796

journal_volume

234

pub_type

杂志文章

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