Diabetes & Metabolism Journal

Original Article

The Association between Midnight Salivary Cortisol and Metabolic Syndrome in Korean Adults: Yun-Mi Jang, Eun Jung Lee, Dong Lim Kim, Suk Kyeong Kim, Kee-Ho Song; Diabetes Metab J. 2012;36(3):245-250. Published online June 14, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.3.245

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Background

The common characteristics of metabolic syndrome (MetS) and Cushing's syndrome suggest that excess cortisol may be involved in the pathogenesis of MetS. Salivary cortisol measurements are simple and can be surrogates for plasma free cortisol, which is the most biologically active form. We evaluated the association between levels of midnight salivary cortisol and MetS in Korean adults.

Methods

A total of 46 subjects, aged 20 to 70 years, who visited the Health Care Center at Konkuk University Hospital from August 2008 to August 2009 were enrolled. We compared the levels of midnight salivary cortisol in subjects with MetS with those in subjects without MetS. We analyzed the associations between midnight salivary cortisol levels and components of MetS.

Results

Midnight salivary cortisol levels were higher in the MetS group (70±42.4 ng/dL, n=12) than that in the group without MetS (48.1±36.8 ng/dL, n=34) (P=0.001). Positive correlations were observed between midnight salivary cortisol levels and waist circumference, fasting blood glucose, and homeostasis model assessment of insulin resistance. The risk for MetS was significantly higher in subjects with midnight salivary cortisol levels ≥100 ng/dL than in those with levels <50 ng/dL (odds ratio, 5.9; 95% confidence interval, 2.35 to 36.4).

Conclusion

The results showed a positive correlation between midnight salivary cortisol levels and MetS, suggesting that hypercortisolism may be related to MetS.

Citations

Citations to this article as recorded by

Evaluation of salivary endothelin-1 as a biomarker for oral cancer and precancer
Sumaiya Irfan, Noorin Zaidi, Kshama Tiwari, Nirupma Lal, Anand Narayan Srivastava, Shivangi Singh
Journal of Cancer Research and Therapeutics.2023;[Epub] CrossRef
Association of primary allostatic load mediators and metabolic syndrome (MetS): A systematic review
Francis Osei, Andrea Block, Pia-Maria Wippert
Frontiers in Endocrinology.2022;[Epub] CrossRef
Salivary cortisol levels during Ramadan fasting in hydrocortisone-treated secondary adrenal insufficiency patients
Melika Chihaoui, Wiem Madhi, Meriem Yazidi, Bessem Hammami, Ibtissem Oueslati, Nadia Khessairi, Wafa Grira, Amina Bibi, Moncef Feki, Fatma Chaker
Endocrine.2020; 70(2): 404. CrossRef
Basal cortisol levels and metabolic syndrome: A systematic review and meta-analysis of observational studies
Anderson Garcez, Heloísa Marquardt Leite, Elisabete Weiderpass, Vera Maria Vieira Paniz, Guilherme Watte, Raquel Canuto, Maria Teresa Anselmo Olinto
Psychoneuroendocrinology.2018; 95: 50. CrossRef
Is salivary gland function altered in noninsulin-dependent diabetes mellitus and obesity–insulin resistance?
Jitjiroj Ittichaicharoen, Nipon Chattipakorn, Siriporn C. Chattipakorn
Archives of Oral Biology.2016; 64: 61. CrossRef
The Role of Cortisol in the Pathogenesis of the Metabolic Syndrome
In-Kyung Jeong
Diabetes & Metabolism Journal.2012; 36(3): 207. CrossRef

Letter

Letter: Effects of Aerobic Exercise Intensity on Insulin Resistance in Patients with Type 2 Diabetes Mellitus (Korean Diabetes J 33(5):401-411, 2009).: Dong Lim Kim; Korean Diabetes J. 2009;33(6):547-548. Published online December 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.6.547

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Abstract PDF: No abstract available.

