title: Relationship of non-alcoholic hepatic steatosis to cortisol secretion in diet-controlled Type 2 diabetic patients.
abstract: OBJECTIVE
  To examine the association of non-alcoholic hepatic steatosis (HS) with the activity of the hypothalamo-pituitary-adrenal (HPA) axis in Type 2 diabetic individuals.
  
  
  METHODS
  The activity of the HPA axis, as measured by 24-h urinary free cortisol (UFC) excretion and serum cortisol levels after 1.0 mg dexamethasone, was measured in 40 diet-controlled, predominantly overweight, Type 2 diabetic patients with non-alcoholic HS and in 40 diabetic patients without HS who were comparable for age, sex and body mass index (BMI).
  
  
  RESULTS
  Subjects with non-alcoholic HS had significantly higher 24-h UFC excretion (191 +/- 4 vs. 102 +/- 3 nmol/24 h; P < 0.001) and post-dexamethasone cortisol concentrations (29.1 +/- 2 vs. 14.4 +/- 1 nmol/l; P < 0.001) than those without HS. Patients with HS had significantly higher values for HOMA insulin resistance score, plasma triglycerides and liver enzymes. Age, sex, BMI, waist-hip ratio (WHR), diabetes duration, HbA1c, LDL-cholesterol and blood pressure values were not different between the groups. The differences in urinary and serum cortisol concentrations between the groups remained significant after adjustment for age, sex, BMI, WHR, HOMA insulin resistance score, plasma triglycerides, HbA1c and liver enzymes. In multiple logistic regression analyses, 24-h UFC or serum cortisol concentrations (P < 0.05 and P = 0.02, respectively), along with age and HOMA insulin resistance, predicted the presence of HS, independently of potential confounders.
  
  
  CONCLUSIONS
  These results demonstrate that non-alcoholic HS is closely associated with a subtle, chronic overactivity of the HPA axis in diet-controlled Type 2 diabetic individuals.
authors.affiliation: Department of Internal Medicine, Sacro Cuore Hospital, Negrar, Italy. targher@sacrocuore.it
authors.forename: G
authors.initials: G
authors.lastname: Targher
authors.forename: L
authors.initials: L
authors.lastname: Bertolini
authors.forename: G
authors.initials: G
authors.lastname: Zoppini
authors.forename: L
authors.initials: L
authors.lastname: Zenari
authors.forename: G
authors.initials: G
authors.lastname: Falezza
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D003907:Dexamethasone / Q000494:pharmacology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy / Q000378:metabolism*; D005234:Fatty Liver / Q000150:complications / Q000378:metabolism*; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D005938:Glucocorticoids; D003907:Dexamethasone; D006854:Hydrocortisone