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Daily cortisol patterns predict future glucose disturbance
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Raised evening cortisol levels in adults were predictive of new-onset type 2 diabetes and impaired glucose metabolism 9 years later, according to research in The Journal of Clinical Endocrinology & Metabolism.
Ruth A. Hackett, a PhD student in the department of epidemiology and public health at University College London, and colleagues analyzed data from 3,270 healthy adults (75.1% men; mean age, 61 years; mean BMI, 26.5 kg/m²) participating in the Whitehall II study, a cohort of 10,308 adults from 20 London-based civil service departments recruited between 1985 and 1988. In phase 7 of the study (2002-2004), researchers collected six saliva samples to measure cortisol levels at waking, 30 minutes, 2.5 hours, 8 hours, 12 hours and bedtime. Participants who were normoglycemic in phase 7 were re-examined in phase 11 (2012-2013). At phase 11, 210 adults (6.4%) had new-onset diabetes; 518 adults (15.8%) had impaired fasting glucose.
Researchers found that raised evening cortisol levels at phase 7 predicted new-onset type 2 diabetes at phase 11 (OR = 1.18; 95% CI, 1.01-1.37). Participants with a flatter slope in cortisol across the day also saw a higher incidence of type 2 diabetes (OR = 1.15; 95% CI, 0.99-1.33).
Researchers also found that a flattened diurnal cortisol slope at phase 7 predicted future impaired fasting glucose and incident diabetes combined (OR = 1.12; 95% CI, 1.02-1.22), as did high evening cortisol levels (OR = 1.1; 95% CI 1.01-1.2). Researchers found no association between cortisol awakening response and incident diabetes (P = .318) or waking cortisol and incident diabetes (P = .745).
“It is plausible that neuroendocrine dysfunction is related to the pathophysiology of type 2 diabetes, but the precise mechanisms through which changes in cortisol secretion impairs glucose metabolism remain to be determined,” the researchers wrote. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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