The association of cortisol curve features with incident diabetes among whites and African Americans: The CARDIA study

PSYCHONEUROENDOCRINOLOGY

卷:123

Article

Kluwe, Bjorn¹  Ortiz, Robin²  Odei, James B.³  Zhao, Songzhu¹  Kline, David¹  Brock, Guy¹  Echouffo-Tcheugui, Justin B.⁴  Lee, Ju-Mi⁵  Lazarus, Sophie⁶  Seeman, Teresa⁷  Greenland, Philip⁸  Needham, Belinda⁹  Carnethon, Mercedes R.⁸  Golden, Sherita H.⁴  Joseph, Joshua J.¹ 

[1] Ohio State Univ, Coll Med, 566 McCampbell Hall,1581 Dodd Dr, Columbus, OH 43210 USA

[2] Univ Penn, Dept Internal Med & Pediat, Philadelphia, PA 19104 USA

[3] Ohio State Univ, Coll Publ Hlth, Div Biostat, Columbus, OH 43210 USA

[4] Johns Hopkins Univ, Sch Med, Div Endocrinol Diabet & Metab, Baltimore, MD USA

[5] Eulji Univ, Coll Med, Dept Preventat Med, Daejeon, South Korea

[6] Ohio State Univ, Coll Med, Dept Psychiat & Behav Hlth, Columbus, OH 43210 USA

[7] Univ Calif Los Angeles, David Geffen Sch Med, Div Geriatr, Los Angeles, CA 90095 USA

[8] Northwestern Univ, Dept Prevent Med, Chicago, IL 60611 USA

[9] Univ Michigan, Dept Epidemiol, Ann Arbor, MI 48109 USA

关键词: Cortisol;    Diabetes;    African American;    Hypothalamic-pituitary-adrenal axis;   

DOI  :  10.1016/j.psyneuen.2020.105041

来源: Elsevier

【 摘 要 】

Introduction: A flatter diurnal cortisol curve has been associated with incident diabetes among older white adults. However, this relationship has not been examined among middle-aged individuals or African Americans [AA]. We analyzed the longitudinal association of baseline diurnal cortisol curve features with incident diabetes over a 10 year period in a cohort of AA and white participants who were, on average, 40 years old. Methods: Salivary cortisol was collected immediately post-awakening, then subsequently 45 min, 2.5 h, 8 h, and 12 h later, as well as at bedtime. Cortisol curve features included wake-up cortisol; cortisol awakening response (CAR); early, late, and overall decline slopes; bedtime cortisol; and 16-h area under the curve (AUC). Salivary cortisol (nmol/L) was log-transformed due to positively skewed distributions. Diabetes was defined as fasting plasma glucose >= 126 mg/dL or taking diabetes medication. Logistic regression models were used to investigate the association of log-transformed cortisol curve features with incident diabetes. The analysis was stratified by race and adjusted for age, sex, education, depressive symptoms, smoking status, beta-blocker and steroid medication use and BMI. Results: Among 376 AA and 333 white participants (mean age 40 years), 67 incident diabetes cases occurred over 10 years. After full adjustment for additional covariates, a 1-unit log increase in CAR was associated with a 53 % lower odds of incident diabetes among whites (Odds Ratio [OR] 0.47, 95 % CI: 0.24, 0.90). A 1-SD increase in late decline slope was associated with a 416 % higher odds of incident diabetes among whites (OR 5.16, 95 % CI: 1.32, 20.20). There were no significant associations in AAs. Conclusion: A robust CAR and flatter late decline slope are associated with lower and higher odds of incident diabetes, respectively, among younger to middle-aged whites and may provide a future target for diabetes prevention in this population.

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