Johar Hamimatunnisa, Emeny Rebecca Thwing, Bidlingmaier Martin, Kruse Johannes, Ladwig Karl-Heinz
Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (HMGU), Neuherberg, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (HMGU), Neuherberg, Germany; Department of Epidemiology, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, NH, USA.
Psychoneuroendocrinology. 2016 Jul;69:133-41. doi: 10.1016/j.psyneuen.2016.04.004. Epub 2016 Apr 9.
Dysregulation in the cortisol secretion may have a role in the development of type 2 diabetes although conflicting evidence on the particular cortisol secretion patterns and type 2 diabetes demands further investigations. We aim to examine the association of cortisol levels and diurnal secretion patterns with prevalence of type 2 diabetes and HbA1c levels as well as the potential impact of sex and adiposity on this association.
A cross-sectional analysis was conducted among 757 participants (aged 65-90 years) of the population-based KORA (Cooperative Health Research in the Region of Augsburg)-Age study. Multivariate regression analyses were employed to examine the association between salivary cortisol (measured upon waking (M1), 30min after awakening (M2), and in the late night (LNSC)) and type 2 diabetes as well as glycated hemoglobin (HbA1c) with adjustments for potential confounders.
In the total sample population, an elevated LNSC level was observed in type 2 diabetes patients compared to non-patients (P=0.04). In sex-stratified analyses, diabetic men showed a greater Cortisol Awakening Response (CAR) (P=0.02). Diabetic women had significantly elevated LNSC levels (P=0.04). HbA1c was positively associated with both CAR and LNSC levels but was negatively associated with M1 to LNSC ratio.
In this aged population, type 2 diabetes is associated with dysregulated cortisol secretion characterized by distinct sex specific diurnal patterns.
尽管关于特定皮质醇分泌模式与2型糖尿病之间相互矛盾的证据需要进一步研究，但皮质醇分泌失调可能在2型糖尿病的发生发展中起作用。我们旨在研究皮质醇水平和昼夜分泌模式与2型糖尿病患病率及糖化血红蛋白（HbA1c）水平之间的关联，以及性别和肥胖对这种关联的潜在影响。
对基于人群的奥格斯堡地区合作健康研究（KORA）-年龄研究中的757名参与者（年龄65 - 90岁）进行横断面分析。采用多变量回归分析来研究唾液皮质醇（在醒来时（M1）、醒来后30分钟（M2）以及深夜测量（LNSC））与2型糖尿病以及糖化血红蛋白（HbA1c）之间的关联，并对潜在混杂因素进行调整。
在总样本人群中，与非2型糖尿病患者相比，2型糖尿病患者的深夜皮质醇（LNSC）水平升高（P = 0.04）。在按性别分层的分析中，糖尿病男性表现出更大的皮质醇觉醒反应（CAR）（P = 0.02）。糖尿病女性的深夜皮质醇（LNSC）水平显著升高（P = 0.04）。HbA1c与CAR和LNSC水平均呈正相关，但与M1至LNSC比值呈负相关。
在这个老年人群中，2型糖尿病与皮质醇分泌失调有关，其特征为具有明显的性别特异性昼夜模式。
