Hair cortisol levels are associated with overweight and obesity in the ELSA-Brasil cohort

Front Endocrinol (Lausanne). 2024 Apr 9:15:1361715. doi: 10.3389/fendo.2024.1361715. eCollection 2024.

Abstract

Introduction: Hair cortisol level has recently been identified as a promising marker for detecting long-term cortisol levels and a marker of hypothalamic-pituitary-adrenal cortex (HPA) axis activity. However, research on the association between obesity and an altered cortisol metabolism remains controversial.

Objective: This study aimed to investigate the relationship between hair cortisol levels and overweight and obesity in participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Methods: This was a cross-sectional study involving 2,499 participants from the second follow-up (visit 3, 2017-2019) attending research centers in Rio de Janeiro and Rio Grande do Sul states. Hair samples were collected, and cortisol levels were analyzed using enzyme-linked immunosorbent assay (ELISA) kits. Cortisol levels were classified as low (< 40 pg/mg), medium (40-128 pg/mg), or high (> 128 pg/mg). The participants were classified as eutrophic, overweight, or obese according to their weight (kg) and height (m2). Odds ratios (ORs) with 95% confidence intervals (95%CI) were estimated.

Results: Of the 2499 individuals, 30% had eutrophic weight, 40% were overweight, and 30% were obese. Notably, cortisol levels gradually increased with increasing body weight. Among participants with high hair cortisol levels, 41.2% were classified as overweight and 34.2% as obese. Multinomial logistic regression analysis indicated that participants with high cortisol levels were 43% (OR =1.43; 95%CI: 1.02-2.03) more likely to be overweight and 72% (OR =1.72; 95%CI:1.20-2.47) more likely to be obese than participants with low hair cortisol levels. After adjustment for all covariates, high cortisol levels remained associated with obesity (OR = 1.54; 95%CI:1.02-2.31) and overweight (OR =1.33; 95%CI:0.91-1.94).

Conclusion: In the ELSA-Brazil cohort, hair stress were positively associated with overweight and obesity. These results underscore the importance of considering stress and cortisol as potential factors in obesity prevention and intervention efforts, and highlight a novel aspect of the complex relationship between stress and obesity in the Brazilian population.

Keywords: ELSA-Brasil; chronic stress; hair cortisol levels; obesity; overweight.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / analysis
  • Biomarkers / metabolism
  • Brazil / epidemiology
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Hair* / chemistry
  • Hair* / metabolism
  • Humans
  • Hydrocortisone* / analysis
  • Hydrocortisone* / metabolism
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Obesity* / epidemiology
  • Obesity* / metabolism
  • Overweight* / epidemiology
  • Overweight* / metabolism

Substances

  • Hydrocortisone
  • Biomarkers

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Council for Scientific and Technological Development (CNPq), grant numbers: 01 06 0010.00 RS and 01 06 0071.00 RJ. RHG, MIS and MJMF are CNPq research fellows. RHG is a research fellow of Fundação de Amparo e Pesquisa do Rio de Janeiro (FAPERJ). This research was also funded by the CNPq (grant number 455,384/2014-2), PAPES/Fiocruz (grant number 401,803/2015-5), and FAPERJ (E-26/205,945/2022).