A Nonlinear Relationship of Generalized and Central Obesity with Diurnal Cortisol Secretion in the Whitehall II Study
A Nonlinear Relationship of Generalized and Central Obesity with Diurnal Cortisol Secretion in the Whitehall II Study
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DOI：
10.1210/jc.2009-2105
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发表时间：
2010-09-01
影响因子：
5.8
通讯作者：
Kivimaki, Mika
中科院分区：
文献类型：
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作者：
Kumari, Meena;Chandola, Tarani;Kivimaki, Mika
目的：本研究的目的是评估体重指数(BMI)、腰围和唾液皮质醇分泌之间的关系。设计：这是一项关于英国白厅II研究第7阶段(2002-2004)的BMI、腰围和唾液皮质醇的横断面研究。背景：该职业队列最初招募于1985-1988年。参与者：参与者包括2915名男性和1041名女性，他们拥有关于身高、体重、腰围和皮质醇分泌的完整信息。结果测量：唾液样本是在清醒时采集的，清醒后0.5、2.5、8和12小时，睡前测定皮质醇。结果：在调整了年龄、性别、社会地位、觉醒时间和从收集样本开始的时间后，中心性和全身性肥胖的增加与觉醒皮质醇的减少相关(P=0.001)。唾液皮质醇的昼夜斜率与体重指数和腰围之间存在明显的U型关联(P<；二次项为0.0001)。例如，唾液皮质醇的最浅(最不利)斜率与BMI最高(31公斤/平方米)和最低(21公斤/平方米)水平相关，而最陡峭的斜率对于那些BMI为26公斤/平方米的人是明显的，与所研究的12个协变量无关。皮质醇唤醒反应没有明显的相关性(P>；0.05)。结论：在老年人中，衡量全身性肥胖和中心性肥胖与唾液皮质醇日斜率之间的关系不是线性的。这些非线性关联可能解释了之前描述的混合发现。(临床内分泌代谢酶95：4415-4423,2010)
Context: Evidence for an association of measures of generalized and central obesity with salivary cortisol secretion is equivocal.Objective: The objective of this study was to assess the relationship between body mass index (BMI), waist circumference, and salivary cortisol.Design: The design was a cross-sectional study of BMI, waist circumference, and salivary cortisol from phase 7 (2002-2004) of the Whitehall II study.Setting: The occupational cohort was originally recruited in 1985-1988.Participants: Participants included 2915 men and 1041 women aged 50-74 yr with complete information on height, weight and waist circumference, and cortisol secretion.Outcome Measures: Saliva samples were taken on waking, waking plus 0.5, 2.5, 8, and 12 h, and bedtime for the assessment of cortisol. The cortisol awakening response and slope in diurnal secretion were calculated.Results: After adjustment for age, sex, social position, waking time, and time since waking of sample collection, increasing central and generalized obesity was associated with lower waking cortisol (P = 0.001). U-shaped associations were apparent between diurnal slope in salivary cortisol and both BMI and waist circumference (P < 0.0001 for quadratic term). For example, the shallowest (most adverse) slopes in salivary cortisol were associated with highest (> 31 kg/m(2)) and lowest (< 21 kg/m2) levels of BMI, and the steepest slopes were apparent for those with BMI of 26 kg/m2, independently of the 12 covariates examined. No associations were apparent for the cortisol awakening response (P > 0.05).Conclusion: The associations of measures of generalized and central obesity with diurnal slope in salivary cortisol are not linear in older adults. These nonlinear associations may explain previously described mixed findings. (J Clin Endocrinol Metab 95: 4415-4423, 2010)