Perceived Stress, Hair Cortisol, and Hair Cortisone in Relation to Appetite-Regulating Hormones in Patients with Obesity

Introduction: Stress predicts unhealthy eating, obesity, and metabolic deterioration, likely mediated by altered levels of appetite-regulating hormones. Yet, evidence regarding the association between long-term stress and levels of appetite-regulating hormones in humans is lacking.

Methods: We included 65 patients with obesity (44 women) to investigate the cross-sectional association of long-term biological stress (scalp hair cortisol and cortisone) and long-term psychological stress (Perceived Stress Scale) with overnight-fasted serum levels of the hormonal appetite regulators leptin, adiponectin, insulin, pancreatic polypeptide, gastric-inhibitory peptide, peptide tyrosine-tyrosine, cholecystokinin and agouti-related protein, adjusted for age, sex, and body mass index.

Results: Hair cortisone and, in trend, hair cortisol were positively associated with cholecystokinin (p = 0.003 and p = 0.058, respectively). No other associations between stress measures and hormonal appetite regulators were observed.

Conclusion: Long-term biological stress, measured using scalp hair glucocorticoid levels, is associated with elevated levels of circulating cholecystokinin. More research is needed to pinpoint potential effects on appetite.