Objectives.

Long-term glucocorticoid levels measured in scalp hair (HairGCs), including hair cortisol and its inactive form hair cortisone, are frequently used biomarkers that represent the cumulative exposure to glucocorticoids over the prior months. HairGCs have repeatedly been associated to cardiometabolic parameters, but longitudinal data are lacking.

Methods.

We investigated 6341 hair samples of participants from a large prospective cohort study (Lifelines) for cortisol and cortisone levels, and associated these to incident cardiovascular diseases (CVD) during the 5-7 years of follow-up. We estimated the odds ratio (OR) of HairGC levels for incident CVD cases, corrected for age, sex, waist circumference, current smoking, systolic blood pressure, and the presence of type 2 diabetes mellitus.

Results.

Hair cortisone levels were associated with incident CVD in both the crude and adjusted analyses (OR 2.91 (95% confidence interval (CI) 1.47-5.60 per point increase in 10-log cortisone concentration (pg/mg).p=0.002), and OR 2.15 (95% CI 0.99-4.55, p=0.049 respectively). This effect was most profound in the youngest half of incident CVD (OR 3.70, 95% CI 1.27-10.3, p=0.014). In the elder half of CVD cases, hair cortisone was not associated with incident CVD. In this cohort, hair cortisol showed no significant associations to incident CVD.  

Conclusions.

In this large prospective cohort study, higher long-term glucocorticoid levels measured in scalp hair, represent a relevant and significant predictor for future cardiovascular diseases. We found the strongest associations for hair cortisone, and within younger individuals.