Blunted glucocorticoid and mineralocorticoid sensitivity to stress in people with diabetes

TY - JOUR

T1 - Blunted glucocorticoid and mineralocorticoid sensitivity to stress in people with diabetes

AU - Carvalho, Livia A

AU - Urbanova, Livia

AU - Hamer, Mark

AU - Hackett, Ruth A

AU - Lazzarino, Antonio I

AU - Steptoe, Andrew

N1 - Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

PY - 2015/1

Y1 - 2015/1

N2 - Psychological stress may contribute to type 2 diabetes but mechanisms are still poorly understood. In this study, we examined whether stress responsiveness is associated with glucocorticoid and mineralocorticoid sensitivity in a controlled experimental comparison of people with type 2 diabetes and non-diabetic participants. Thirty-seven diabetes patients and 37 healthy controls underwent psychophysiological stress testing. Glucocorticoid (GR) and mineralocorticoid sensitivity (MR) sensitivity were measured by dexamethasone- and prednisolone-inhibition of lipopolysaccharide (LPS)-induced interleukin (IL) 6 levels, respectively. Blood pressure (BP) and heart rate were monitored continuously, and we periodically assessed salivary cortisol, plasma IL-6 and monocyte chemotactic protein (MCP-1). Following stress, both glucocorticoid and mineralocorticoid sensitivity decreased among healthy controls, but did not change in people with diabetes. There was a main effect of group on dexamethasone (F(1,74)=6.852, p=0.013) and prednisolone (F(1,74)=7.295, p=0.010) sensitivity following stress at 45 min after tasks. People with diabetes showed blunted stress responsivity in systolic BP, diastolic BP, heart rate, IL-6, MCP-1, and impaired post-stress recovery in heart rate. People with Diabetes had higher cortisol levels as measured by the total amount excreted over the day and increased glucocorticoid sensitivity at baseline. Our study suggests that impaired stress responsivity in type-2 diabetes is in part due to a lack of stress-induced changes in mineralocorticoid and glucocorticoid sensitivity.

AB - Psychological stress may contribute to type 2 diabetes but mechanisms are still poorly understood. In this study, we examined whether stress responsiveness is associated with glucocorticoid and mineralocorticoid sensitivity in a controlled experimental comparison of people with type 2 diabetes and non-diabetic participants. Thirty-seven diabetes patients and 37 healthy controls underwent psychophysiological stress testing. Glucocorticoid (GR) and mineralocorticoid sensitivity (MR) sensitivity were measured by dexamethasone- and prednisolone-inhibition of lipopolysaccharide (LPS)-induced interleukin (IL) 6 levels, respectively. Blood pressure (BP) and heart rate were monitored continuously, and we periodically assessed salivary cortisol, plasma IL-6 and monocyte chemotactic protein (MCP-1). Following stress, both glucocorticoid and mineralocorticoid sensitivity decreased among healthy controls, but did not change in people with diabetes. There was a main effect of group on dexamethasone (F(1,74)=6.852, p=0.013) and prednisolone (F(1,74)=7.295, p=0.010) sensitivity following stress at 45 min after tasks. People with diabetes showed blunted stress responsivity in systolic BP, diastolic BP, heart rate, IL-6, MCP-1, and impaired post-stress recovery in heart rate. People with Diabetes had higher cortisol levels as measured by the total amount excreted over the day and increased glucocorticoid sensitivity at baseline. Our study suggests that impaired stress responsivity in type-2 diabetes is in part due to a lack of stress-induced changes in mineralocorticoid and glucocorticoid sensitivity.

KW - Aged

KW - Blood Pressure/drug effects

KW - Chemokine CCL2/blood

KW - Dexamethasone/pharmacology

KW - Diabetes Mellitus, Type 2/blood

KW - Female

KW - Glucocorticoids/pharmacology

KW - Heart Rate/drug effects

KW - Humans

KW - Hydrocortisone/analysis

KW - Hypothalamo-Hypophyseal System/drug effects

KW - Interleukin-6/blood

KW - Male

KW - Middle Aged

KW - Pituitary-Adrenal System/drug effects

KW - Prednisolone/pharmacology

KW - Saliva/chemistry

KW - Stress, Psychological/blood

U2 - 10.1016/j.psyneuen.2014.09.023

DO - 10.1016/j.psyneuen.2014.09.023

M3 - Article

C2 - 25462894

SN - 0306-4530

VL - 51

SP - 209

EP - 218

JO - Psychoneuroendocrinology

JF - Psychoneuroendocrinology

ER -