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Does sympathoadrenal activity predict changes in body fat? An 18-y follow-up study^1,2,3

¹ From the Cardiovascular and Renal Research Center and Department of Acute Medicine (AF and MR), Department of Statistics/Centre for Clinical Research (LS), Cardiovascular and Renal Research Center and Department of Cardiology (SEK), and Cardiovascular and Renal Research Center (IKE), Ullevaal University Hospital, Oslo, Norway

Background:Whether alterations in the sympathoadrenal system contribute to obesity or, rather, are consequences of it, is an unresolved issue.

Objective:We hypothesized that the sympathoadrenal system plays a predictive role in the development of body fat.

Design:At entry, arterial plasma epinephrine and norepinephrine concentrations were measured in 99 healthy men ( ± SD age: 19.3 ± 0.4 y) at rest and during a mental stress test and a cold pressor test. Body mass index (BMI; in kg/m²), waist circumference, and triceps skinfold thickness were measured at entry and after 18 y of follow-up.

Results:Eighty subjects (81%) were available for follow-up analyses after a mean (±SD) of 18.0 ± 0.9 y. The epinephrine responses to the mental stress test (E_MST) showed a negative relation to changes in BMI (P = 0.01) and waist circumference (P = 0.007). The mean increase in BMI was 6.3 among subjects in the lowest E_MST quartile and 3.7 in the remaining subjects. In multiple regression analyses corrected for level of exercise, BMI, waist circumference, and triceps skinfold thickness at entry, E_MST was found to be a consistent negative predictor of future BMI (P = 0.005), waist circumference (P = 0.001), and triceps skinfold thickness (P = 0.05).

Conclusions:We present the first long-term follow-up study in whites showing that the epinephrine response to mental stress is a negative predictor of future BMI, waist circumference, and triceps skinfold thickness after 18 y of follow-up. These findings may provide further insights into the pathophysiology of obesity.