Variation in glucocorticoid sensitivity and the relation with obesity

Robin Lengton, Anand M. Iyer, Eline S. van der Valk, Ellen K. Hoogeveen, Onno C. Meijer, Bibian van der Voorn, Elisabeth F.C. van Rossum*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)
44 Downloads (Pure)


Increasing evidence points to a relation between increased glucocorticoid (GC) exposure and weight gain. In support, long-term cortisol measurements using hair analysis revealed that many individuals with obesity appear to have cortisol values in the high physiological range. The mechanisms behind this relationship need to be determined in order to develop targeted therapy to reach sustainable weight loss in these subgroups. The effect of GCs is not only determined by the plasma concentration of GCs but also by individual differences in GC sensitivity and the target tissue, which can be analyzed by functional GC assays. GC sensitivity is influenced by multiple genetic and acquired (e.g., disease-related) factors, including intracellular GC availability, hormone binding affinity, and expression levels of the GC receptors and their isoforms, as well as factors involved in the modulation of gene transcription. Interindividual differences in GC sensitivity also play a role in the response to exogenous GCs, with respect to both therapeutic and adverse effects. Accordingly, in this review, we summarize current knowledge on mechanisms that influence GC sensitivity and their relationships with obesity and discuss personalized treatment options targeting the GC receptor.

Original languageEnglish
Article numbere13401
JournalObesity Reviews
Issue number3
Publication statusPublished - Mar 2022

Bibliographical note

EFCvR is supported by a Vidi grant from the Netherlands Organisation for Scientific Research (NWO) (grant number: 91716453). EFCvR and BvdV are also funded by the Elisabeth Foundation.

Publisher Copyright:
© 2021 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.


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