Associations of the –344T>C polymorphism of CYP11B2 gene with 24-hour blood pressure profiles in middle-aged women with essential hypertension

Background In this cross-sectional study, we assessed the impact of –344T>C polymorphism of the CYP11B2 gene which encodes aldosterone synthase on 24-hour blood pressure patterns.Material and methods The study was performed in 137 females with essential hypertension aged 42−60 years. We measured plasma aldosterone level and renin activity (PRA), fasting glucose, lipid profiles and 24-hour urinary sodium and potassium excretion. Based on 24-hour blood pressure monitoring we identified cases with dipping and non-dipping patterns of blood pressure.Results Mean PRA and aldosterone levels and aldosterone-to-renin ratio (ARR) were within normal range. Non-dipping hypertension was found in 54.3% of patients. Genotype frequencies of TT, CC and CT were 27%, 27% and 46%, respectively. Carriers of the C allele had significantly lower nocturnal blood pressure reduction (P = 0.004) and higher nocturnal systolic (P = 0.02) and diastolic blood pressure (P = 0.044), frequency of non-dipping profile (P = 0.001), and 24-hour urinary potassium excretion (P = 0.047). Urinary sodium excretion was positively correlated with a decrease in nocturnal blood pressure (R = 0.202; P = 0.037). In a multiple regression analysis, ARR and presence of the C allele adjusted for confounding variables were inversely associated with the nocturnal blood pressure decline (b = −0.348; P = 0.022 and b = −0.222; P = 0.018, respectively).Conclusions In conclusion, in middle-aged females with essential hypertension carrying the C allele we found higher nocturnal blood pressure, lower nocturnal blood pressure reduction, and higher prevalence of non-dipping hypertension than in TT carriers.Background In this cross-sectional study, we assessed the impact of –344T>C polymorphism of the CYP11B2 gene which encodes aldosterone synthase on 24-hour blood pressure patterns.Material and methods The study was performed in 137 females with essential hypertension aged 42−60 years. We measured plasma aldosterone level and renin activity (PRA), fasting glucose, lipid profiles and 24-hour urinary sodium and potassium excretion. Based on 24-hour blood pressure monitoring we identified cases with dipping and non-dipping patterns of blood pressure.Results Mean PRA and aldosterone levels and aldosterone-to-renin ratio (ARR) were within normal range. Non-dipping hypertension was found in 54.3% of patients. Genotype frequencies of TT, CC and CT were 27%, 27% and 46%, respectively. Carriers of the C allele had significantly lower nocturnal blood pressure reduction (P = 0.004) and higher nocturnal systolic (P = 0.02) and diastolic blood pressure (P = 0.044), frequency of non-dipping profile (P = 0.001), and 24-hour urinary potassium excretion (P = 0.047). Urinary sodium excretion was positively correlated with a decrease in nocturnal blood pressure (R = 0.202; P = 0.037). In a multiple regression analysis, ARR and presence of the C allele adjusted for confounding variables were inversely associated with the nocturnal blood pressure decline (b = −0.348; P = 0.022 and b = −0.222; P = 0.018, respectively).Conclusions In conclusion, in middle-aged females with essential hypertension carrying the C allele we found higher nocturnal blood pressure, lower nocturnal blood pressure reduction, and higher prevalence of non-dipping hypertension than in TT carriers