Case Report

Hypoglycemia due to Focal Nesidioblastosis in a Patient with Type 2 Diabetes Mellitus.: Eun Jung Lee, Kee Ho Song, Suk Kyeong Kim, Seong Hwan Chang, Dong Lim Kim; Korean Diabetes J. 2009;33(3):251-256. Published online June 1, 2009; DOI: https://doi.org/10.4093/kdj.2009.33.3.251

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Abstract PDF: We report a 45-year-old man with type 2 diabetes who presented with recurrent hypoglycemia. Biochemical and imagingstudies did not show any mass-like lesion in the pancreas, so prednisolone and diazoxide were administered for the treatment of hypoglycemia. However, the hypoglycemia persisted during and after the medical treatment. A selective arterial calcium stimulation test was performed and revealed a suspicious lesion at the head of the pancreas. The patient underwent enucleation of the pancreas head lesion. The lesion was confirmed histologically to be focal nesidioblastosis and surgical resection was successfully performed. The patient showed no hypoglycemic symptoms postoperatively.

Letter

The Effect of Rosiglitazone and Metformin Therapy, as an Initial Therapy, in Patients with Type 2 Diabetes Mellitus.: Dong Lim Kim; Korean Diabetes J. 2008;32(6):532-533. Published online December 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.6.532

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Abstract PDF: No abstract available.

Case Report

A Case of Ketosis-Prone Type 2 Diabetes Mellitus.: Dong Lim Kim, Suk Kyeong Kim, Kee Ho Song; Korean Diabetes J. 2007;31(3):293-296. Published online May 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.3.293

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Abstract PDF

Ketosis-prone type 2 diabetes (KPD) has been characterized as diabetes with severe insulin deficiency at diagnosis associated with ketosis or ketoacidosis without a precipitating cause. Improvement in beta-cell function and insulin sensitivity by aggressive diabetic management could allow discontinuation of insulin therapy within a few month of therapy. These subjects are usually obese, have a strong family history of diabetes, absence of beta-cell autoimmune markers and lack of human leukocyte antigen genetic association. This clinical presentation has been reported primarily in African and African Americans, but rare in Asian and white person. We recently experienced a case of KPD in Korea and present it with literature review.

Citations

Citations to this article as recorded by

A Case of Autoantibody-Positive Ketosis-Prone Diabetes Mellitus
Bora Yoon, Gyuri Kim, Jae Hyun Bae, Yu Jung Yun, Yong Ho Lee, Byung Wan Lee, Chul Woo Ahn, Bong Soo Cha, Hyun Chul Lee, Eun Seok Kang
The Journal of Korean Diabetes.2016; 17(1): 60. CrossRef

Original Articles

Effects of Lovastatin on Free Fatty Acid Oxidation in Cultured L6 Rat Skeletal Muscle Cells.: Dong Lim Kim, Kee Ho Song, Hae Rim Kim, Suk Kyeong Kim; Korean Diabetes J. 2007;31(3):230-235. Published online May 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.3.230

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Abstract PDF

BACKGROUND
Recent clinical studies suggest that statins improve insulin resistance and glucose metabolism in patients with metabolic syndrome and type 2 diabetes. To evaluate the possible mechanism of this action, we measured free fatty acid oxidation in cultured L6 rat skeletal muscle cell line. METHODS: Cultured L6 myotubes were treated with or without lovastatin (1, 5, 20 micrometer) for 24 hours or 48 hours and palmitate oxidation was measured. We also measured protein concentration of the cells. RESULTS: Lovastain increased palmitate oxidation in dose and time dependent manner in L6 myotubes (24 hr; 1 micrometer 119.2 +/- 11.9% of control, 5 micrometer 140.9 +/- 8.1%, 20 micrometer 150 +/- 5%, P = 0.05 vs control, respectively, 48 hr 1 micrometer 120.9 +/- 14.5%, 5 micrometer 176.6 +/- 28.2%, 20 micrometer 196.0 +/- 19.9%, P < 0.01 vs control, respectively). However, lovastatin decreased total cellular protein (24 hr: 1 micrometer 89.2 +/- 6.1% of control, 5 micrometer 79.3 +/- 7.6%, 20 micrometer 65.4 +/- 4.2%, P = 0.05 vs control, respectively, 48 hr: 1 micrometer 81.7 +/- 5.1%, 5 micrometer 58.6 +/- 11.9%, 20 micrometer 48.1 +/- 6.9%, P < 0.01 vs control, respectively). CONCLUSION: Lovastatin increased skeletal muscle free fatty acid oxidation in L6 rat skeletal muscle cells. This would be one of the mechanisms which lovastatin improves insulin resistance.

