HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Chiodini, I. Articles by Arosio, M. Search for Related Content PubMed PubMed Citation Articles by Chiodini, I. Articles by Arosio, M. Social Bookmarking                What's this?

Cortisol Secretion in Patients With Type 2 Diabetes

Relationship with chronic complications

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

Address correspondence and reprint requests to Iacopo Chiodini, MD, Endocrine Unit, Department of Medical Sciences, University of Milan, Fondazione Policlinico, Mangiagalli e Regina Elena, IRCCS, Milan, Italy, via Francesco Sforza 35, 20122 Milan, Italy. E-mail: ichiodini{at}katamail.com

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.

Abbreviations: F24, serum cortisol levels at 12:00 P.M. • F-Dex, dexamethasone suppression test • HOMA-IR • homeostasis model assessment of insulin resistance • HPA, hypothalmic-pituitary-adrenal • UFC, urinary free cortisol

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				H. E. Bates, A. S. Sirek, M. A. Kiraly, J. T. Y. Yue, D. Goche Montes, S. G. Matthews, and M. Vranic Adaptation to Mild, Intermittent Stress Delays Development of Hyperglycemia in the Zucker Diabetic Fatty Rat Independent of Food Intake: Role of Habituation of the Hypothalamic-Pituitary-Adrenal Axis Endocrinology, June 1, 2008; 149(6): 2990 - 3001. [Abstract] [Full Text] [PDF]

				J. I. Castillo-Quan and J. M. Perez-Osorio Cortisol Secretion in Patients With Type 2 Diabetes: Relationship With Chronic Complications: Response to Chiodini et al. Diabetes Care, June 1, 2007; 30(6): e49 - e49. [Full Text] [PDF]

				I. Chiodini, G. Adda, P. Beck-Peccoz, E. Orsi, B. Ambrosi, and M. Arosio Cortisol Secretion in Patients With Type 2 Diabetes: Relationship With Chronic Complications: Response to Castillo-Quan and Perez-Osorio Diabetes Care, June 1, 2007; 30(6): e50 - e50. [Full Text] [PDF]