Plasma adiponectin in hypertensive patients with and without metabolic syndrome

Introduction. The metabolic syndrome is defined on the basis of a cluster of coexisting metabolic deteriorations, which increase the risk of cardiovascular disease. Earlier studies suggested a role of adipokines and proinflammatory cytokines in the pathogenesis of metabolic syndrome-induced complications. Some clinical studies reported the association of hypoadiponectinemia with cardiovascular diseases, diabetes mellitus, hypertension and dyslipidemia. Decreased adiponectin has been proposed as a useful biomarker of the metabolic syndrome. The aim of the study was to compare serum adiponectin levels in patients with primary hypertension with and without coexisting metabolic syndrome. Material and methods. The study group comprised 145 patients aged 18–50 years with primary hypertension. On the basis of IDF diagnostic criteria, all patients were categorized in groups with (HTMS; n = 73) and without (HTC; n = 72) metabolic syndrome. Study protocol included anthropometric measurements including waist circumference, 24 hour blood pressure measurement, serum levels of adiponectin, uric acid, lipids, insulin and glucose, and assessment of insulin resistance using HOMA-IR index. Results. The plasma levels of adiponectin were significantly lower in the subjects with hypertension and metabolic syndrome as compared with those without the MS (4.2 ± 3.1 μg/dL vs. 6.7 ± 6.5 μg/dL, p = 0.0026). In all patients with hypertension, adiponectin negatively correlated with insulin (r = −0.20; p = 0.014), HOMA-IR (r = −0.24; p = 0.003), triglycerides (r = −0.19; p = 0.025), uric acid (r = −0.25; p = 0.003) and positively with HDL-cholesterol (r = 0.33; p = 0.0001). In the ROC curve analysis, the cut-off value predicting metabolic syndrome in patients with hypertension was 4.1 μg/mL for adiponectin. Conclusions. In conclusion, low adiponectin levels should be taken into account as a potential non-classical biomarker of metabolic complications in patients with primary hypertension, not only with concomitant metabolic syndrome.Introduction. The metabolic syndrome is defined on the basis of a cluster of coexisting metabolic deteriorations, which increase the risk of cardiovascular disease. Earlier studies suggested a role of adipokines and proinflammatory cytokines in the pathogenesis of metabolic syndrome-induced complications. Some clinical studies reported the association of hypoadiponectinemia with cardiovascular diseases, diabetes mellitus, hypertension and dyslipidemia. Decreased adiponectin has been proposed as a useful biomarker of the metabolic syndrome. The aim of the study was to compare serum adiponectin levels in patients with primary hypertension with and without coexisting metabolic syndrome. Material and methods. The study group comprised 145 patients aged 18–50 years with primary hypertension. On the basis of IDF diagnostic criteria, all patients were categorized in groups with (HTMS; n = 73) and without (HTC; n = 72) metabolic syndrome. Study protocol included anthropometric measurements including waist circumference, 24 hour blood pressure measurement, serum levels of adiponectin, uric acid, lipids, insulin and glucose, and assessment of insulin resistance using HOMA-IR index. Results. The plasma levels of adiponectin were significantly lower in the subjects with hypertension and metabolic syndrome as compared with those without the MS (4.2 ± 3.1 μg/dL vs. 6.7 ± 6.5 μg/dL, p = 0.0026). In all patients with hypertension, adiponectin negatively correlated with insulin (r = −0.20; p = 0.014), HOMA-IR (r = −0.24; p = 0.003), triglycerides (r = −0.19; p = 0.025), uric acid (r = −0.25; p = 0.003) and positively with HDL-cholesterol (r = 0.33; p = 0.0001). In the ROC curve analysis, the cut-off value predicting metabolic syndrome in patients with hypertension was 4.1 μg/mL for adiponectin. Conclusions. In conclusion, low adiponectin levels should be taken into account as a potential non-classical biomarker of metabolic complications in patients with primary hypertension, not only with concomitant metabolic syndrome

The influence of varying dietary sodium content on circadian blood pressure profile in patients with salt-sensitive hypertension

The pathogenesis of essential hypertension is not fully understood. Literature indicates the complexity of blood pressure regulating mechanisms with a high impact of genetics and environmental factors. Previous experimental studies have shown the importance of salt intake in the development of hypertension. The aim of the study was to explore the influence of varying dietary sodium content on circadian blood pressure profile in patients with salt-sensitive hypertension. The study was carried out among 69 salt-sensitive hypertensive patients (19 females i 50 males) mean aged 36.1 ± 8.0 years. Study protocol provided low sodium diet firstly then high sodium diet containing 10–20 mmol and 220–240 mmol of sodium per day respectively. On each of the diet ABPM was performed. Our results suggest that in salt-sensitive patients the reduction of salt intake may decrease blood pressure and restore its circadian profile and thus lead to the reduction in the rate of complications of hypertension

