Johanneke Oosterman1, Lisa Brinkman2, Carlijn Hoekx3, Robin Lengton4, Borja Martinez-Tellez4, Patrick Rensen4, Elisabeth van Rossum5, Mariëtte Boon6
(1) Obesity Center CGG, Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. (2) Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands. (3) Division of Endocrinology, Department of Medicine, Leiden University Medical Center; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands. (4) Obesity Center CGG, Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. (5) Obesity Center CGG, Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. (6) Obesity Center CGG, Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam; 2Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands; , Rotterdam, the Netherlands.
Background:
The rising incidence of cardiometabolic diseases disproportionately affects South Asians (SA) compared to Europids (EUR). The increased risk in SA is linked to their unfavorable metabolic phenotype, including central obesity, low muscle mass and insulin resistance. Of note, this phenotype shows similarities with hypercortisolism, which is evident from the extreme case of Cushing’s syndrome, and may suggest increased glucocorticoid activity in SA. Furthermore, perceived psychological stress may stimulate the glucocorticoid system, leading to excessive cortisol secretion.
Aim:
This study aimed to compare perceived stress and glucocorticoid dynamics between healthy lean SA and EUR participants.
Methods:
In this cross-sectional study, 49 young (age 18-30 years, male and female), lean (body mass index (BMI) 18 – 25 kg/m2) South Asian (n=24) and Europid (n=25) participants living in the Netherlands were included. Anthropometric measurements, perceived stress score (PSS-14; range 0-59), plasma morning cortisol, and hair cortisol and cortisone levels as a measure of long-term glucocorticoid exposure, were assessed.
Results:
BMI, fat mass and fat % were higher in SA men vs EUR men (all p<0.01), whereas lean mass did not differ. In women, BMI and fat mass were similar, while fat % was higher and lean mass was lower in SA vs EUR (both p<0.05). PSS-14 was higher in SA vs EUR (24.4 ± 7.6 vs 20.7 ± 5.0; p<0.05). Plasma cortisol levels were significantly lower in SA vs EUR (467 ± 139 vs 595 ± 167 nmol/L; p<0.01), particularly pronounced in SA vs EUR women (454 ± 158 vs 654 ± 207; p<0.05). Hair cortisol and cortisone were similar between SA and EUR (p=0.865 and p=0.565, respectively).
Conclusion:
In this study, perceived stress was higher, while plasma morning cortisol levels were lower in SA compared to EUR. Surprisingly, long-term glucocorticoids did not differ. This may fit with increased glucocorticoid receptor sensitivity, alterations in cortisol-binding globulin or a difference in cortisol rhythm in SA compared to EUR, which will be further studied.