Int J Med Sci 2020; 17(18):2998-3004. doi:10.7150/ijms.48742 This issue

Research Paper

The Association Of Serum Cortisol Level With Microalbuminuria In Patients With Type 2 Diabetes And Prediabetes

Xiaodan Zhang1, Xiaoyi Deng1, Jianlong Zhou2, Kangshou Qiu2, Mingye Deng2, Zhuohang Lin2, Singla Sethiel Mosha1, Wangen Li1✉

1. Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, 250 East Changgang Road, Haizhu District, Guangzhou, China
2. The Second Clinical Medicine School, Guangzhou Medical University, Guangzhou, China

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Citation:
Zhang X, Deng X, Zhou J, Qiu K, Deng M, Lin Z, Mosha SS, Li W. The Association Of Serum Cortisol Level With Microalbuminuria In Patients With Type 2 Diabetes And Prediabetes. Int J Med Sci 2020; 17(18):2998-3004. doi:10.7150/ijms.48742. Available from https://www.medsci.org/v17p2998.htm

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Abstract

Whether cortisol secretion is linked with microalbuminuria remains undefined. We aimed to investigate the relationship between serum cortisol levels and the presence of microalbuminuria in patients with type 2 diabetes (T2DM) and prediabetes. A cross-sectional study was conducted with 211 patients with T2DM or prediabetes. Serum cortisol was measured at 8:00 h, 16:00 h, and 0:00 h. The level and circadian rhythm of ACTH were also evaluated. Urine excretion of albumin was measured. Patients were subdivided into microalbuminuria (MAU) group (n= 120) and normoalbuminuria (NAU) group (n = 91) according to the status of microalbuminuria. Levels of serum cortisol (8:00 h: 426.9 ± 155.0 nmol/; 16:00 h: 303.7 ± 144.7 nmol/L) were significantly higher in MAU group than in NAU group (8:00 h: 370.2 ±130.6 nmol/L, P = 0.004; 16:00 h: 234.7 ± 120.2 nmol/L, P = 0.001). After adjustment for multiple factors, the correlation between cortisol levels (both at 8:00 h (P = 0.005) and at 16:00 h (P = 0.001)) and microalbuminuria remained consistent and significant. Higher levels of cortisol (cut-off value: 390.5 nmol/L at 8:00 h, 203.5 nmol/L at 16:00 h) help to detect the development of microalbuminuria. Serum cortisol secretion is associated with the presence of microalbuminuria in patients with T2DM and patients with prediabetes. Higher levels of cortisol, even in the normal range, may be related with the development of microalbuminuria.

Keywords: Hydrocortisone, Diabetes Mellitus, Type 2, Prediabetic State, Diabetic Nephropathies