Citations

Citations to this article as recorded by

Characterization and Mechanisms of Action of Avocado Extract Enriched in Mannoheptulose as a Candidate Calorie Restriction Mimetic
Donald K. Ingram, Paul J. Pistell, Zhong Q. Wang, Yongmei Yu, Stefan Massimino, Gary M. Davenport, Michael Hayek, George S. Roth
Journal of Agricultural and Food Chemistry.2021; 69(26): 7367. CrossRef

Effects of Troglitazone on the Expression of VEGF and TGF-beta in Cultured Rat Mesangial Cells.: Dong Lim Kim, Nan Hee Kim, Dong Seop Choi; Korean Diabetes J. 2007;31(3):220-229. Published online May 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.3.220

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Abstract PDF: BACKGROUND
Clinical study reported that troglitazone ameliorated microalbuminuria in diabetic nephropathy. However, the mechanism of action is not fully understood. Vascular endothelial growth factor (VEGF) is known as vascular permeability factor and it is considered the most likely cause of glomerular hyperfiltration and proteinuria in diabetic nephropathy. Transforming growth factor-beta (TGF-beta) is a potent inducer of extracellular matrix production and fibrosis in renal cells and one of the important cytokine in the pathogenesis of diabetic nephropathy. To determine whether troglitazone affects VEGF and TGF-beta production in diabetic nephropathy, we examined the effects of troglitazone on the VEGF and TGF-beta expression in cultured rat mesangial cells exposed to high glucose concentration. METHODS: Rat mesangial cells were cultured in media with D-glucose 5.5 mM (NG) or D-glucose 30 mM (HG), or D-glucose 30 mM/troglitazone 20 micrometer(HTz) and for 6, 24, or 72 hours, respectively. VEGF and TGF-beta expression were assessed by semiquantitative RT-PCR and western blot analysis. RESULTS: Troglitazone decreased the VEGF164 and VEGF120 mRNA expressions in cultured rat mesangial cells exposed to high glucose concentration with incubation for 24 and 72 hours, respectively. VEGF protein was also decreased in experimental group treated with troglitazone (HTz) than in those with HG for 24 and 72 hours. However troglitazone had no effect on the expression of TGF-beta mRNA in mesangial cells. CONCLUSION: This study suggested that troglitazone may modulate the development and progression of diabetic nephropathy by reducing the expression of VEGF in mesangial cells

Detection of Diabetic Autonomic Neuropathy by 24-Hour Heart Rate Variability Analysis in Type 2 Diabetes Mellitus Patients.: Young Hee Rho, Nan Hee Kim, Dong Lim Kim, Dong Hyun Shin, Sin Gon Kim, Kyung Mook Choi, Woo Hyuk Song, Sei Hyun Baik, Woo Keun Seo, Min Kyu Park, Dong Seop Choi; Korean Diabetes J. 2002;26(3):208-219. Published online June 1, 2002

