Elevated fasting plasma cortisol is associated with ischemic heart disease and its risk factors in people with type 2 diabetes

Rebecca M Reynolds, Javier Labad, Mark W J Strachan, Anke Braun, F Gerry R Fowkes, Amanda Jane Lee, Brian M Frier, Jonathan R Seckl, Brian R Walker, Jackie F Price, Edinburgh Type 2 Diabetes Study (ET2DS) Investigators

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

CONTEXT: Increased activity of the hypothalamic-pituitary-adrenal (HPA) axis may underlie the metabolic syndrome, but whether circulating cortisol levels predict cardiovascular end points is less clear. People with type 2 diabetes are at increased cardiovascular disease risk and thus are suitable to study associations of plasma cortisol with cardiovascular risk. OBJECTIVE: We aimed to assess whether altered HPA axis activity was associated with features of the metabolic syndrome and ischemic heart disease in people with type 2 diabetes. DESIGN AND SETTING: We conducted a cross-sectional cohort study in the general community, including 919 men and women aged 67.9 (4.2) yr with type 2 diabetes (the Edinburgh Type 2 Diabetes Study). INTERVENTION: We measured fasting morning plasma cortisol. MAIN OUTCOME MEASUREMENT: Associations between cortisol levels, features of the metabolic syndrome, obesity, and ischemic heart disease were determined. RESULTS: Elevated plasma cortisol levels were associated with raised fasting glucose and total cholesterol levels (P <0.001). These findings remained significant after adjustment for potential confounding factors (P <0.001). Elevated cortisol levels were associated with prevalent ischemic heart disease (>800 vs.
Original languageEnglish
Pages (from-to)1602-1608
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number4
DOIs
Publication statusPublished - 2010

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Medical problems
Type 2 Diabetes Mellitus
Myocardial Ischemia
Hydrocortisone
Fasting
Plasmas
Cohort Studies
Cardiovascular Diseases
Obesity
Cross-Sectional Studies
Cholesterol
Glucose

Cite this

Reynolds, R. M., Labad, J., Strachan, M. W. J., Braun, A., Fowkes, F. G. R., Lee, A. J., ... Edinburgh Type 2 Diabetes Study (ET2DS) Investigators (2010). Elevated fasting plasma cortisol is associated with ischemic heart disease and its risk factors in people with type 2 diabetes. Journal of Clinical Endocrinology and Metabolism, 95(4), 1602-1608. https://doi.org/10.1210/jc.2009-2112

Elevated fasting plasma cortisol is associated with ischemic heart disease and its risk factors in people with type 2 diabetes. / Reynolds, Rebecca M; Labad, Javier; Strachan, Mark W J; Braun, Anke; Fowkes, F Gerry R; Lee, Amanda Jane; Frier, Brian M; Seckl, Jonathan R; Walker, Brian R; Price, Jackie F; Edinburgh Type 2 Diabetes Study (ET2DS) Investigators.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 95, No. 4, 2010, p. 1602-1608.

Research output: Contribution to journalArticle

Reynolds, RM, Labad, J, Strachan, MWJ, Braun, A, Fowkes, FGR, Lee, AJ, Frier, BM, Seckl, JR, Walker, BR, Price, JF & Edinburgh Type 2 Diabetes Study (ET2DS) Investigators 2010, 'Elevated fasting plasma cortisol is associated with ischemic heart disease and its risk factors in people with type 2 diabetes', Journal of Clinical Endocrinology and Metabolism, vol. 95, no. 4, pp. 1602-1608. https://doi.org/10.1210/jc.2009-2112
Reynolds, Rebecca M ; Labad, Javier ; Strachan, Mark W J ; Braun, Anke ; Fowkes, F Gerry R ; Lee, Amanda Jane ; Frier, Brian M ; Seckl, Jonathan R ; Walker, Brian R ; Price, Jackie F ; Edinburgh Type 2 Diabetes Study (ET2DS) Investigators. / Elevated fasting plasma cortisol is associated with ischemic heart disease and its risk factors in people with type 2 diabetes. In: Journal of Clinical Endocrinology and Metabolism. 2010 ; Vol. 95, No. 4. pp. 1602-1608.
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AU - Reynolds, Rebecca M

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AU - Strachan, Mark W J

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AU - Fowkes, F Gerry R

AU - Lee, Amanda Jane

AU - Frier, Brian M

AU - Seckl, Jonathan R

AU - Walker, Brian R

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AU - Edinburgh Type 2 Diabetes Study (ET2DS) Investigators

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N2 - CONTEXT: Increased activity of the hypothalamic-pituitary-adrenal (HPA) axis may underlie the metabolic syndrome, but whether circulating cortisol levels predict cardiovascular end points is less clear. People with type 2 diabetes are at increased cardiovascular disease risk and thus are suitable to study associations of plasma cortisol with cardiovascular risk. OBJECTIVE: We aimed to assess whether altered HPA axis activity was associated with features of the metabolic syndrome and ischemic heart disease in people with type 2 diabetes. DESIGN AND SETTING: We conducted a cross-sectional cohort study in the general community, including 919 men and women aged 67.9 (4.2) yr with type 2 diabetes (the Edinburgh Type 2 Diabetes Study). INTERVENTION: We measured fasting morning plasma cortisol. MAIN OUTCOME MEASUREMENT: Associations between cortisol levels, features of the metabolic syndrome, obesity, and ischemic heart disease were determined. RESULTS: Elevated plasma cortisol levels were associated with raised fasting glucose and total cholesterol levels (P <0.001). These findings remained significant after adjustment for potential confounding factors (P <0.001). Elevated cortisol levels were associated with prevalent ischemic heart disease (>800 vs.

AB - CONTEXT: Increased activity of the hypothalamic-pituitary-adrenal (HPA) axis may underlie the metabolic syndrome, but whether circulating cortisol levels predict cardiovascular end points is less clear. People with type 2 diabetes are at increased cardiovascular disease risk and thus are suitable to study associations of plasma cortisol with cardiovascular risk. OBJECTIVE: We aimed to assess whether altered HPA axis activity was associated with features of the metabolic syndrome and ischemic heart disease in people with type 2 diabetes. DESIGN AND SETTING: We conducted a cross-sectional cohort study in the general community, including 919 men and women aged 67.9 (4.2) yr with type 2 diabetes (the Edinburgh Type 2 Diabetes Study). INTERVENTION: We measured fasting morning plasma cortisol. MAIN OUTCOME MEASUREMENT: Associations between cortisol levels, features of the metabolic syndrome, obesity, and ischemic heart disease were determined. RESULTS: Elevated plasma cortisol levels were associated with raised fasting glucose and total cholesterol levels (P <0.001). These findings remained significant after adjustment for potential confounding factors (P <0.001). Elevated cortisol levels were associated with prevalent ischemic heart disease (>800 vs.

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