Hypothalamic-Pituitary-Adrenal (HPA) axis

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Increased adrenocortical secretion of hormones, primarily cortisol in depression, is one of the most consistent findings in neuropsychiatry. The maintenance of the internal homeostatic state of an individual is facilitated by the ability to circulate glucocorticoids to exert negative feedback on the secretion of hypothalamic-pituitary-adrenal (HPA) hormones through binding to mineralocorticoid (MR) and glucocorticoid (GR) receptors, thus limiting the vulnerability to diseases related to psychological stress in genetically predisposed individuals. The HPA axis response to stress can be thought of as a crucial part of the organism's response to stress: acute responses are generally adaptive, but excessive or prolonged responses can lead to deleterious effects. A spectrum of conditions may be associated with increased and prolonged activation of the HPA axis, including depression, poorly controlled diabetes mellitus, and metabolic syndrome. HPA axis dysregulation and hypercortisolemia may further contribute to a hyperglycaemic or poorly controlled diabetic state.
Original languageEnglish
Title of host publicationDepression and Type 2 Diabetes
EditorsKhalida Ismail, Andreas Barthel, Stefan R. Bornstein, Julio Licinio
Number of pages14
Publication statusPublished - 6 Sept 2018


  • hypothalamic–pituitary–adrenal (HPA) axis, cortisol, mineralocorticoid (MR) receptors, glucocorticoid (GR) receptors, depression, diabetes


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