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Association of diurnal patterns in salivary cortisol with type 2 diabetes in the Whitehall II study

Hackett, RA; Steptoe, A; Kumari, M; (2014) Association of diurnal patterns in salivary cortisol with type 2 diabetes in the Whitehall II study. J Clin Endocrinol Metab , Article jc20142459. 10.1210/jc.2014-2459. Green open access

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Abstract

Context: The hypothalamic pituitary-adrenal (HPA) axis is thought to play a role in Type 2 Diabetes (T2D). However, the evidence for an association between diurnal cortisol patterns and T2D is equivocal. Objective: The aim was to examine the association of cortisol patterns throughout the day with T2D status in a community-dwelling population. Design: This was a cross-sectional study of T2D status and salivary cortisol from phase 7 (2002-2004) of the Whitehall II study, United Kingdom. Setting: The occupational cohort was originally recruited in 1985-1988. Participants: 3508 white men and women including 238 participants with T2D aged 50-74 years with complete information on cortisol secretion. Outcome Measures: We measured diurnal cortisol (nmol/l) patterns from six saliva samples obtained over the course of a normal day: at waking, +30 min, +2.5 h, +8 h, +12 h, and bedtime. The cortisol awakening response and slope in diurnal secretion were calculated. Results: T2D status was associated with a flatter slope in cortisol decline across the day (B = 0.004, C.I. = 0.001 to 0.007, p = 0.014) and greater bedtime cortisol (B = 0.063, C.I. = 0.010 to 0.117, p =0.020) independent of a wide range of covariates measured at the time of cortisol assessment. There was no association between morning cortisol, the cortisol awakening response and T2D (p > 0.05). Conclusions: In this non-clinical population, T2D was associated with a flatter slope in cortisol levels across the day and raised bedtime cortisol values.

Type: Article
Title: Association of diurnal patterns in salivary cortisol with type 2 diabetes in the Whitehall II study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1210/jc.2014-2459
Publisher version: http://dx.doi.org/10.1210/jc.2014-2459
Language: English
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1448489
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