Diurnal Cortisol Profile as a Predictor of Weight Change over 6 years: The Multiethnic Study of Atherosclerosis (MESA) Stress Study Joshua J. Joseph, MD Endocrinology Fellow Division of Endocrinology, Diabetes and Metabolism Johns Hopkins University School of Medicine
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Diurnal Cortisol Profile as a Predictor of Weight Change over 6 … · Cortisol Diurnal Cortisol Variability Subclinical Hypercortisolism and Obesity OBESITY Sleep Apnea Sleep Deprivation
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Diurnal Cortisol Profile as a Predictor of
Weight Change over 6 years: The Multiethnic
Study of Atherosclerosis (MESA) Stress
Study
Joshua J. Joseph, MD
Endocrinology Fellow
Division of Endocrinology, Diabetes and Metabolism
Johns Hopkins University School of Medicine
Background
Hypothalamic-pituitary-adrenal (HPA) axis
- controls the response to stress
- participates in the regulation of many
processes that affect energy storage and
expenditure
Background
The effector
molecule of the HPA
axis is cortisol
production from the
adrenal gland
STRESS
STRESS
Cortisol
Diurnal Cortisol Variability
Subclinical Hypercortisolism and Obesity
OBESITY
Sleep Apnea Sleep Deprivation
Physical Abuse
Sexual Abuse History of Trauma
STRESS Work Stress, Low SES,
Anxiety, Depression, PTSD
50-70 Million
Americans
57 Million
Americans
OBESITY
Hypothalamic –
Pituitary –
Adrenal Axis
&
Obesity
Adapted from Miller et al, Biological Psychiatry, 2006.
(-)
(-
)
Challenges to neuroendocrine assessment
in population studies
• Epidemiological studies limited by imprecise measures of glucocorticoid exposure