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Interleukin-1 Antagonism Decreases Cortisol Levels in Obese Individuals

Urwyler, Sandrine Andrea ; Schuetz, Philipp ; Ebrahimi, Fahim ; Donath, Marc Y. ; Christ-Crain, Mirjam

In: The Journal of Clinical Endocrinology & Metabolism, 2017, vol. 102, no. 5, p. 1712-1718

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    Titel
    • Interleukin-1 Antagonism Decreases Cortisol Levels in Obese Individuals
    Autor
    • Urwyler, Sandrine Andrea. Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, CH-4031 Basel, Switzerland
    • Schuetz, Philipp. Department of Clinical Research, University Hospital Basel, CH-4031 Basel, Switzerland
    • Ebrahimi, Fahim. Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, CH-4031 Basel, Switzerland
    • Donath, Marc Y.. Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, CH-4031 Basel, Switzerland
    • Christ-Crain, Mirjam. Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, CH-4031 Basel, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • The Journal of Clinical Endocrinology & Metabolism, 2017, vol. 102, no. 5, p. 1712-1718. Endocrine Society
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:331237
    Summary
    Abstract Context: Increased cortisol levels in obesity may contribute to the associated metabolic syndrome. In obesity, the activated innate immune system leads to increased interleukin (IL)-1β, which is known to stimulate the release of adrenocorticotropin hormone (ACTH). Objectives: We hypothesized that in obesity IL-1 antagonism would result in downregulation of the hypothalamo-pituitary-adrenal axis, leading to decreased cortisol levels. Design and Participants: In this prospective intervention study, we included 73 patients with obesity (body mass index [BMI] ≥30 kg/m2) and at least one additional feature of the metabolic syndrome. Outcome Measures: The primary end point was change in morning cortisol from baseline to after the administration of the IL-1 receptor antagonist (anakinra/Kineret®, total dose 3 × 100 mg). Secondary end points were effects on salivary cortisol and ACTH. Results: Median age was 56 years, 50.7% of patients were female, and median BMI was 36.3 kg/m2. Median morning serum cortisol levels (nmol/L) decreased significantly after IL-1 antagonism [from baseline, 452 to 423; absolute difference, −38.7; 95% confidence interval (CI), −64 to −13.4; P = 0.0019]. Similar effects were found for salivary cortisol levels (−2.8; 95% CI, −4.4 to −1.3; P = 0.0007), ACTH levels (−2.2; 95% CI; −4.2 to −0.1; P = 0.038), systolic blood pressure (−5.2, 95% CI, −8.5 to −1.8; P = 0.0006), and heart rate (−2.9; 95% CI, −4.7 to −1.0; P = 0.0029). Conclusion: IL-1 antagonism in obese individuals with features of the metabolic syndrome leads to a decrease in serum cortisol, salivary cortisol, and ACTH levels along with a reduction in systolic blood pressure and heart rate.