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Diurnal Cortisol Patterns, Future Diabetes, and Impaired Glucose Metabolism in the Whitehall II Cohort Study

Hackett, Ruth A and Kivimäki, Mika and Kumari, Meena and Steptoe, Andrew (2016) 'Diurnal Cortisol Patterns, Future Diabetes, and Impaired Glucose Metabolism in the Whitehall II Cohort Study.' The Journal of Clinical Endocrinology & Metabolism, 101 (2). pp. 619-625. ISSN 0021-972X

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Abstract

Context: The hypothalamic pituitary-adrenal axis is thought to play a role in type 2 diabetes (T2D). However, evidence for an association between cortisol and future glucose disturbance is sparse. Objective: The aim was to examine the association of diurnal cortisol secretion with future T2D and impaired glucose metabolism in a community-dwelling population. Design: This is a prospective cohort study of salivary cortisol measured at the 2002-2004 clinical examination of the Whitehall II study, United Kingdom. We measured cortisol (nmol/l) from six saliva samples obtained over the course of a day: at waking, 30 minutes, 2.5 hours, 8 hours, 12 hours, and bedtime. Participants who were normoglycemic in 2002-2004 (phase 7) were reexamined in 2012-2013 (phase 11). Setting: The occupational cohort was originally recruited in 1985-1988. Participants: A total of 3270 men and women with an average age of 60.85 years at phase 7 (2002-2004). Outcome Measures: Incident T2D and impaired fasting glucose in 2012-2013 were measured. Results: Raised evening cortisol at phase 7 was predictive of new-onset T2D at phase 11 (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.01-1.37) with a trend for a flatter slope in participants with incident T2D (odds ratio, 1.15; 95% CI, 0.99-1.33). When expanDing this analysis to a broader category of glucose disturbance we found that a flattened diurnal cortisol slope at phase 7 was predictive of future impaired fasting glucose or T2D at phase 11 (OR, 1.12; 95% CI, 1.02-1.22), as was high bedtime cortisol (OR, 1.10; 95% CI, 1.01-1.20). Conclusions: In this nonclinical population, alterations in diurnal cortisol patterns were predictive of future glucose disturbance.

Item Type: Article
Uncontrolled Keywords: Saliva; Humans; Diabetes Mellitus, Type 2; Hydrocortisone; Glucose; Blood Glucose; Cohort Studies; Prospective Studies; Predictive Value of Tests; Circadian Rhythm; Algorithms; Aged; Middle Aged; Female; Male; United Kingdom
Subjects: H Social Sciences > H Social Sciences (General)
R Medicine > R Medicine (General)
Divisions: Faculty of Social Sciences
Faculty of Social Sciences > Institute for Social and Economic Research
SWORD Depositor: Elements
Depositing User: Elements
Date Deposited: 20 Nov 2016 12:06
Last Modified: 11 Apr 2022 20:50
URI: http://repository.essex.ac.uk/id/eprint/18105

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