An increased aldosterone-to-renin ratio in patients with non-dipper hypertension

Wstęp Celem pracy było porównanie aktywności reninowej osocza (PRA), stężenia aldosteronu oraz wskaźnika aldosteronowo-reninowego (ARR) u pacjentów zakwalifikowanych do grupy non-dippers i dippers na podstawie dobowego profilu ciśnienia tętniczego. Materiał i metody W badaniu wzięło udział 96 osób (47 kobiet i 49 mężczyzn) z nadciśnieniem tętniczym. U wszystkich pacjentów wykonano 24 godzinną rejestrację ciśnienia tętniczego metodą ambulatoryjną (ABPM) aparatem firmy Spacelabs 90207, przeprowadzając pomiary co 20 minut między godziną 6.00, a 22.00 oraz co 30 minut między godziną 22.00 a 6.00. Obliczano średnie dobowe, dzienne, nocne ciśnienie tętnicze ze wszystkich pomiarów w ciągu doby oraz spadek nocny średniego ciśnienia dziennego. Określano cechę dippers, gdy spadek nocny średniego ciśnienia dziennego wynosił co najmniej 10% , natomiast cechę non-dippers przy spadku tego ciśnienia poniżej 10%, zgodnie z przyjętymi kryteriami. U wszystkich chorych będących po 8-godzinnym spoczynku nocnym i pozostających w pozycji leżącej oznaczono PRA, stężenie aldosteronu, a następnie wyliczono ARR, przyjmując za nieprawidłową wartość wskaźnika większą lub równą 20. Wyniki Spośród 96 badanych cechę non-dippers stwierdzono u 47 osób (24 K, 23 M, w wieku 45,9 &#177; 14,5 roku), a cechę dippers u 49 osób (23 K, 26 M w wieku 44,0 &#177; 13,6 roku). Badane grupy nie różniły się wskaźnikiem masy ciała, parametrami biochemicznymi, średnimi wartościami ciśnienia w ABPM oraz stężeniem aldosteronu w surowicy. Stwierdzono nieznaczne, ale istotnie wyższe, wartości ARR w grupie non-dippers. Cechę non-dippers wykazywało 31 (65,9%) osób z ARR co najmniej 20 i i 16 osób (34,1%) z ARR poniżej 20. Ponadto w grupie non-dippers stężenie aldosteronu dodatnio korelowało z parametrami ciśnienia w ABPM, a ujemnie - ze stężeniem potasu w surowicy. Wnioski Stwierdzony u chorych z nadciśnieniem tętniczym brak nocnego spadku oraz nieprawidłowy profil ciśnienia w ABPM istotnie wiążą się z podwyższonym ARR oraz dodatnio korelują ze stężeniem aldosteronu, co sugeruje, że zależą one od nieprawidłowego wydzielania tego hormonu. Nadciśnienie Tętnicze 2010, tom 14, nr 5, strony 381-386.Background The purpose of this work was to assess plasma aldosterone concentration (PAC), plasma renin activity (PRA) and aldosterone to renin ratio (ARR) in patients with dipping and non-dipping pattern of nocturnal blood pressure. Material and methods The study was performed on 96 subjects (47 F, 49 M) with primary hypertension. In all patients a 24-h ambulatory blood pressure monitoring (ABPM) protocol was performed using a Spacelabs 90207 monitor. Blood pressure was measured every 20 min during the daytime (from 06.00 to 22.00) and every 30 min at night-time (22.00-06.00). The following parameters were recorded: 24-h mean, daytime mean and night-time mean systolic and diastolic blood pressures. The nondipper hypertension was diagnosed if the declines in blood pressure at night were below 10% of the daytime values. After an overnight fast, blood samples were drawn in a supine position for PAC and PRA concentrations, sodium, potassium, and creatinine concentrations using routine methods. Results Of 96 patients we identified 47 non-dippers (24 F, 23 M; mean age 45.9 &#177; 14.5 years) and 49 dippers (23 F, 26 M; mean age 44.0 &#177; 13.6 years). Body mass index, biochemical parameters and PAC values were comparable between dippers and nondippers groups. However, nondippers had significantly higher ARR as compared to dippers (22.6 &#177; 13.7 and 18.8 &#177; 7.9, respectively; p < 0.005). Similarly, the incidence of ARR &#8805; 20 was significantly higher in non-dippers (65.9%) than in dippers (32.8%; p < 0.005). In non-dippers, but not in dippers, there were significant positive correlations found between PAC and the ABPM parameters. Conclusions In patients with primary hypertension, a nondipping pattern of nocturnal blood pressure is associated with an increased ARR, suggesting an abnormal aldosterone secretion. Arterial Hypertension 2010, vol. 14, no 5, pages 381-386

