Journal article
Diurnal salivary cortisol, glycemia and insulin resistance: The multi-ethnic study of atherosclerosis
Psychoneuroendocrinology, v 62, pp 327-335
01 Dec 2015
PMCID: PMC4637243
PMID: 26356041
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Hypercortisolism is associated with insulin resistance (IR) and diabetes mellitus (DM); however, to our knowledge prior studies have not examined the association of diurnal cortisol curve features with measures of glycemia or IR in a population-based setting. Using log-transformed salivary cortisol data on 850 ethnically diverse men and women from the Multi-Ethnic Study of Atherosclerosis, we investigated the cross-sectional association of cortisol curve features with (1) glycemia in those with and without DM and (2) IR, in non-diabetic subjects. The log-transformed salivary cortisol curve features included wake-up cortisol, cortisol awakening response (CAR), early decline slope (30 min to 2 h post-awakening), late decline slope (2 h post-awakening to bedtime), overall decline slope (0 min to bedtime, excluding 30 min cortisol), bedtime cortisol and total area under the curve (AUC). Overall, following multivariable adjustment, among those with diabetes mellitus (DM), early decline slope, overall decline slope, bedtime cortisol, and AUC were significantly and positively associated with a 5.4% (95% CI: 1.3, 9.7), 54.7% (95% CI: 12.4, 112.9), 4.0% (95% CI: 1.6,6.4), and 6.8% (95% CI: 3.3,10.4) higher HbA1c per 1 unit increase in log cortisol feature, respectively. Cortisol curve features were not associated with HbA1c among nondiabetic participants; however, wake-up cortisol and AUC were associated with a 8.2% lower (95% CI: -13.3,-2.7) and 7.9% lower (95% CI: -.14.6, -0.6) log HOMA-IR, respectively. This was attenuated by adjustment for waist circumference. Among participants with DM, cortisol curve parameters suggestive of higher hypothalamic-pituitary-adrenal (HPA) axis activity and dysfunction were associated with higher HbA1c. In non-diabetic participants, greater HPA activity was paradoxically associated with lower insulin resistance. (C) 2015 Elsevier Ltd. All rights reserved.
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Details
- Title
- Diurnal salivary cortisol, glycemia and insulin resistance: The multi-ethnic study of atherosclerosis
- Creators
- Joshua J. Joseph - Johns Hopkins MedicineXu Wang - Drexel UniversityElias Spanakis - University of Maryland, BaltimoreTeresa Seeman - University of California, Los AngelesGary Wand - Johns Hopkins MedicineBelinda Needham - University of Michigan–Ann ArborSherita Hill Golden - BloombergXuehang Wang - A.J. Drexel Nanomaterials Institute
- Publication Details
- Psychoneuroendocrinology, v 62, pp 327-335
- Publisher
- Elsevier
- Number of pages
- 9
- Grant note
- NO1-HC-95159; NO1-HC-95160; NO1-HC-95161; NO1-HC-95162; NO1-HC-95163; NO1-HC-95164; NO1-HC-95165; NO1- HC-95169 / National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) T32 DK062707 / National Institute of Diabetes, Digestive, and Kidney Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Nanomaterials Institute
- Web of Science ID
- WOS:000365062900036
- Scopus ID
- 2-s2.0-84947433587
- Other Identifier
- 991019173709204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Endocrinology & Metabolism
- Neurosciences
- Psychiatry