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Abstract PDF: BACKGROUND
Diabetic autonomic neuropathy is a relatively common diabetic complication, associated with high long-term mortality. Ewing's test is known as the 'gold standard' for evaluating and diagnosing this disease, yet is not widely used due to the inconvenient procedures of the test. 24-hour Holter EKG monitoring, and the analytical product, heart rate variability, is being introduced as a relatively simple and reliable procedure for the evaluation of diabetic autonomic neuropathy. We explored whether such heart rate variability products derived from Holter monitoring, correlated with the presence, absence, or severity of diabetes mellitus, and whether it correlated well with conventional autonomic tests. METHODS: We compared 59 type 2 diabetic patients with 71 normal subjects. All underwent 24-hr Holter EKG monitoring and basic autonomic evaluations, such as the head-up tilting, hand grip, and deep breathing-heart rate variability tests. Those who had diabetes also underwent evaluation for basic blood chemistry, and complication studies, for things such as: 24-hour urine albumin excretion, fundoscopy and nerve conduction. RESULTS: Variables for heart rate variability were expressed as SDDN, rMSSD, LF, HF, and LF/HF, where SDDN is the Standard Deviation of all RR intervals, rMSSD the square root of the mean of the sum of the squares of differences between adjacent RR intervals, LF the power in the Low Frequency range and HF the power in the High Frequency range, with LF/HF being the ratio between LF and HF. Heart rate variability was significantly lower in terms of rMSSD, LF, HF, but not in terms of the LF/HF ratio, for the diabetic patients compared to the normal subjects. These three variables also correlated with the conventional autonomic tests of systolic blood pressure changes during standing up (negatively), and heart rate variability during deep breathing (positively). SDDN, rMSSD, LF, and HF also correlated negatively with the duration of diabetes. SDDN, LF and HF were significantly lower among patients who had complications such as: retinopathy, nephropathy or peripheral neuropathy, than in those who did not. CONCLUSION: Heart rate variability was lower in type 2 diabetic patients than the control subjects, which correlated well with the duration of diabetes mellitus, diabetic chronic complications and the conventional autonomic nervous function tests, so could be an useful adjunct or even a replacement, for conventional autonomic nervous system testing procedures. More research is needed in this field.

Plasma Leptin Concentration, Obesity, and Insulin Resistance in Healthy Korean Population.: Dong Lim Kim, Nan Hee Kim, Dong Hyun Shin, Sin Gon Kim, Kyung Mook Choi, Jin Kwan Kim, Chol Shin, Seung Gwan Lee, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 2002;26(2):100-111. Published online April 1, 2002

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Abstract PDF: BACKGROUND
Leptin is a hormone that regulates food intake and body weight. It has been demonstrated that the plasma leptin levels correlates with body adiposity. Increased adiposity is accompanied by a low insulin sensitivity, which turns into insulin resistance. Recent studies suggest a complex interrelationship between leptin and insulin or insulin resistance. Therefore, the relationship between leptin and the variables of body adiposity, and insulin resistance in a non-diabetic population was examined. METHODS: 555 healthy non-diabetic people aged 20 to 80 were enrolled in this study. Leptin was measured by the mean radioimmunoassay. Multiple logistic regression analysis was performed with leptin as a dependent variable and with age, sex, BP, the lipid profile, the fasting plasma glucose levels, HOMA-IR and the trunk fat contents as independent variables. RESULTS: The plasma leptin concentrations were higher in women than in men. The leptin concentrations correlated with the body fat content, BMI and HOMA-IR but, less so with age, the fasting plasma glucose levels, the postprandial glucose levels, total cholesterol and LDL-cholesterol levels. After adjusting for the body mass index, the leptin levels significantly correlated with both the body fat content and the HOMA-IR. The results between males and females were similar when the data was analyzed after dividing by gender. Gender, the trunk fat content, HOMA-IR, and the total cholesterol and HDL cholesterol levels were independent variables which influences the log transformed leptin in multiple logistic regression analysis. When the subjects were grouped according to the number of insulin resistance syndrome including dyslipidemia, obesity, hypertension, and glucose intolerance, there was a linear increase in the leptin concentration with an increase in the number of the components of insulin resistance syndrome. CONCLUSION: The plasma leptin concentrations are related to adiposity, insulin resistance, and dyslipidemia in the non-diabetic Korean population. The relationship between leptin and insulin resistance independent of body fat suggests that insulin resistance might play some role in the development of hyperleptinemia and vice versa

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