The influence of non-pharmacological management of obesity on a diurnal blood pressure profile

Background. Obesity is one of the main factors increasing mortality and the incidence of diseases of the cardiovascular system. The base treatment is a non-pharmacological approach: diet and physical training. We see hypertension in obese people more often than in people of normal weight. The aim of this study was to answer the question of whether or not a 3-month comprehensive program of non-pharmacological treatment of obesity affects the circadian blood pressure profile. Material and methods. The study was performed with 60 obese women aged 20–37 years who had an average body mass index (BMI) of 36 ± 4.9 kg/m2 and who declared their willingness to participate in the treatment of obesity. Qualified researchers proposed participation in the comprehensive, outpatient, non-pharmacological treatment program for obesity. The program included activities with a dietician, physiotherapist and physician. Patients performed blood pressure measurements using 24-hour ambulatory monitoring (ABPM). Results. After 3 months of treatment, the participants had a significant decrease in BMI and waist circumference. These changes were accompanied by a significant reduction in fasting insulin concentrations and a decrease in the insulin resistance index. Findings also showed a small but significant reduction in systolic blood pressure — circadian, daytime and nighttime — and a reduction in the incidence characteristics of of ‘non-dipper’ pattern. In the study group significant positive correlations were found between the change in fasting insulin concentration and the change in circadian systolic blood pressure. Conclusion. A non-pharmacological, comprehensive treatment program for obesity through weight reduction and a reduction of insulin resistance improves the profile of circadian systolic blood pressure and leads to the conversion of ‘non-dipper’ pattern to favourable ‘dipper’ pattern

Comparison of the concentration of leptin between obese women and obese men with essential hypertension

