Endocrine stress responses and risk of type 2 diabetes mellitus

Abstract

This study was carried to ascertain whether stress responses are associated with abnormalities in glucose tolerance, insulin sensitivity and pancreatic beta cell function and risk of type 2 Diabetes Mellitus. Salivary cortisol, a marker of hypothalamic-pituitary-adrenal (HPA) axis and salivary α-amylase, a marker of sympathetic nervous system (SNS) were compared in 125 subjects of newly detected diabetes mellitus (NDDM) and normal glucose tolerance (NGT) subjects who were diagnosed on the basis of oral glucose tolerance test (OGTT). Assessment of stress in them was done through stress scales - presumptive stressful life events scale (PSLES), perceived stress scale (PSS) and sense of coherence (SOC) and correlated with these and other stress response markers. Significantly higher 10 pm salivary cortisol and post dexamethasone salivary cortisol were found in NDDM subjects as compared to NGT. 10 pm salivary cortisol correlated significantly with fasting plasma glucose (FPG), 2 h plasma glucose (2h PG) and glycated hemoglobin (HbA1c) while post dex salivary cortisol correlated with 2h PG, HbA1c and salivary α-amylase with 2h PG. Stepwise logistic regression analysis showed that body mass index (OR: 1.840), SOC (OR: 0.688) and 10 pm salivary cortisol (OR: 1.427) were the strongest predictors of NDDM. The results of the present study indicate that NDDM subjects display significantly higher chronic stress and stress responses when compared to subjects with NGT. Chronic stress and endocrine stress responses are significantly associated with glucose intolerance, insulin resistance and diabetes mellitus.

HPA-axis and inflammatory reactivity to acute stress is related with basal HPA-axis activity

“…These interpersonal differences in stress reactivity are relatively stable and their health implications were investigated by several studies (Cohen and Hamrick, 2003). Alterations in HPA axis stress reactivity were found to be related with certain diseases, including atopic dermatitis (Buske-Kirschbaum et al, 2002), depression (Burke et al, 2005), diabetes mellitus (Siddiqui et al, 2015), incident hypertension (Hamer and Steptoe, 2012), and childhood cancer (Laufer et al, 2012). Individual differences in habituation to stress are also important in terms of health, with participants showing lesser HPA axis habituation reporting lower self-esteem, more physical symptoms (Kirschbaum et al, 1995), and greater vital exhaustion (Kudielka et al, 2006).…”

Emerging Cardiovascular Risk Research: Impact of Pets on Cardiovascular Risk Prevention

“…Cortisol has large diurnal variation and may be associated with longer latency between the stressor and its response [28]. Elevated cortisol has been associated with risk of glucose intolerance, insulin resistance and type 2 diabetes [29] as well as endothelial damage, visceral fat accumulation, and impaired lipid metabolism in individuals with subclinical hypercortisolism [30]. As a measure, salivary cortisol has been shown to detect individual differences in activity of the HPA axis, to be reduced with positive touch, and to be increased with distinct stressors such as depression, social or economic hardship, and acute stressors such as math challenges.…”

Is Being Single a Risk Factor for Previously Undetected Abnormal Glucose Tolerance?

“…In the development of glucose metabolism disorder and ultimately diabetes, stress has been a heavily studied source of abnormal glucose tolerance (Siddiqui et al, 2015). Cortisol levels increase when the body and mind are undergoing stress, which in turn results in increased blood glucose levels.…”