This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints, Permissions and Rights Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yanovski, J. A. Articles by Chrousos, G. P. Search for Related Content PubMed PubMed Citation Articles by Yanovski, J. A. Articles by Chrousos, G. P.

Differences in Corticotropin-Releasing Hormone-Stimulated Adrenocorticotropin and Cortisol before and after Weight Loss

Developmental Endocrinology Branch, National Institute of Child Health and Human Development (J.A.K., G.P.C.); Office of the Director, The Warren Grant Magnuson Clinical Center (J.A.Y.); the Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (S.Z.Y.); and the Clinical Neuroendocrinology Branch, National Institute of Mental Health (P.W.G.), National Institutes of Health, Bethesda, Maryland 20892

Address all correspondence and requests for reprints to: Jack A. Yanovski, M.D., Ph.D., National Institutes of Health, Building 10, Room 10N262–1862, 9000 Rockville Pike, Bethesda, Maryland 20892-1862. E-mail: YANOVSKJ{at}CC1.NICHD.NIH.GOV

Little is known about the effects of intentional weight loss on the function of the hypothalamic-pituitary-adrenal (HPA) axis of obese individuals. We studied the HPA axis of 34 healthy obese women (body mass index, 40.2 ± 7.9 kg/m²) before and after a 21.0 ± 7.9-kg weight loss induced by a 26-week weight loss program that included 12 weeks of a 3350 kJ/day (800 Cal/day) liquid formula diet, 6 weeks of gradual refeeding, and 6 weeks of caloric stabilization at 5020–6280 kJ/day (1200–1500 Cal/day). Obese subjects were evaluated twice: before caloric restriction and during the last 3 weeks of caloric stabilization with a 3-h evening 1 µg/kg ovine CRH (oCRH) stimulation test. CRH-stimulated ACTH and cortisol values were compared to those of a control group of 12 normal weight women. Before caloric restriction, both ACTH and cortisol responses to oCRH were similar in obese women and normal weight controls. Weight loss did not significantly alter the ACTH response to oCRH; however, the total plasma cortisol response to oCRH decreased significantly with weight loss (area under the curve, 96,320 ± 21,040 nmol/L·min before weight loss; 82,450 ± 22,460 nmol/L·min after weight loss; P < 0.001). Cortisol-binding globulin also decreased significantly after weight loss (2,270 ± 1,050 nmol/L) compared either to values obtained before weight loss (3,590 ± 1,360 nmol/L; P < 0.001) or to those of normal weight controls (3,910 ± 1,400 nmol/L; P < 0.001). Assay for plasma free cortisol, either before or 180 min after oCRH treatment, showed no significant changes in cortisol responses resulting from weight loss. As plasma free cortisol was not altered by weight reduction, the decrease in the total cortisol response to oCRH after weight loss appears to be secondary to significant decreases in cortisol-binding globulin. We conclude that when obese women lose large amounts of weight with a 3350 kJ/day, very low energy diet, such weight reduction does not significantly affect the HPA axis.

This article has been cited by other articles:

				A. N. Vgontzas, S. Pejovic, E. Zoumakis, H.-M. Lin, C. M. Bentley, E. O. Bixler, A. Sarrigiannidis, M. Basta, and G. P. Chrousos Hypothalamic-Pituitary-Adrenal Axis Activity in Obese Men with and without Sleep Apnea: Effects of Continuous Positive Airway Pressure Therapy J. Clin. Endocrinol. Metab., November 1, 2007; 92(11): 4199 - 4207. [Abstract] [Full Text] [PDF]

				M. Manco, J. M. Fernandez-Real, M. E. Valera-Mora, H. Dechaud, G. Nanni, V. Tondolo, M. Calvani, M. Castagneto, M. Pugeat, and G. Mingrone Massive Weight Loss Decreases Corticosteroid-Binding Globulin Levels and Increases Free Cortisol in Healthy Obese Patients: An adaptive phenomenon? Diabetes Care, June 1, 2007; 30(6): 1494 - 1500. [Abstract] [Full Text] [PDF]

				J. W. Tomlinson, J. S. Moore, P. M. S. Clark, G. Holder, L. Shakespeare, and P. M. Stewart Weight Loss Increases 11{beta}-Hydroxysteroid Dehydrogenase Type 1 Expression in Human Adipose Tissue J. Clin. Endocrinol. Metab., June 1, 2004; 89(6): 2711 - 2716. [Abstract] [Full Text] [PDF]

				D. S. Jessop, M. F. Dallman, D. Fleming, and S. L. Lightman Resistance to Glucocorticoid Feedback in Obesity J. Clin. Endocrinol. Metab., September 1, 2001; 86(9): 4109 - 4114. [Abstract] [Full Text] [PDF]

				J. A. Yanovski, K. D. Miller, T. Kino, T. C. Friedman, G. P. Chrousos, C. Tsigos, and J. Falloon Endocrine and Metabolic Evaluation of Human Immunodeficiency Virus-Infected Patients with Evidence of Protease Inhibitor-Associated Lipodystrophy J. Clin. Endocrinol. Metab., June 1, 1999; 84(6): 1925 - 1931. [Abstract] [Full Text]