Background The main determinants of the level of leptin in human plasma are the fat mass and sex. In recent literature many papers have been published indicating the participation of leptin in the pathogenesis of essential hypertension. The aim of this study was to compare serum levels of leptin and evaluate its importance in the pathophysiology of hypertension in obese men and women. Material and methods The study was conducted in a group of a total of 52 obese individuals (26 women and 26 men) with newly diagnosed essential hypertension. The study protocol included blood sample collection for the measurements of biochemical parameters and hormone levels. Biochemical assays were performed using routine methods. Serum insulin was determined by immunoradiometric assay (IRMA). The index of insulin resistance (IR) was calculated using HOMA. Leptin, plasma renin activity (PRA) and plasma aldosterone concentration were determined by radioimmunoassay (RIA). Results No significant differences were found between women and men in terms of age, BMI, blood pressure, total cholesterol, LDL and fasting glucose. Men had slightly but significantly higher waist circumference. The group of women had significantly higher levels of leptin, insulin and insulin resistance, and a higher PRA and aldosterone levels than males. In the group studied, leptin significantly positively correlated with blood pressure, as well as with the concentration of aldosterone and renin both in women and in men. There was no similar relationship between leptin and insulin and the insulin resistance index. Conclusions Women with obesity and hypertension have higher levels of leptin than obese men with hypertension. Reported correlations between plasma leptin concentration and blood pressure suggest that it is directly or indirectly involved in the pathophysiology of hypertension in obese individuals regardless of gender.Background The main determinants of the level of leptin in human plasma are the fat mass and sex. In recent literature many papers have been published indicating the participation of leptin in the pathogenesis of essential hypertension. The aim of this study was to compare serum levels of leptin and evaluate its importance in the pathophysiology of hypertension in obese men and women. Material and methods The study was conducted in a group of a total of 52 obese individuals (26 women and 26 men) with newly diagnosed essential hypertension. The study protocol included blood sample collection for the measurements of biochemical parameters and hormone levels. Biochemical assays were performed using routine methods. Serum insulin was determined by immunoradiometric assay (IRMA). The index of insulin resistance (IR) was calculated using HOMA. Leptin, plasma renin activity (PRA) and plasma aldosterone concentration were determined by radioimmunoassay (RIA). Results No significant differences were found between women and men in terms of age, BMI, blood pressure, total cholesterol, LDL and fasting glucose. Men had slightly but significantly higher waist circumference. The group of women had significantly higher levels of leptin, insulin and insulin resistance, and a higher PRA and aldosterone levels than males. In the group studied, leptin significantly positively correlated with blood pressure, as well as with the concentration of aldosterone and renin both in women and in men. There was no similar relationship between leptin and insulin and the insulin resistance index. Conclusions Women with obesity and hypertension have higher levels of leptin than obese men with hypertension. Reported correlations between plasma leptin concentration and blood pressure suggest that it is directly or indirectly involved in the pathophysiology of hypertension in obese individuals regardless of gender

The associations between metabolic abnormalities, 24-h blood pressure cicardian rhythm and morning cortisol serum level in patients with essential hypertension

