The relationship between 24-h urinary cortisol and bone in healthy young women

Int J Behav Med. 2010 Sep;17(3):207-15. doi: 10.1007/s12529-009-9064-2.


Background: Cortisol within the normal range has been associated with reduced bone density in the elderly, but little is known about this relationship in healthy young women.

Purpose: The purpose of this study is to assess whether 24-h urinary free cortisol excretion (UFC) is related to bone density in 132 healthy, non-obese, regularly menstruating women, aged 19-35.

Method: Participants completed questionnaires (food frequency, demographics, physical activity, dietary restraint, perceived stress, and daily stress) and a 24-h urine collection. UFC was determined by high-throughput liquid chromatography and tandem mass spectrometry. Anthropometrics were completed and a dual energy X-ray absorptiometry scan measured areal bone mineral density (aBMD, g/cm(2)) and bone mineral content (BMC, g) at the lumbar spine (L1-4), hip, and total body (TB) as well as total body lean (LBM) and fat mass.

Results: aBMD and BMC were significantly positively associated with height, LBM, physical activity, calcium intake, and duration of previous oral contraceptive use (except L1-4) and negatively with perceived stress. UFC was not correlated with any measured variables except urine volume (r = 0.17, p = 0.046). After adjusting for urine volume, height, LBM, ethnicity, and prior oral contraceptive use, UFC was significantly inversely associated with TB BMC (r = -0.30, p < 0.001) and aBMD (r = -0.27, p = 0.003), L1-4 aBMD (r = -0.19, p = 0.035) and BMC (r = -0.18, p = 0.049), and hip BMC (r = -0.23, p = 0.011). Further adjustment for sport activity, calcium intake and perceived stress did not change these relationships meaningfully except that L1-4 became nonsignificant (p < 0.07).

Conclusion: Cortisol within the normal range appears to have a minor negative influence on bone density in healthy young women.

MeSH terms

  • Adult
  • Body Composition / physiology
  • Body Height / physiology
  • Body Weight / physiology
  • Bone Density / physiology*
  • Contraceptives, Oral, Hormonal / metabolism
  • Eating
  • Female
  • Humans
  • Hydrocortisone / urine*
  • Motor Activity
  • Surveys and Questionnaires
  • Waist Circumference / physiology
  • Young Adult


  • Contraceptives, Oral, Hormonal
  • Hydrocortisone

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