Measurement of Cortisol and Testosterone in Hair of Obese and Non-Obese Human Subjects

Summary

Objective: Hair analysis has been demonstrated to accurately reflect exposure to drug abuse, environmental toxins and exogenous hormones. We tested the feasibility of measuring cortisol and testosterone in hair of healthy and obese subjects.

Measurements: A modified immunoassay (ELISA) originally developed for saliva was used. Hair, urine and blood samples were collected from young non-obese and obese patients. Perceived stress (PSS) was measured using a validated questionnaire.

Results: There was no difference in PSS between non-obese and obese subjects. Hair cortisol levels were significantly correlated with weight (r=0.27, p<0.05) and systolic blood pressure (r=0.28, p<0.05), while the correlation with BMI did not reach statistical significance (p=0.063). Hair cortisol levels did not correlate with age or urinary cortisol. There was a negative correlation between hair testosterone and age (r=−0.47, p<0.05) and BMI (r=−0.40, p<0.05). The correlation between hair testosterone and free androgen index (FAI) did not reach statistical significance (p=0.098). The ratio of hair cortisol over hair testosterone (C/T) was higher in the obese group than in the young non-obese group. The C/T ratio correlated positively with age (r=0.56, p<0.01), waist circumference (r=0.63, p<0.01) and BMI (r=0.62, p<0.01), while the correlation between C/T ratio and FAI did not reach statistical significance.

Conclusion: Hair cortisol levels increase, while hair testosterone levels decrease with obesity. The hair C/T ratio was significantly correlated with age, BMI and waist circumference better than hair cortisol or testosterone alone. As hair collection is non-invasive and is not influenced by moment-to-moment variations, the measurement of hormones in hair is a useful tool in research and possibly clinical practice.