Wstęp Celem pracy była ocena wpływu porannego stężenia kortyzolu w surowicy na zaburzenia metaboliczne oraz na 24-godzinny profil ciśnienia tętniczego mierzony metodą ABPM u chorych z pierwotnym nadciśnieniem tętniczym non-dippers i dippers. Materiał i metody W badaniu wzięło udział 96 osób (47 kobiet i 49 mężczyzn) z pierwotnym nadciśnieniem tętniczym. U wszystkich chorych wyznaczono wzrost, masę ciała i obwód pasa (talia) oraz obliczono BMI. U wszystkich pacjentów wykonano całodobową rejestrację ciśnienia tętniczego metodą ABPM aparatem firmy Spacelabs 90207, przeprowadzając pomiary co 20 minut między godziną 6:00 a 22:00 oraz co 30 minut między godziną 22:00 a 6:00. Obliczano średnie dobowe (24hMAP), dzienne (dMAP), nocne (nMAP) ciśnienie tętnicze ze wszystkich pomiarów w ciągu doby oraz nocny spadek średniego ciśnienia dziennego. Określano cechę dippers, gdy spadek nocny średniego ciśnienia dziennego wynosił co najmniej 10%, natomiast cechę non-dippers przy spadku tego ciśnienia poniżej 10%, zgodnie z przyjętymi kryteriami. U chorych będących na czczo pobierano próbki krwi, w których oznaczono stężenie kortyzolu, glukozy, kwasu moczowego, cholesterolu całkowitego, frakcji LDL i HDL, triglicerydów. Ponadto u wszystkich chorych wykonano ponowne oznaczenia stężenia kortyzolu w surowicy po podaniu 1 mg deksametazonu oraz wykonano oznaczenie glukozy w teście obciążenia 75 g glukozy (OGTT). Wyniki Wśród 96 badanych cechę non-dippers stwierdzono u 47 osób (24 kobiet, 23 mężczyzn, w wieku 45,9 &#177; 14,5 roku) a cechę dippers u 49 osób (23 kobiet, 26 mężczyzn w wieku 44 &#177; 13,6 roku). Badane grupy nie różniły się BMI, parametrami biochemicznymi, średnimi wartościami ciśnienia w ABPM. W grupie non-dippers stwierdzono znamiennie (p < 0,05) więszy obwód talii (99,8 &#177; 10,8 v 92,8 &#177; 11,9), wyższe stężenie glukozy w OGTT (139 &#177; 67,3 v. 129,8 &#177; 32,6) i wyższe stężenie kortyzolu w surowicy w porównaniu z dippers (20,1 &#177; 6,8 v.18,3 &#177; 5,7). Ponadto w grupie non-dippers wykazano statystycznie istotną, dodatnią korelację między stężeniem kortyzolu a wartością wskaźnika BMI (r = 0,6; p < 0,005, obwodem pasa (r = 0,54; p < 0,005, stężeniem glukozy na czczo (r = 0,39; p < 0,05) i w OGTT (r = 0,65; p < 0,005), a także ujemną, znamienną korelację pomiędzy stężeniem kortyzolu a cholesterolu frakcji HDL (r = &#8211;0,38; p < 0,05). Ponadto w tej grupie chorych stwierdzono statystycznie istotną, dodatnią korelację między stężeniem kortyzolu a parametrami ABPM. Podobnych zależności nie wykazano w grupie dippers. Wnioski Podwyższone poranne stężenie kortyzolu w surowicy odpowiada za zaburzenia metaboliczne, nieprawidłowy profil ciśnienia tętniczego oraz brak jego spadku nocnego u chorych z pierwotnym nadciśnieniem tętniczym. Nadciśnienie Tętnicze 2011, tom 15, nr 4, strony 236&#8211;241.Background To assess an impact of morning cortisol level on metabolic abnormalities and 24-h ambulatory blood pressure profile in patients with dipping and non-dipping hypertension. Material and methods The study was performed on 96 subjects (47 F, 49 M) with essential hypertension. The anthropometric assessments included height, weight, waist circumference and body mass index (BMI). In all patients a 24-h blood pressure monitoring (ABPM) protocol was performed using a Spacelabs 90207 monitor. Blood pressure was measured every 20 min during the daytime (from 06.00 to 22.00) and every 30 min at night-time (22.00&#8211;06.00). The following parameters were recorded: 24-h mean (MAP), daytime mean (dMAP) and night-time mean (nMAP) systolic (SBP) and diastolic (DBP) blood pressures. The non-dippers hypertension was defined if the declines in blood pressure at night were below 10% of the daytime values. The morning blood samples for serum cortisol, glucose, uric acid, cholesterol, and triglycerides levels were drawn. All patients had also a 75 g oral glucose tolerance test (OGTT) and a 1 mg dexamethasone suppression test. Results Of 96 patients we identified 47 non-dippers (24 F, 27 M; mean age 45.9 &#177; 14.5 years) and 49 dippers (23 F, 26 M; mean age 44 &#177; 13.6 years); BMI, MAP, serum uric acid, total cholesterol and its LDL and HDL fractions, triglycerides, fasting glucose were similar in both groups. All patients had normal dexamethasone suppression test. Non-dipperes had significantly higher waist circumference (99.8 &#177; 10.8) and glucose results of the OGTT (139.3 &#177; 67.30 as compared to dippers (respectively: 92.8 &#177; 11.9; 129.8 &#177; 32.6). Furthermore, the morning cortisol level was significantly higher in non-dippers group as compared to dippers (20.7 &#177; 6.7 v.18.3 &#177; 5.6 &#956;g/dl; p < 0.05) and in non-dippers was positively correlated with BMI (r = 0.6; p < 0.005), waist circumference (r = 0.54; p < 0.005), fasting glucose (r = 0.39; p < 0.05), 2-h post load glucose (r = 0.65; p < 0.005) and inversely with HDL cholesterol (r = &#8211;0.38; r < 0.05). Similarly, in non-dippers, but not in dippers, the morning cortisol level correlated with the following ABPM values. Conclusions In patients with essential hypertension, an increased morning cortisol level is associated with metabolic abnormalities, circadian blood pressure profile and non-dipping pattern of blood pressure. Arterial Hypertension 2011, vol. 15, no 4, pages 236&#8211;241

