eprintid: 6552 rev_number: 52 eprint_status: archive userid: 598 dir: disk0/00/00/65/52 datestamp: 2008-05-13 11:08:59 lastmod: 2015-07-23 09:34:03 status_changed: 2008-05-13 11:08:59 type: article metadata_visibility: show creators_name: Brunner, E.J. creators_name: Hemingway, H. creators_name: Walker, B.R. creators_name: Page, M. creators_name: Clarke, P. creators_name: Juneja, M. creators_name: Shipley, M.J. creators_name: Kumari, M. creators_name: Andrew, R. creators_name: Seckl, J.R. creators_name: Papadopoulos, A. creators_name: Checkley, S. creators_name: Rumley, A. creators_name: Lowe, G.D.O. creators_name: Stansfeld, S.A. creators_name: Marmot, M.G. creators_id: EJBRU90 creators_id: HHEMI65 creators_id: creators_id: creators_id: creators_id: creators_id: MJSHI88 creators_id: MKUMA95 creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: MGMAR64 title: Adrenocortical, autonomic, and inflammatory causes of the Metabolic Syndrome: nested case-control study ispublished: pub subjects: 3000 divisions: G19 keywords: Norepinephrine, coronary disease, stress, metabolism, heart rate abstract: Background: The causes of metabolic syndrome (MS), which may be a precursor of coronary disease, are uncertain. We hypothesize that disturbances in neuroendocrine and cardiac autonomic activity (CAA) contribute to development of MS. We examine reversibility and the power of psychosocial and behavioral factors to explain the neuroendocrine adaptations that accompany MS. Methods and Results: This was a double-blind case-control study of working men aged 45 to 63 years drawn from the Whitehall II cohort. MS cases (n=30) were compared with healthy controls (n=153). Cortisol secretion, sensitivity, and 24-hour cortisol metabolite and catecholamine output were measured over 2 days. CAA was obtained from power spectral analysis of heart rate variability (HRV) recordings. Twenty-four-hour cortisol metabolite and normetanephrine (3-methoxynorepinephrine) outputs were higher among cases than controls (+ 0.49, +0.45 SD, respectively). HRV and total power were lower among cases (both -0.72 SD). Serum interleukin-6, plasma C-reactive protein, and viscosity were higher among cases (+0.89, +0.51, and +0.72 SD). Lower HRV was associated with higher normetanephrine output (r=-0.19; P=0.03). Among former cases (MS 5 years previously, n=23), cortisol output, heart rate, and interleukin-6 were at the level of controls. Psychosocial factors accounted for 37% of the link between MS and normetanephrine output, and 7% to 19% for CAA. Health-related behaviors accounted for 5% to 18% of neuroendocrine differences. Conclusions: Neuroendocrine stress axes are activated in MS. There is relative cardiac sympathetic predominance. The neuroendocrine changes may be reversible. This case-control study provides the first evidence that chronic stress may be a cause of MS. Confirmatory prospective studies are required. date: 2002-11-19 date_type: published official_url: http://dx.doi.org/10.1161/01.CIR.0000038364.26310.BD vfaculties: VFPHS rae2008: 6 oa_status: green language: eng primo: open primo_central: open_green doi: 10.1161/01.CIR.0000038364.26310.BD lyricists_name: Brunner, E lyricists_name: Hemingway, H lyricists_id: EJBRU90 lyricists_id: HHEMI65 full_text_status: public publication: Circulation volume: 106 number: 21 pagerange: 2659-2665 refereed: TRUE issn: 0009-7322 citation: Brunner, E.J.; Hemingway, H.; Walker, B.R.; Page, M.; Clarke, P.; Juneja, M.; Shipley, M.J.; ... Marmot, M.G.; + view all <#> Brunner, E.J.; Hemingway, H.; Walker, B.R.; Page, M.; Clarke, P.; Juneja, M.; Shipley, M.J.; Kumari, M.; Andrew, R.; Seckl, J.R.; Papadopoulos, A.; Checkley, S.; Rumley, A.; Lowe, G.D.O.; Stansfeld, S.A.; Marmot, M.G.; - view fewer <#> (2002) Adrenocortical, autonomic, and inflammatory causes of the Metabolic Syndrome: nested case-control study. Circulation , 106 (21) pp. 2659-2665. 10.1161/01.CIR.0000038364.26310.BD <https://doi.org/10.1161/01.CIR.0000038364.26310.BD>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/6552/1/6522.pdf