Cortisol Secretion in Patients With Type 2 Diabetes
Author:
Chiodini Iacopo1, Adda Guido2, Scillitani Alfredo3, Coletti Francesca2, Morelli Valentina2, Di Lembo Sergio2, Epaminonda Paolo2, Masserini Benedetta2, Beck-Peccoz Paolo1, Orsi Emanuela1, Ambrosi Bruno4, Arosio Maura12
Affiliation:
1. Endocrine Unit, Department of Medical Sciences, University of Milan, Fondazione Policlinico, Mangiagalli e Regina Elena, IRCCS, Milan, Italy 2. Department of Endocrinology, San Giuseppe-Fatebenefratelli Hospital, A.Fa.R., Milan, Italy 3. Unit of Endocrinology, Scientific Institute “Casa Sollievo della Sofferenza,” San Giovanni Rotondo, Foggia, Italy 4. Unit of Endocrinology, Department of Medical and Surgical Sciences, University of Milan, IRCCS Policlinico San Donato Institute, San Donato Milanese, Milan, Italy
Abstract
OBJECTIVE—The presence of an enhanced cortisol secretion in patients with type 2 diabetes is debated. In type 2 diabetic subjects, cortisol secretion was found to be associated with the complications and metabolic control of diabetes. We evaluated cortisol secretion in 170 type 2 diabetic subjects and in 71 sex-, age-, and BMI-matched nondiabetic subjects.
RESEARCH DESIGN AND METHODS—In all subjects, we evaluated ACTH at 8:00 a.m. in basal conditions and serum cortisol levels at 12:00 p.m. (F24) and at 9:00 a.m. after a 1-mg overnight dexamethasone suppression test and 24-h urinary free cortisol (UFC). In diabetic patients, we evaluated the presence of chronic complications (incipient nephropathy, asymptomatic neuropathy, background retinopathy, and silent macroangiopathy). Patients were subdivided according to the absence (group 1, n = 53) or presence (group 2, n = 117) of diabetes complications.
RESULTS—In group 2, UFC (125.2 ± 4.6 nmol/24 h) and F24 (120.6 ± 4.1 nmol/l) were higher than in group 1 (109.2 ± 6.8 nmol/24 h, P = 0.057, and 99.7 ± 6.1 nmol/l, P = 0.005, respectively) and in nondiabetic patients (101.7 ± 5.9 nmol/24 h, P = 0.002, and 100.3 ± 5.3 nmol/l, P = 0.003, respectively). In diabetic patients, the number of complications was associated with F24 (R = 0.345; P < 0.0001) and diabetes duration (R = 0.39; P < 0.0001). Logistic regression analysis showed that the presence of diabetes complications was significantly associated with F24, sex, duration of diabetes, and glycated hemoglobin.
CONCLUSIONS—In type 2 diabetic subjects, hypothalmic-pituitary-adrenal activity is enhanced in patients with diabetes complications and the degree of cortisol secretion is related to the presence and number of diabetes complications.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Reference37 articles.
1. Andrews RC, Walker BR: Glucocorticoids and insulin resistance old hormones, new targets. Clinl Sci (Lond) 96: 513–523, 1999 2. Bjontorp P, Holm G, Rosmond R: Hypothalamic arousal, insulin-resistance and type 2 diabetes mellitus. Diabet Med 16:373–381, 1999 3. Phillips DI, Barker DJ, Fall CH, Seckl JR, Whorwood CB, Wood PJ, Walker BR: Elevated plasma cortisol concentrations: a link between low birth weight and the insulin resistance syndrome? J Clin Endocrinol Metab 83:757–760, 1998 4. Andrews RC, Herlihy O, Livingstone DE, Andrew R, Walker BR: Abnormal cortisol metabolism and tissue sensitivity to cortisol in patients with glucose intolerance. J Clin Endocrinol Metab 87:5587–5593, 2002 5. Arnaldi G, Angeli A, Atkinson AB, Bertagna X, Cavagnini F, Chrousos GP, Fava GA, Findling JW, Gaillard RC, Grossman AB, Kola B, Lacroix A, Mancini T, Mantero F, Newell-Price J, Nieman LK, Sonino N, Vance ML, Giustina A, Boscaro M: Diagnosis and complications of Cushing’s syndrome: a consensus statement. J Clin Endocrinol Metab 88:5593–5602, 2003
Cited by
184 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|