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The cortisol burden in elderly subjects with metabolic syndrome and its association with low-grade inflammation

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Abstract

Background

Elderly people are exposed to an increased load of stressful events and neuro-hormonal stimulation is a key finding in metabolic syndrome and its related disorders.

Aims

To determine the role of cortisol in elderly subjects, with or without metabolic syndrome (MetS), by means of a national multicentre observational study, AGICO (AGIng and Cortisol).

Methods

From 2012 to 2017, the AGICO study enrolled n.339 subjects (aged > 65), after obtaining their informed consent. The investigators assessed a cardio-metabolic panel (including electrocardiogram, carotid ultrasonography and echocardiography), the presence of MetS (on Adult Treatment Panel III criteria), a neurological examination (including brain imaging), and cortisol activity (using a consecutive collection of diurnal and nocturnal urine).

Results

In the patients presenting with MetS, the standardized diurnal and nocturnal cortisol excretion rates were 210.7 ± 145.5 and 173.7 ± 118.1 (mean ± standard deviation) μg/g creatinine/12 h; in those without MetS, the standardized diurnal and nocturnal cortisol excretion rates were 188.7 ± 92.7 and 144.1 ± 82.3 μg/g creatinine/12 h, respectively (nocturnal urinary cortisol in patients with MetS versus those without MetS p = 0.05, female patients with MetS vs female patients without MetS, p < 0.025). A significant positive correlation was found between the CRP levels and both the diurnal and nocturnal urinary cortisol levels with r = 0.187 (p < 0.025) and r = 0.411 (p < 0.00000001), respectively.

Discussion

The elderly patients with MetS showed a trend towards increased standardized nocturnal cortisol excretions, with particular regard to the female subjects.

Conclusion

The positive correlation between cortisol excretion and low-grade inflammation suggests a common mechanism driving both hormonal and inflammatory changes.

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Author information

Authors and Affiliations

  1. S. Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189, Rome, Italy

    A. Martocchia, M. Stefanelli, A. Proietti, L. Toussan, F. Pastore, G. M. Falaschi & P. Falaschi

  2. Cognitive Impairment Centre, Local Health Authority n.2, Marca Trevigiana, Treviso, Italy

    M. Gallucci

  3. National Research Council, Neuroscience Institute, Padua, Italy

    M. Noale & S. Maggi

  4. S. Pietro Fatebenefratelli Hospital, Rome, Italy

    M. Cassol

  5. Italian National Research Centre on Aging IRCCS-INRCA, Fermo, Italy

    D. Postacchini

  6. Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy

    M. Barbagallo & L. J. Dominguez

  7. University of L’Aquila, L’Aquila, Italy

    C. Ferri & G. Desideri

  8. Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, Naples, Italy

    G. Paolisso

Authors
  1. A. Martocchia
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  2. M. Gallucci
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  3. M. Noale
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  4. S. Maggi
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  5. M. Cassol
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  6. M. Stefanelli
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  7. D. Postacchini
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  8. A. Proietti
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  9. M. Barbagallo
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  10. L. J. Dominguez
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  11. C. Ferri
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  12. G. Desideri
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  13. L. Toussan
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  14. F. Pastore
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  15. G. M. Falaschi
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  16. G. Paolisso
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  17. P. Falaschi
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Consortia

AGICO Investigators

  • Paolo Falaschi
  • , Antonio Martocchia
  • , Manuela Stefanelli
  • , Lavinia Toussan
  • , Francesca Pastore
  • , Stefano Eleuteri
  • , Giulia Maria Falaschi
  • , Antonella Proietti
  • , Rosaria D’Urso
  • , Letizia Petricca
  • , Patrizia Cardelli
  • , Maurizio Gallucci
  • , Maria Grazia Oddo
  • , Stefania Maggi
  • , Marianna Noale
  • , Demetrio Postacchini
  • , Cinzia Giuli
  • , Ilenia Macchiati
  • , Monica Migale
  • , Francesca Sorvillo
  • , Roberto Brunelli
  • , Monia Francavilla
  • , Silvia Santini
  • , Luciano Marini
  • , Elpidio Santillo
  • , Luca Fallavollita
  • , Maurizio Cassol
  • , Sara Rotunno
  • , Giuseppe Paolisso
  • , Michelangela Barbieri
  • , Edith Angellotti
  • , Claudio Ferri
  • , Valeria Ludovici
  • , Paola Cheli
  • , Rita Del Pinto
  • , Giovambattista Desideri
  • , Mario Barbagallo
  • , Ligia J. Dominguez
  • , Giovanna Di Bella
  •  & Valentino Culotta

Corresponding author

Correspondence to A. Martocchia.

Ethics declarations

Conflict of interest

On behalf of all the authors, the corresponding author states that there is no conflict of interest.

Research involving human participants and/or animals

All the procedures carried out by this study involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all the individual participants included in this study.

Additional information

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See Appendix for the AGICO Investigators.

Appendix

Appendix

AGICO Study Investigators

Paolo Falaschi, Antonio Martocchia, Manuela Stefanelli, Lavinia Toussan, Francesca Pastore, Stefano Eleuteri, Giulia Maria Falaschi (Geriatric Unit, S. Andrea Hospital, Sapienza University of Rome); Antonella Proietti, Rosaria D’Urso, Letizia Petricca, Patrizia Cardelli (Department of Clinical and Molecular Medicine, Laboratory Medicine Unit, S. Andrea Hospital, Sapienza University of Rome); Maurizio Gallucci, Maria Grazia Oddo (Cognitive Impairment Centre, Local Health Autority n.2 Marca Trevigiana, Treviso, Italy, Centro per i Disturbi Cognitivi e le Demenze, Azienda ULSS2 Marca Trevigiana); Stefania Maggi, Marianna Noale (National Research Council, Neuroscience Institute, Padova); Demetrio Postacchini, Cinzia Giuli, Ilenia Macchiati, Monica Migale, Francesca Sorvillo, Roberto Brunelli, Monia Francavilla, Silvia Santini (Geriatric Unit, Italian National Research Centre on Aging IRCCS-INRCA, Fermo, Italy); Luciano Marini, Elpidio Santillo, Luca Fallavollita (Geriatric-Rehabilitative Department, Italian National Research Centre on Aging IRCCS-INRCA, Fermo, Italy); Maurizio Cassol, Sara Rotunno (Internal Medicine Unit, S. Pietro Fatebenefratelli Hospital, Rome); Giuseppe Paolisso, Michelangela Barbieri, Edith Angellotti (Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, Naples); Claudio Ferri, Valeria Ludovici, Paola Cheli, Rita Del Pinto (Division of Internal Medicine & Nephrology, Cardiometabolic Prevention Unit and School of Internal Medicine, University of L’Aquila - San Salvatore Hospital); Giovambattista Desideri (University of L’Aquila); Mario Barbagallo, Ligia J. Dominguez, Giovanna Di Bella, Valentino Culotta (Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo).

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Martocchia, A., Gallucci, M., Noale, M. et al. The cortisol burden in elderly subjects with metabolic syndrome and its association with low-grade inflammation. Aging Clin Exp Res 32, 1309–1315 (2020). https://doi.org/10.1007/s40520-019-01322-3

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  • DOI: https://doi.org/10.1007/s40520-019-01322-3

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