Cortisol secretary pattern and glucocorticoid feedback sensitivity in women from a Mediterranean area: relationship with anthropometric characteristics, dietary intake and plasma fatty acid profile.

BACKGROUND: Chronic stress is associated with a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis consisting on disturbances on the cortisol response and lipid metabolism. OBJECTIVE: To evaluate the HPA axis activity in women from a Mediterranean area, comparing three different measurements: daily cortisol secretory variability, postprandial cortisol secretion and glucocorticoid feedback sensitivity. In addition, HPA axis disturbance is correlated with dietary habits and plasma fatty acid profiles. DESIGN: The participants were 41 women born during the first 6 months of 1960 and living in a Mediterranean area (Murcia, Spain). They were of normal weight, with a waist circumference of 80.5 +/- 9.3 cm. Their salivary cortisol levels, 7-day dietary record and plasma fatty acid profile were evaluated. Daily cortisol variability and postlunch cortisol secretion were recorded and a dexamethasone suppression test is performed in order to detect possible HPA disturbance. RESULTS: Both the methods used for HPA axis evaluation were positively correlated (r = 0.448, P = 0.004). Subjects with normal diurnal curves (high cortisol variability) showed significantly higher cortisol values in the morning and postprandial cortisol secretion than women with pathological curves (medium and low variability). Cortisol variability was inversely correlated with waist circumference (r = -0.312, P = 0.047), suggesting that a disturbed HPA axis response may lead to an android pattern of body fat distribution. Dietary fat and saturated fatty acid intake were lower in the high cortisol variability group, while monounsaturated fatty acid intake was higher (P < 0.05). No major differences were reported in plasma fatty acid profile. CONCLUSIONS: A disturbed HPA axis is associated with abdominal fat distribution and a higher content of fat and saturated fatty acids in the diet. Women who chose a dietary pattern closer to the Mediterranean diet, with high monounsaturated fatty acid intake, showed lower levels on HPA axis disturbance.

Body fat distribution in pre-and post-menopausal women: metabolic and anthropometric variables.

BACKGROUND: Abdominal obesity is associated with coronary risk although the causality is not well established. OBJECTIVE: To compare body fat distribution and metabolic variables in obese pre- and post- menopausal women. DESIGN: The study was conducted in 55 obese female subjects (22 pre- and 33 post- menopausal) with body mass indices (BMI) from 27 to 35 Kg/m2. Body fat distribution was measured using waist and hip circumference and computerized tomography. Hormones such as estradiol, testosterone, androstenedione, dehydroepiandrosterone-sulfate, as well as plasma lipids such as triglycerides, total cholesterol, high density lipoprotein, low density lipoprotein, apoproteins A and B, were also determined. RESULTS: No significant differences were found between the two groups in BMI, percentage of body fat, waist circumference, triceps, biceps, suprailiac and abdominal skinfolds. Hip circumference, subscapular skinfold and subcutaneous abdominal adipose tissue area were significantly lower, and waist-hip ratio, visceral area and visceral to subcutaneous area ratios significantly higher in post- menopausal women (P < 0.05). As was expected, basal plasma estrogens, and dehydroepiandrosterone-sulfate, were significantly higher in pre-menopausal women. When comparing plasma lipids, blood cholesterol and low density lipoprotein, values were significantly higher in the post-menopausal group (P < 0.05). CONCLUSIONS: Our data suggest that body fat distribution changes according to menopausal status, with central obesity more pronounced in post- menopausal women. Metabolic abnormalities are related more to visceral adipose tissue and estrogen plasma levels than to BMI.