Awakening cortisol response in lean, obese, and reduced obese individuals: effect of gender and fat distribution

Objective: Our goal was to assess the awakening cortisol response (ACR) in obese and reduced obese men and women. Research Methods and Procedures: Fifty‐one men (16 lean, 19 abdominally obese, and 16 reduced obese) and 31 women (12 lean, 10 subcutaneously obese, and 9 reduced obese) were selected to participate to this study. Strict ranges of BMI and waist circumference were used to select the participants. Medical examination, psychological assessment, anthropometric measurements, and blood sampling were undergone at the laboratory. Cortisol response to awakening was determined with saliva cortisol sampling being taken immediately at the time of awakening and 30 minutes thereafter over 3 days within a period of 2 months. Results: Men with visceral obesity exhibited an enhanced ACR, whereas this response tends to return to normal in a reduced obese state. In women, peripheral fat accumulation does not modify ACR, but weight loss increased the response. Discussion: These results highlight gender effects on ACR of obese and reduced obese subjects, which could be accounted for by the different fat distribution profiles that characterize men and women. They also provide further support for the usefulness of ACR in assessing the hypothalamic‐pituitary‐adrenal axis activity status.