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© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Flattened Circadian Cortisol Rhythm in Type 2 Diabetes
first decision 04.03.2011
06 April 2011 (online)
Introduction: While altered cortisol concentrations have been observed in subjects with type 2 diabetes their circadian cortisol profile is unknown.
Patients and methods: Using a cross-sectional design, we studied 63 ambulatory individuals with type 2 diabetes and 916 non-diabetic control subjects of the Cooperative Research in the Region of Augsburg (KORA)-F3 study. Circadian cortisol profiles were derived from saliva cortisol concentrations, determined on a regular weekday upon wake-up (F0), as well as œ h (Fœ), 8 (F8) and 14 h (F14) after wake-up.
Results: Diabetic subjects exhibited a flattened circadian cortisol profile (rm-ANOVA: F[3,654]=3.41, p=0.02), with lower morning and higher afternoon and evening cortisol concentrations.
Conclusion: We observed a flattened circadian cortisol rhythm in subjects with type 2 diabetes, providing evidence for a specific HPA system dysfunction.
glucocorticoids - hypothalamic-pituitary-adrenal system - circadian rhythm
- 1 Abercrombie HC, Giese-Davis J, Sephton S. et al . Flattened cortisol rhythms in metastatic breast cancer patients. Psychoneuroendocrinology. 2004; 29 1082-1092
- 2 Barker DJ, Hales CN, Fall CH. et al . Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia. 1993; 36 62-67
- 3 Boyar RM, Witkin M, Carruth A. et al . Circadian cortisol secretory rhythms in Cushing's disease. J Clin Endocrinol Metab. 1979; 48 760-765
- 4 Chiodini I, Adda G, Scillitani A. et al . Cortisol secretion in patients with type 2 diabetes: relationship with chronic complications. Diabetes Care. 2007; 30 83-88
- 5 Hastings MH, Reddy AB, Maywood ES. A clockwork web: circadian timing in brain and periphery, in health and disease. Nat Rev Neurosci. 2003; 4 649-661
- 6 Hudson JI, Hudson MS, Rothschild AJ. et al . Abnormal results of dexamethasone suppression tests in nondepressed patients with diabetes mellitus. Arch Gen Psychiatry. 1984; 41 1086-1089
- 7 Lederbogen F, Kuehner C, Kirschbaum C. et al . Salivary cortisol in a community sample, 50–69 years of age. Results from 990 men and women of the KORA-F3 Augsburg study. Eur J Endocrinol. 2010; 163 443-451
- 8 Lentle BC, Thomas JP. Adrenal function and the complications of diabetes mellitus. Lancet. 1964; 2 544-549
- 9 Liu H, Bravata DM, Cabaccan J. et al . Elevated late-night salivary cortisol levels in elderly male type 2 diabetic veterans. Clin Endocrinol (Oxf). 2005; 63 642-649
- 10 Neeck G, Federlin K, Graef V. et al . Adrenal secretion of cortisol in patients with rheumatoid arthritis. J Rheumatol. 1990; 17 24-29
- 11 Pruessner JC, Kirschbaum C, Meinlschmid G. et al . Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology. 2003; 28 916-931
- 12 Roberge C, Carpentier AC, Langlois MF. et al . Adrenocortical dysregulation as a major player in insulin resistance and onset of obesity. Am J Physiol Endocrinol Metab. 2007; 293 E1465-E1478
- 13 Roy M, Collier B, Roy A. Dysregulation of the hypothalamo-pituitary-adrenal axis and duration of diabetes. J Diabet Complications. 1991; 5 218-220
- 14 Roy MS, Roy A, Brown S. Increased urinary-free cortisol outputs in diabetic patients. J Diabetes Complications. 1998; 12 24-27
- 15 Seckl JR, Meaney MJ. Glucocorticoid programming. Ann NY Acad Sci. 2004; 1032 63-84
- 16 Serio M, Tarquini B, Contini P. et al . Plasma cortisol response to insulin and circadian rhythm in diabetic subjects. Diabetes. 1968; 17 124-126
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