Dual-hormone clamp mediates effects of sleep restriction on insulin resistance

Peter Y. Liu

CHICAGO — The negative effect of sleep restriction on glucose metabolism was reduced during a dual-hormone clamp intervention of testosterone and cortisol in young men, according to a presenter here.

“Insufficient sleep reduces testosterone and increases cortisol,” Peter Y. Liu, MBBS, PhD, professor of medicine with the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center in Torrance, Calif., told Endocrine Today. “This testosterone-cortisol imbalance leads to an anabolic-catabolic imbalance and the development of insulin resistance.”

Liu and colleagues conducted a dual-hormone clamp intervention on 34 healthy men (mean age, 33.3 years; mean BMI, 25.4 kg/m²) to determine whether testosterone and cortisol affect insulin resistance due to sleep restriction. Researchers conducted 5 nights of sleep studies and controlled what the participants ate and how much they slept. Participants were permitted to sleep 10 hours the first night and were restricted to 4 hours per night for the remaining 4 nights on two separate occasions; during the first occasion, participants underwent a testosterone-cortisol clamp and during the second, matching placebo. After the baseline night and the fourth night of sleep restriction, participants underwent a 3-hour OGTT to calculate insulin resistance.

In both conditions, Matsuda Index revealed greater insulin resistance after sleep restriction; however, the increase was dampened during the clamp condition compared with placebo (P = .029 for interaction). Similar patterns were observed for insulin area under the curve (AUC; P = .012) and insulin/glucose AUC ratio (P = .022).

“Manipulating the specific downstream molecular mediators of the testosterone-cortisol imbalance that cause insulin resistance could lead to novel methods to prevent the metabolic sequalae of insufficient sleep, such as prediabetes or type 2 diabetes, without requiring more sleep,” Liu told Endocrine Today. “[Research moving forward needs to] identify these downstream mediators. Also, although we discovered a hormone mechanism by which insufficient sleep leads to insulin resistance, there are other mechanisms at play. We need to work to work out what these other mechanisms are.” – by Amber Cox

Reference:

Sidebottom DH, et al. OR15-3. Presented at: The Endocrine Society Annual Meeting; March 17-20, 2018; Chicago.

Disclosures: The authors report no relevant financial disclosures.