Is there an association between cortisol and hypertension in overweight or obese children?

Objective: the precise mechanisms behind the development of hypertension in overweight or obese children are not yet completely understood. alterations in hypothalamic-pituitary-adrenal axis activity may play a role. we aimed to investigate the association between cortisol parameters and hypertension in overweight or obese children. methods: random urine (n=180) and early-morning saliva samples (n=126) for assessment of cortisol and cortisone were collected from 1) hypertensive overweight children (n=50),2) normotensive overweight children (n=145),and 3) normotensive non-overweight children (n=75). results: the age of participants was 10.4±3.3 years and 53% were boys. the urinary cortisol-to-cortisone ratio [β 1.11,95% confidence interval (ci) 1.05-1.19] as well as urinary cortisol/creatinine (β 1.38,95% ci 1.09-1.54),and cortisone/creatinine ratios (β 1.26,95% ci 1.17-1.36) were significantly higher in overweight or obese than in non-overweight children. after adjusting for body mass index-standard deviation score and urinary cortisone/creatinine ratio,but not cortisol/creatinine ratio,was significantly associated with presence of hypertension (β 1.12,95% ci 1.02-1.23). salivary cortisol and cortisone levels were significantly lower in overweight or obese than in non-overweight children (β -4.67,95% ci -8.19- -1.15,and β 0.89,95% ci 0.80-0.97 respectively). there were no significant differences in cortisol parameters between hypertensive and normotensive overweight or obese children. conclusion: this study provided further evidence for an increased cortisol production rate with decreased renal 11β-hydroxysteroid dehydrogenase 2 activity and flattening of early-morning peak cortisol and cortisone in overweight or obese children. however,there were no significant differences in cortisol parameters between hypertensive and normotensive overweight and obese children. © 2017 by turkish pediatric endocrinology and diabetes society.