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Relative hypocortis...
Relative hypocortisolism is associated with obesity and the metabolic syndrome in recurrent affective disorders
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- Maripuu, Martin (author)
- Umeå universitet,Psykiatri
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- Wikgren, Mikael (author)
- Umeå universitet,Psykiatri
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- Karling, Pontus (author)
- Umeå universitet,Medicin
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- Adolfsson, Rolf (author)
- Umeå universitet,Psykiatri
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- Norrback, Karl-Fredrik (author)
- Umeå universitet,Psykiatri
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(creator_code:org_t)
- Elsevier BV, 2016
- 2016
- English.
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In: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 204, s. 187-196
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Background: Cardiovascular disease (CVD) is one of the main causes of excess deaths in affective disorders. Affective disorders are associated with increased frequencies of CVD risk-factors such as obesity, dyslipidemia, and metabolic syndrome. Stress-induced chronic cortisol excess has been suggested to promote obesity and metabolic syndrome. Chronic stress with frequent or persisting hypothalamic-pituitary-adrenal-axis (HPA-axis) hyperactivity may, over time, lead to a state of low HPA-axis activity, also denoted hypocortisolism. A low-dose weight-adjusted dexamethasone-suppression-test (DST) is considered to be a sensitive measure of hypocortisolism.Methods: 245 patients with recurrent depression or bipolar disorder and 258 controls participated in a low-dose DST and were also examined with regard to metabolic status.Results: Patients with hypocortisolism (low post-DST cortisol) compared with patients without hypocortisolism (normal or high post-DST cortisol) exhibited increased odds ratios (OR) for obesity (OR=4.0), overweight (OR=4.0), large waist (OR=2.7), high LDL (OR=4.2), low HDL (OR=2.4), high LDL/HDL ratio (OR=3.3), high TC/HDL ratio (OR=3.4) and metabolic syndrome (OR=2.0). A similar pattern but less pronounced was also found in the control sample.Limitations: The cross sectional study design and absence of analyses addressing lifestyle factors.Conclusions: Our findings suggest that a substantial portion of the metabolic disorders and cardiovascular risk factors seen in recurrent affective disorders are found among individuals exhibiting hypocortisolism. This might indicate that long-term stress is a central contributor to metabolic abnormalities and CVD mortality in recurrent affective disorders.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
Keyword
- Affective disorder
- Cortisol
- Dyslipidemia
- Hypocortisolism
- Metabolic syndrome
- Obesity
Publication and Content Type
- ref (subject category)
- art (subject category)
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