TY - JOUR
T1 - Cortisol metabolism, postnatal depression and weight changes in the first 12 months postpartum.
AU - Rogers, Samantha
AU - Hughes, Beverly A.
AU - Tomlinson, Jeremy
AU - Blissett, Jacqueline
N1 - This is the peer-reviewed version of the following article: S. L. Rogers, B. A. Hughes, J. W. Tomlinson, and J. Blissett, 'Cortisol metabolism, postnatal depression and weight changes in the first 12 months postpartum', Clinical Endocrinology, Vol. 85 (6): 881-890, December 2016, which has been published in final form at doi: http://onlinelibrary.wiley.com/doi/10.1111/cen.13150/abstract.
This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
PY - 2016/11/14
Y1 - 2016/11/14
N2 - Background & Objectives: Postnatal depression correlates with postpartum weight retention, and dysregulated cortisol metabolism is evident in depressed individuals. Cortisol metabolism, BMI and metabolic phenotype are robustly associated, but the role of cortisol metabolism in postnatal mental health and weight loss has never been examined.
Design: A longitudinal observation.
Patients: Forty nine healthy women with uncomplicated pregnancy.
Measurements: BMI and urinary steroid metabolites at 1 week and 1, 3, 6 and 12 months postpartum. Validated urinary steroid metabolite ratios were measured to determine the activities of 11β-hydroxysteroid dehydrogenases (11β-HSD) that interconvert inactive cortisone and active cortisol and the 5α-reductases that clear cortisol to its inactive metabolites. Postnatal depression symptoms were measured at 1, 6 and 12 months.
Results: Low 5α-reductase activity was associated with greater weight loss across the first year, independent of demographics, breastfeeding and depression. Postpartum BMI change was unrelated to postnatal depression at any time. Symptoms of postnatal depression were related to higher cortisol metabolite production at 12 months, independent of demographics and breastfeeding.
Conclusions: Greatest weight loss in the postpartum year was associated with lower conversion of cortisone to cortisol and lower conversion of cortisol to its metabolites, supporting previous work that demonstrates the facilitative role of lower 5α-reductase and 11β-HSD-1 in weight loss. Greater depression symptoms were associated with higher cortisol metabolite production rates. Whilst weight and mental health are both associated with dysregulation of the HPA axis, there may be different pathways towards depressed and obese phenotypes in healthy postpartum samples.
AB - Background & Objectives: Postnatal depression correlates with postpartum weight retention, and dysregulated cortisol metabolism is evident in depressed individuals. Cortisol metabolism, BMI and metabolic phenotype are robustly associated, but the role of cortisol metabolism in postnatal mental health and weight loss has never been examined.
Design: A longitudinal observation.
Patients: Forty nine healthy women with uncomplicated pregnancy.
Measurements: BMI and urinary steroid metabolites at 1 week and 1, 3, 6 and 12 months postpartum. Validated urinary steroid metabolite ratios were measured to determine the activities of 11β-hydroxysteroid dehydrogenases (11β-HSD) that interconvert inactive cortisone and active cortisol and the 5α-reductases that clear cortisol to its inactive metabolites. Postnatal depression symptoms were measured at 1, 6 and 12 months.
Results: Low 5α-reductase activity was associated with greater weight loss across the first year, independent of demographics, breastfeeding and depression. Postpartum BMI change was unrelated to postnatal depression at any time. Symptoms of postnatal depression were related to higher cortisol metabolite production at 12 months, independent of demographics and breastfeeding.
Conclusions: Greatest weight loss in the postpartum year was associated with lower conversion of cortisone to cortisol and lower conversion of cortisol to its metabolites, supporting previous work that demonstrates the facilitative role of lower 5α-reductase and 11β-HSD-1 in weight loss. Greater depression symptoms were associated with higher cortisol metabolite production rates. Whilst weight and mental health are both associated with dysregulation of the HPA axis, there may be different pathways towards depressed and obese phenotypes in healthy postpartum samples.
U2 - 10.1111/cen.13150
DO - 10.1111/cen.13150
M3 - Article
SN - 1365-2265
VL - 85
SP - 881
EP - 890
JO - Clinical Endocrinology
JF - Clinical Endocrinology
IS - 6
ER -