title: Association between Higher Serum Cortisol Levels and Decreased Insulin Secretion in a General Population.
abstract: 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.
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Kamba
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Daimon
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Otaka
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Matsuki
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Sato
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Jutaro
authors.initials: J
authors.lastname: Tanabe
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Takayasu
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsuhashi
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Yanagimachi
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Terui
authors.affiliation: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kageyama
authors.affiliation: Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Itoyo
authors.initials: I
authors.lastname: Tokuda
authors.affiliation: Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Takahashi
authors.affiliation: Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Nakaji
mesh_terms: D000328:Adult; D001786:Blood Glucose; D004198:Disease Susceptibility; D005260:Female; D006706:Homeostasis; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062486:Public Health Surveillance; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin; D006854:Hydrocortisone