Supplementary Material for: 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- and metabolism-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 biological stress (scalp hair cortisol and cortisone) and 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, indicating a link between long-term stress and hormonal appetite signaling.

引言：压力可预测不健康饮食、肥胖及代谢恶化，其潜在机制可能由食欲与代谢调节激素水平的改变所介导。然而，目前尚缺乏关于人类长期压力与食欲调节激素水平之间关联的相关证据。
方法：本研究纳入65例肥胖患者（其中44例为女性），旨在探讨生物压力（头皮毛发皮质醇与皮质酮）及心理压力（感知压力量表（Perceived Stress Scale））与隔夜空腹血清中食欲调节激素（瘦素（leptin）、脂联素（adiponectin）、胰岛素（insulin）、胰多肽（pancreatic polypeptide）、胃抑肽（gastric-inhibitory peptide）、酪酪肽（peptide tyrosine-tyrosine）、胆囊收缩素（cholecystokinin）及刺豚鼠相关蛋白（agouti-related protein））水平的横断面关联，校正因素包括年龄、性别与体质量指数。
结果：头皮毛发皮质酮水平与胆囊收缩素呈显著正相关，毛发皮质醇水平也呈现出相似的正向关联趋势（分别对应p=0.003与p=0.058）。未观察到其余压力指标与食欲调节激素之间存在统计学关联。
结论：通过头皮毛发糖皮质激素水平检测的长期生物压力，与循环中胆囊收缩素水平升高存在关联，这表明长期压力与激素介导的食欲信号通路之间存在潜在联系。