Cortisol Metabolism in Obesity

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Abstract
Cortisol metabolism in obesity was studied in 11 grossly obese patients (96–150 kg) and in 8 control patients. Plasma time course disappearance studies of cortisol-1, 2-3H were done in the basal and ACTHstimulated states. A highly specific plasma cortisol determination was used. The results were also compared to the findings in a patient with adrenal hyperplasia. Adrenal hyperactivity in the obese patients and in the patient with adrenal hyperplasia was indicated by increased urinary 17-OHCS excretion, increased cortisol production rates and excessive increase in these values with ACTH. Some obese patients had normal cortisol pools and low plasma cortisol concentrations, others had large pools and high cortisol concentrations, but in nearly all the “relative distribution space” was increased. In most of the obese subjects either the disappearance half-times were rapid or the amount of cortisol disappearing per hour was increased. ACTH stimulation in these patients resulted in an increase in urinary 17-OHCS which was disproportionate to the increase in cortisol production rate. Persistent abnormalities were found in one obese patient after a weight reduction of 80 kg.