![]() ![]() Regardless of the discrepancies between the aforementioned studies, the most used biomarkers to assess the association between weight status and cortisol level were blood serum, saliva and 24 h urine cortisol measurements. However, contradictory findings have also been published reporting a blunted cortisol secretion in individuals with a higher BMI. Evidence showing higher cortisol levels in obese and overweight subjects when compared with normal weight participants has been established. The latter occurs due to GCs’ impact both on the maturation of adipose stromal cells and in storage of lipids. Glucocorticoids (GCs) act on the adipose tissue in a dose -and time-dependent fashion, as the acute release of GCs plays a lipolytic role regarding mature adipocytes, although chronic exposure leads to hyperplasia and hypertrophy of adipocytes. ![]() ![]() More importantly, when adiposity is increased there is a local increase in the active glucocorticoid, cortisol, concentration since adipocytes express higher levels of the 11-beta hydroxysteroid dehydrogenase 1 (HSD1) enzyme, that leads to the conversion of the inactive cortisol form to the active one, the cortisol. Chronic activation of the stress system and over-secretion of its hormones increases not only appetite, but visceral fat accumulation as well, due to the alteration in the secretion of other hormones such as insulin. Stress hormones affect the regulation of appetite and, depending on the extent of the stress exposure, this can be expressed by either a decrease or an increase in food consumption. ![]() The association between body weight and stress is well established, as reflected by the interplay of the hypothalamic-pituitary-adrenal (HPA) axis activation leading to glucocorticoids’ production, and adverse metabolic health has been found. Thus, the risk of developing cardiometabolic diseases, type 2 diabetes and a variety of cancer types in later life is increased in children and adolescents with an elevated Body Mass Index (BMI). Furthermore, taking into consideration that most overweight and obese minors may carry their weight status into adulthood, long term health consequences may occur. Additionally, the prevalence of physical comorbidities such as hypertension, dyslipidemia, self-reported asthma and especially non-alcoholic fatty liver disease (6.1 for overweight and 26.1 for obese children and adolescents) is higher in individuals with excess body weight than in normal weight ones. Obese children and adolescents are more likely to suffer from depression, anxiety, lower self-esteem and behavioral disorders compared to their normal weight peers. Excess weight is recognized as one of the most burdening health factors due to its association with psychological and physical comorbidities. According to the World Health Organization, in the last four decades its prevalence in children and adolescents aged 5 to 19 years has increased from 4% to 18%. Further research is needed to provide more solid results.Ĭhildhood obesity constitutes a major health issue worldwide. Different methodologies applied, and confounding factors could explain the inconsistency in the findings. On the contrary, the remaining four found no statistically significant differences in hair cortisol concentrations between obese and non-obese subjects. Five of them demonstrated significantly higher hair cortisol concentrations in obese children and adolescents than normal weight subjects. Among them, the results could be characterized as inconclusive. The initial search yielded 56 studies, while the last step of the screening procedure concluded in 9 observational studies. The work was conducted following the PRISMA guidelines, using prespecified search terms in the Pubmed database. Children and adolescents with genetic, somatic or psychiatric comorbidities were excluded. The aim of this systematic review was to investigate the difference in hair cortisol concentrations between obese and non-obese minors ≤ 19 years of age. Among the biological tissues used to evaluate cortisol concentrations, scalp hair can provide retrospective measures. A bidirectional link between body weight and the stress system appears to exist, as cortisol may affect the regulation of appetite, while adiposity can affect cortisol secretion. Childhood obesity has been linked to physical and psychological comorbidities that can be carried into adulthood. ![]()
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