Key words

cortisol - testosterone - ratio - hair - obesity

• References

• 1 Andrew R, Phillips DI, Walker BR. Obesity and gender influence cortisol secretion and metabolism in man. J Clin Endocrinol Metab 1998; 83: 1806-1809
• 2 Andrew R, Westerbacka J, Wahren J et al. The contribution of visceral adipose tissue to splanchnic cortisol production in healthy humans. Diabetes 2005; 54: 1364-1370
• 3 Bremner WJ, Vitiello MV, Prinz PN. Loss of circadian rhythmicity in blood testosterone levels with aging in normal men. J Clin Endocrinol Metab 1983; 56: 1278-1281
• 4 Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24: 385-396
• 5 Davenport MD, Tiefenbacher S, Lutz CK et al. Analysis of endogenous cortisol concentrations in the hair of rhesus macaques. Gen Comp Endocrinol 2006; 147: 255-261
• 6 Dettenborn L, Tietze A, Bruckner F et al. Higher cortisol content in hair among long-term unemployed individuals compared to controls. Psychoneuroendocrinol 2010; 35: 1404-1409
• 7 Dettenborn L, Tietze A, Kirschbaum C et al. The assessment of cortisol in human hair: Associations with sociodemographic variables and potential confounders. Stress 2012; 15: 578-588
• 8 Dunn JF, Nisula BC, Rodbard D. Transport of steroid hormones: binding of 21 endogenous steroids to both testosterone-binding globulin and corticosteroid-binding globulin in human plasma. J Clin Endocrinol Metab 1981; 53: 58-68
• 9 Empen K, Lorbeer R, Dorr M et al. Association of testosterone levels with endothelial function in men: Results from a population-based study. Arterioscler Thromb Vasc Biol 2012; 32: 481-486
• 10 Gow R, Koren G, Rieder M et al. Hair cortisol content in patients with adrenal insufficiency on hydrocortisone replacement therapy. Clin Endocrinol 2011; 74: 687-693
• 11 Haring R, Volzke H, Steveling A et al. Low serum testosterone levels are associated with increased risk of mortality in a population-based cohort of men aged 20–79. Eur Heart J 2010; 31: 1494-1501
• 12 Haring R, Teng Z, Xanthakis V et al. Association of sex steroids, gonadotrophins, and their trajectories with clinical cardiovascular disease and all-cause mortality in elderly men from the framingham heart study. Clin Endocrinol 2013; 78: 629-634
• 13 Harman SM, Metter EJ, Tobin JD et al. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. baltimore longitudinal study of aging. The J Clin Endocrinol Metab 2001; 86: 724-731
• 14 Lamberts SW, van den Beld AW, van der Lely AJ. The endocrinology of aging. Science 1997; 278: 419-424
• 15 Manenschijn L, Koper JW, Lamberts SW et al. Evaluation of a method to measure long term cortisol levels. Steroids 2011; 76: 1032-1036
• 16 Manenschijn L, Schaap L, van Schoor NM et al. High long-term cortisol levels, measured in scalp hair, are associated with a history of cardiovascular disease. J Clin Endocrinol Metab 2013; 98: 2078-2083
• 17 Manenschijn L, van Kruysbergen RG, de Jong FH et al. Shift work at young age is associated with elevated long-term cortisol levels and body mass index. J Clin Endocrinol Metab 2011; 96: E1862-E1865
• 18 Morley JE, Charlton E, Patrick P et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism 2000; 49: 1239-1242
• 19 Pereg D, Gow R, Mosseri M et al. Hair cortisol and the risk for acute myocardial infarction in adult men. Stress 2011; 14: 73-81
• 20 Plymate SR, Tenover JS, Bremner WJ. Circadian variation in testosterone, sex hormone-binding globulin, and calculated non-sex hormone-binding globulin bound testosterone in healthy young and elderly men. J Androl 1989; 10: 366-371
• 21 Purnell JQ, Brandon DD, Isabelle LM et al. Association of 24-hour cortisol production rates, cortisol-binding globulin, and plasma-free cortisol levels with body composition, leptin levels, and aging in adult men and women. J Clin Endocrinol Metab 2004; 89: 281-287
• 22 Raul JS, Cirimele V, Ludes B et al. Detection of physiological concentrations of cortisol and cortisone in human hair. Clin Biochem 2004; 37: 1105-1111
• 23 Russell E, Koren G, Rieder M et al. Hair cortisol as a biological marker of chronic stress: Current status, future directions and unanswered questions. Psychoneuroendocrinol 2012; 37: 589-601
• 24 Sauve B, Koren G, Walsh G et al. Measurement of cortisol in human hair as a biomarker of systemic exposure. Clin Invest Med 2007; 30: E183-E191
• 25 Smith GD, Ben-Shlomo Y, Beswick A et al. Cortisol, testosterone, and coronary heart disease: Prospective evidence from the caerphilly study. Circulation 2005; 112: 332-340
• 26 Soisson V, Brailly-Tabard S, Empana JP et al. Low plasma testosterone and elevated carotid intima-media thickness: Importance of low-grade inflammation in elderly men. Atherosclerosis 2012; 223: 244-249
• 27 Stalder T, Steudte S, Alexander N et al. Cortisol in hair, body mass index and stress-related measures. Biol Psychol 2012; 90: 218-223
• 28 Svartberg J, von Muhlen D, Sundsfjord J et al. Waist circumference and testosterone levels in community dwelling men. The Tromso study. Eur J Epidemiol 2004; 19: 657-663
• 29 Thomson S, Koren G, Van Steen V et al. Testosterone concentrations in hair of hypogonadal men with and without testosterone replacement therapy. Ther Drug Monit 2009; 31: 779-782
• 30 Thomson S, Koren G, Fraser LA et al. Hair analysis provides a historical record of cortisol levels in cushing’s syndrome. Exp Clin Endocrinol Diabetes 2009; 118: 133-138
• 31 Vila R, Granada ML, Guitierrez RM et al. Urinary free cortisol excretion pattern in morbid obese women. Endocr Res 2001; 27: 261-268
• 32 Villain M, Cirimele V, Kintz P. Hair analysis in toxicology. Clin Chem Lab Med 2004; 42: 1265-1272
• 33 Vogelzangs N, Beekman AT, Milaneschi Y et al. Urinary cortisol and six-year risk of all-cause and cardiovascular mortality. J Clin Endocrinol Metab 2010; 95: 4959-4964
• 34 Walker RF, Riad-Fahmy D, Read GF. Adrenal status assessed by direct radioimmunoassay of cortisol in whole saliva or parotid saliva. Clin Chem 1978; 24: 1460-1463
• 35 Yamada J, Stevens B. Hair cortisol as a potential biologic marker of chronic stress in hospitalized neonates. Neonatology 2007; 92: 42-49
• 36 Zelissen PM, Koppeschaar HP, Erkelens DW et al. Beta-endorphin and adrenocortical function in obesity. Clin Endocrinol 1991; 35: 369-372