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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
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  • 23 Download
  • 6 Crossref
AbstractAbstract PDFPubReader   

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.


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.


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).


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


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
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
  • 2,194 View
  • 17 Download
AbstractAbstract 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.
Original Articles
Association between Genetic Polymorphisms in Hepatocyte Nuclear Factor 4alpha and Type 2 Diabetes in Koreans.
Eun Jung Lee, Soo Heon Kwak, Sun Wook Jo, Hyung Jin Choi, Hyoung Doo Shin, Min Kyong Moon, Young Min Cho, Hak Chul Jang, Kyong Soo Park, Houng Kyu Lee
Korean Diabetes J. 2006;30(1):10-16.   Published online January 1, 2006
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  • 18 Download
AbstractAbstract PDF
Hepatocyte nuclear factor-4alpha (HNF-4alpha) is a member of transcription factor network which is essential for the development and function of the beta cell. Furthermore mutations in the HNF-4alpha gene have been known to cause maturity-onset diabetes of the young. Therefore we aimed to examine the association between polymorphisms in the HNF-4alpha gene and the risk of type 2 diabetes (T2DM) and its related phenotypes in the Korean population. METHODS: Two single nucleotide polymorphisms (SNPs) in the HNF-4alpha gene, g.4681C>T and HNF-4alpha g.12352C>T (Thr139Ile), were genotyped in unrelated T2DM (n=760) and non-diabetic subjects (n=303). The genetic associations between these SNPs and the risk of T2DM and metabolic phenotypes were analyzed. RESULTS: There was no significant association between genetic polymorphisms in the HNF-4alpha and the risk of T2DM. However HNF-4alpha g.4681C>T increased total cholesterol in the recessive model (P = 0.02) and showed marginal association with fasting plasma glucose (P = 0.049) in the additive model. CONCLUSION: There was no significant association between genetic polymorphisms and the risk of T2DM in the Korean populations. But HNF-4alpha g.4681C>T was associated with higher level of total cholesterol and fasting plasma glucose.
Increasing Trends of Metabolic Syndrome in Korea -Based on Korean National Health and Nutrition Examination Surveys-.
Soo Lim, Eun Jung Lee, Bo Kyeong Koo, Sung Il Cho, Kyong Soo Park, Hak Chul Jang, Seong Yeon Kim, Hong Kyu Lee
Korean Diabetes J. 2005;29(5):432-439.   Published online September 1, 2005
  • 1,366 View
  • 25 Download
AbstractAbstract PDF
BACKGOUND: The number of individuals with metabolic syndrome is increasing in Asian as well as in Western countries. The aim of this study was to compare the prevalence and patterns of metabolic syndrome as determined by the 1998 and 2001 Korean National Health and Nutrition Examination Surveys(KNHANES). METHODS: A total of 6,907 and 4,536 Koreans aged over 20 years participated in the KNHANES in 1998 and 2001, respectively. A stratified multistage probability sampling design and weighting adjustments were made to obtain a representative Korean population. The working definition of the National Cholesterol Education Program-Adult Treatment Panel III was used to define metabolic syndrome. The International Obesity Task Force criteria for the Asian-Pacific population were used to determine waist circumference criteria. RESULTS: The age-adjusted prevalence of metabolic syndrome significantly increased from 22.5 to 24.1% between 1998 and 2001(P<0.01). Of the five components composing metabolic syndrome, low HDL-cholesterolemia showed the highest increase(32.6%) over this period, followed by hypertriglyceridemia and abdominal obesity, with 15.9% and 4.3% increases, respectively. In contrast, the number of subjects with high blood pressure or elevated fasting glucose levels were reduced(37.1-->33.1% and 18.9-->15.4%, respectively, both P<0.01). CONCLUSION: Dyslipidemia and abdominal obesity were primarily responsible for the increase in metabolic syndrome in Korea over the period 1998 to 2001. Changes to diet patterns and a reduction in physical activity are likely to have contributed to the rapid increase in metabolic syndrome in Korea; therefore, national strategies will be needed to counteract this increase.

Diabetes Metab J : Diabetes & Metabolism Journal