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Diabetology & Metabolic Syndrome
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Open Access 01-12-2024 | Type 2 Diabetes | Research

Stronger association between morning serum cortisol level and diurnal time in range in type 2 diabetes?

Authors: Yue Liang, Jingjing Liang, Wenwen Jiang, Wei Wang, Xinyi Yang, Yanyu Liu, Xuguang Jin, Qingyu Guo, Yixin Xu, Bin Lu, Ping Gu, Jiaqing Shao

Published in: Diabetology & Metabolic Syndrome | Issue 1/2024

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Abstract

Background

The hypothalamic-pituitary-adrenal axis is thought to play a vital role in glucose homeostasis and diabetes. This study investigated the association between morning serum cortisol and time in range (TIR), including daytime TIR, in type 2 diabetes (T2DM).

Methods

310 patients with T2DM had serum cortisol measured at 8 a.m. All participants underwent continuous glucose monitoring (CGM) for three consecutive days, then TIR and glycemic variability (GV) parameters were evaluated. Using 100 g standard steamed bread meal test, blood glucose, C peptide and insulin at different points were collected to assess insulin sensitivity and islet function.

Results

Patients with higher serum cortisol exhibited lower TIR and TITR (P < 0.001). Spearman correlation analysis showed that the negative correlation between cortisol and daytime TIR (r=-0.231, P < 0.001) was stronger than that of overnight TIR (r=-0.134, P = 0.028). Similarly, there existed a negative correlation between cortisol and pancreatic function indicators such as HOMA-β, insulinogenic index (IGI), area under the curve of C-peptide within half an hour (AUCCp0.5 h) and three hours (AUCCp3h) (r=-0.248, -0.176, -0.140, -0.185, respectively, P < 0.05). In contrast, cortisol was positively associated with TAR (r = 0.217, P < 0.001) and GV parameters including MBG, MAGE, LAGE, HBGI, MODD, ADDR (P of MAGE and MODD > 0.05). Multiple stepwise regression revealed that cortisol was an independent contributor of TIR, TITR and diurnal TIR, with diurnal TIR of stronger relevance.

Conclusions

Morning serum cortisol is negatively correlated with TIR, especially diurnal TIR and positively associated with GV parameters. Inappropriate cortisol secretion may have an adverse influence on glucose homeostasis in T2DM.
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Metadata
Title
Stronger association between morning serum cortisol level and diurnal time in range in type 2 diabetes?
Authors
Yue Liang
Jingjing Liang
Wenwen Jiang
Wei Wang
Xinyi Yang
Yanyu Liu
Xuguang Jin
Qingyu Guo
Yixin Xu
Bin Lu
Ping Gu
Jiaqing Shao
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Diabetology & Metabolic Syndrome / Issue 1/2024
Electronic ISSN: 1758-5996
DOI
https://doi.org/10.1186/s13098-024-01515-5

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