• Femke Rutters, Arie G Nieuwenhuizen, Sofie G T Lemmens, Jurriaan M Born, and Margriet S Westerterp-Plantenga.
• Department of Human Biology, Maastricht University, Maastricht, The Netherlands. F.Rutters@hb.unimaas.nl
• Clin. Endocrinol. (Oxf). 2010 Jun 1; 72 (6): 738-43.

ObjectiveTo relate hypothalamic-pituitary-adrenal (HPA) axis functioning and HPA feedback functioning to body fat distribution in normal weight to obese subjects.Patients91 men and 103 women [age 18-45 years, BMI 19-35 kg/m(2), waist-to-hip ratio (WHR) 0.6-1.1].MeasurementsAnthropometry, body composition using hydrodensitometry and deuterium dilution method, cortisol variability by measuring 5-h cortisol concentrations, HPA axis feedback functioning using a dexamethasone suppression test, and HPA axis functioning under a challenged condition consisting of a standardized high-intensity test with ingestion of 4 mg dexamethasone.ResultsIn men, an inverse relationship was observed between 5-h cortisol exposure (nmol/ml) and fat mass index (FMI) (kg/m(2)) (r = -0.55, P < 0.001). In women, relationships were observed between 5-h cortisol exposure (nmol/ml.min) and WHR (r = -0.49, P < 0.001), maximal workload (r = 0.32, P < 0.001) as well as oral contraceptive use (r = 0.38, P < 0.001). Similarly, in men, an inverse relationship was observed between negative feedback expressed as baseline concentrations minus post dexamethasone cortisol concentrations (nmol/ml) and FMI (r = -0.53, P < 0.001). In women, relationships were observed between negative feedback expressed as baseline concentrations minus post dexamethasone cortisol concentrations (nmol/ml) and WHR (r = -0.43, P < 0.001), maximal workload (r = 0.30, P < 0.001) as well as oral contraceptive use (r = 0.43, P < 0.001) in women. Moreover, an inverse relationship was observed between HPA axis functioning in a challenged condition expressed as percentage increase of cortisol concentrations after standardized high-intensity test with ingestion of 4 mg dexamethasone (%) and waist circumference (r = -0.21, P < 0.10) in men and WHR (r = -0.21, P < 0.05) in women. In men, strong positive relationships were observed between FMI and waist circumference (r = 0.85, P < 0.001), as well as waist-to-hip ratio (r = 0.70, P < 0.001).ConclusionDisturbance of HPA axis functioning under basal and challenged conditions is related to visceral fat accumulation.

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