Testosterone assocition with blood pressure profile and left ventricular mass in a young hypertensive population

Sex hormones not only regulate the gonads function, but also may affect the cardiovascular system, although their role is still not clear. Testosterone influence on arterial pressure and left ventricular hypertrophy were widely reported. A number of factors have been implicated as the underlying cause of the relation between testosterone and blood pressure, including sex and age as most important ones. In present findings, a 24-hour ABPM revealed that 33.9% of patients had an altered pattern of blood pressure with no significant differences between sexes. In the whole studied sample, positive correlation has been found between testosterone and 24-hour systolic blood pressure, daytime BP, sodium and potassium levels in the 24-hour urine collection, and left ventricular mass index. In conclusion, testosterone association with blood pressure profile and left ventricular mass in a young hypertensive population seems to be probable, but further analysis is necessary

Metabolically obese normal-weight individuals and 11&#946;-hydroxysteroid dehydrogenase type 2 (11&#946;-HSD 1)

Na początku lat 80. XX wieku wykazano, że zaburzenia biochemiczne składające się na obraz zespołu metabolicznego stwierdza się także u młodych, szczupłych osób, uważanych za zdrowe. Osoby te określono nazwą metabolicznie otyłych z prawidłową masą ciała (MONWI). Cechują się one większą masą tkanki tłuszczowej trzewnej i insulinoopornością, niekiedy hipercholesterolemią i hipertriglicerydemią oraz zaburzeniami tolerancji węglowodanów. Podobieństwo wymienionych cech zespołu do objawów wynikających z przewlekłej hiperkortyzolemii skłania do uwzględnienia wśród środowiskowych przyczyn metabolicznej otyłości roli stresu psychogennego. Stres aktywuje czynność układu podwzgórze-przysadka-nadnercza oraz enzym 11&#946;-dehydrogenazę hydroksysteroidową typu 1 (11&#946;-HSD1) w tkance tłuszczowej trzewnej i wątrobie. Ta ostatnia zdolna jest wygenerować ilość kortyzolu porównywalną z wytwarzaną przez nadnercza. W niniejszej pracy przedstawiono dane wskazujące na powiązanie aktywności 11&#946;-HSD1 z objawami zespołu metabolicznej otyłości u osób z prawidłową masą ciała. Stres, jako czynnik aktywujący działanie enzymu, może zajmować szczególne miejsce wśród przyczyn MONWI.At the beginning of the eighties 20th century it was shown that some biochemical abnormalities which are associated with metabolic syndrome might be also presented in young, considered as healthy, non-obese individuals. These individuals were described as metabolically-obese normal-weight individuals (MONWI). They are characterized by a higher visceral fat mass and insulin-resistance, sometimes hypercholesterolemia, hypertriglycerydemia and impaired glucose tolerance. The resemblance of these features to some symptoms associated with chronic hypercortisolemia allows to consider a role of psychogenic stress as a possible risk factor. Chronic stress activates not only hypothalamo-pituitary&#8211;adrenal axis, but also 11&#946;-hydroxysteroid dehydrogenase type 1 (11&#946;-HSD1) in the liver and visceral fat tissue. The latter is involved in the produce of such amount of cortisol that can be compared with secretion of adrenal glands. In this article we showed some data indicating a possible relation between 11&#946;-HSD1 activity and some symptoms of MONWI syndrome. Stress, as an enzyme-activating factor, may play a crucial role in the development of MONWI syndrome