Kamba Aya, Daimon Makoto, Murakami Hiroshi, Otaka Hideyuki, Matsuki Kota, Sato Eri, Tanabe Jutaro, Takayasu Shinobu, Matsuhashi Yuki, Yanagimachi Miyuki, Terui Ken, Kageyama Kazunori, Tokuda Itoyo, Takahashi Ippei, Nakaji Shigeyuki
Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
PLoS One. 2016 Nov 18;11(11):e0166077. doi: 10.1371/journal.pone.0166077. eCollection 2016.
Glucocorticoids (GCs) are well known to induce insulin resistance. However, the effect of GCs on insulin secretion has not been well characterized under physiological conditions in human. We here evaluated the effect of GCs on insulin secretion/ß-cell function precisely in a physiological condition. A population-based study of 1,071 Japanese individuals enrolled in the 2014 Iwaki study (390 men, 681 women; aged 54.1 ± 15.1 years), those excluded individuals taking medication for diabetes or steroid treatment, were enrolled in the present study. Association between serum cortisol levels and insulin resistance/secretion assessed by homeostasis model assessment using fasting blood glucose and insulin levels (HOMA-R and HOMA-ß, respectively) were examined. Univariate linear regression analyses showed correlation of serum cortisol levels with HOMA-ß (ß = -0.134, p <0.001) but not with HOMA-R (ß = 0.042, p = 0.172). Adjustments for age, gender, and the multiple clinical characteristics correlated with HOMA indices showed similar results (HOMA-ß: ß = -0.062, p = 0.025; HOMA-R: ß = -0.023, p = 0.394). The correlation between serum cortisol levels and HOMA-ß remained significant after adjustment for HOMA- R (ß = -0.057, p = 0.034). When subjects were tertiled based on serum cortisol levels, the highest tertile was at greater risk of decreased insulin secretion (defined as lower one third of HOMA-ß (≤70)) than the lowest tertile, after adjustment for multiple factors including HOMA- R (odds ratio 1.26, 95% confidence interval 1.03-1.54). In conclusion, higher serum cortisol levels are significantly associated with decreased insulin secretion in the physiological cortisol range in a Japanese population.
糖皮质激素(GCs)可诱导胰岛素抵抗,这是众所周知的。然而,在人体生理条件下,GCs对胰岛素分泌的影响尚未得到充分阐明。我们在此精确评估了生理条件下GCs对胰岛素分泌/β细胞功能的影响。本研究纳入了基于人群的1071名日本个体,这些个体来自2014年磐城研究(390名男性,681名女性;年龄54.1±15.1岁),排除了正在服用糖尿病药物或接受类固醇治疗的个体。通过使用空腹血糖和胰岛素水平的稳态模型评估(分别为HOMA-R和HOMA-β)来检测血清皮质醇水平与胰岛素抵抗/分泌之间的关联。单变量线性回归分析显示血清皮质醇水平与HOMA-β相关(β = -0.134,p <0.001),但与HOMA-R不相关(β = 0.042,p = 0.172)。对年龄、性别以及与HOMA指数相关的多种临床特征进行调整后,结果相似(HOMA-β:β = -0.062,p = 0.025;HOMA-R:β = -0.023,p = 0.394)。在对HOMA-R进行调整后,血清皮质醇水平与HOMA-β之间的相关性仍然显著(β = -0.057,p = 0.034)。当根据血清皮质醇水平将受试者分为三分位数时,在对包括HOMA-R在内的多种因素进行调整后,最高三分位数的受试者胰岛素分泌减少(定义为HOMA-β的较低三分之一(≤70))的风险高于最低三分位数(优势比1.26,95%置信区间1.03 - 1.54)。总之,在日本人群的生理皮质醇范围内,较高的血清皮质醇水平与胰岛素分泌减少显著相关。
J Clin Endocrinol Metab. 2002-10
Curr Cardiol Rev. 2025
Diabetol Metab Syndr. 2024-11-29
Front Endocrinol (Lausanne). 2023
Int J Mol Sci. 2023-5-10
Lancet Diabetes Endocrinol. 2016-5-10
Pituitary. 2015-4
Horm Mol Biol Clin Investig. 2014-8
J Diabetes Investig. 2010-10-19
Curr Hypertens Rep. 2014-7