Increased response of cortisol and ACTH to corticotrophin releasing hormone in centrally obese men, but not in post-menopausal women

There is evidence for enhanced hypothalamo - pituitary - adrenal axis (HPAA ) activity in centrally obese premenopausal women. This has led to the hypo thesis that increased cortisol production rates may be an aetiological fact or in the genesis of central obesity. However, the relationship of obesity and body fat distribution to HPAA activity in men and postmenopausal women has not been established. We carried out CRH tests in 13 men and 8 post-men opausal women. We measured 24 h urine cortisol metabolites prior to the CRH test in each subject, as an indication of cortisol production rate. There was a significant direct relationship between central obesity as measured b y the ratio of subscapular:triceps skinfold thickness (STR)-and the ACTH:co rtisol response to CRH in men, but not in postmenopausal women. There was n o relationship between obesity or body fat distribution and 24 h urine cort isol metabolites. This study provides evidence for hyperactivity of the HPA A in centrally obese men, but not in postmenopausal women.