Association of serum cortisol with insulin secretion and plasma aldosterone with insulin resistance in untreated type 2 diabetes: a cross-sectional study

Abstract Background Insulin secretion and resistance are key pathophysiological factors in type 2 diabetes. However, only 55% of patients achieve long-term blood glucose treatment goals, highlighting the need to clarify the pathophysiology of type 2 diabetes. While cortisol and aldosterone levels ha...

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Main Authors: Masahiro Ohira, Naoyuki Kawagoe, Chisato Kameyama, Yuko Kondou, Madoka Igarashi, Hajime Ueshiba
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01706-8
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author Masahiro Ohira
Naoyuki Kawagoe
Chisato Kameyama
Yuko Kondou
Madoka Igarashi
Hajime Ueshiba
author_facet Masahiro Ohira
Naoyuki Kawagoe
Chisato Kameyama
Yuko Kondou
Madoka Igarashi
Hajime Ueshiba
author_sort Masahiro Ohira
collection DOAJ
description Abstract Background Insulin secretion and resistance are key pathophysiological factors in type 2 diabetes. However, only 55% of patients achieve long-term blood glucose treatment goals, highlighting the need to clarify the pathophysiology of type 2 diabetes. While cortisol and aldosterone levels have been linked to insulin secretion and resistance in participants without type 2 diabetes, their role in patients with type 2 diabetes remains unclear. In this study, we aimed to investigate the relationships among insulin secretion, insulin resistance, and cortisol or aldosterone levels in patients with untreated type 2 diabetes. Methods We retrospectively reviewed 121 patients with untreated type 2 diabetes mellitus. We analyzed the relationships between various clinical parameters, including adrenal hormones, and insulin secretion (homeostatic model assessment [HOMA2-%B]) or insulin resistance (HOMA2-IR). Multiple regression analysis was performed to identify parameters associated with HOMA2-%B or HOMA2-IR. Results Spearman’s rank correlation coefficient revealed that body weight (BW); body mass index (BMI); estimated glomerular filtration rate; and serum creatinine, uric acid, total cholesterol, high-density lipoprotein cholesterol (HDL-C), sodium, potassium, chloride, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum C-peptide, and cortisol levels were significantly correlated with HOMA2-%B. Similarly, BW, BMI, aspartate transaminase levels, alanine transaminase (ALT) levels, triglyceride levels, HDL-C levels, FBG levels, serum C-peptide levels, renin activity, and plasma aldosterone concentration (PAC) were significantly correlated with HOMA2-IR. Multiple regression analysis revealed BMI, HbA1c levels, and cortisol levels as predictors of HOMA2-%B, whereas ALT levels and the PAC were predictors of HOMA2-IR. Conclusion Serum cortisol levels are associated with insulin secretion, and the PAC is associated with insulin resistance in patients with untreated type 2 diabetes. These findings suggest that aldosterone blockade may represent a potential therapeutic approach for reducing insulin resistance in patients with type 2 diabetes.
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spelling doaj-art-ed8eceafc4664536bd6eebde9c2aeca52025-08-20T02:10:54ZengBMCDiabetology & Metabolic Syndrome1758-59962025-04-011711810.1186/s13098-025-01706-8Association of serum cortisol with insulin secretion and plasma aldosterone with insulin resistance in untreated type 2 diabetes: a cross-sectional studyMasahiro Ohira0Naoyuki Kawagoe1Chisato Kameyama2Yuko Kondou3Madoka Igarashi4Hajime Ueshiba5Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical CenterDivision of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical CenterDivision of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical CenterDivision of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical CenterDivision of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical CenterDivision of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Ohashi Medical CenterAbstract Background Insulin secretion and resistance are key pathophysiological factors in type 2 diabetes. However, only 55% of patients achieve long-term blood glucose treatment goals, highlighting the need to clarify the pathophysiology of type 2 diabetes. While cortisol and aldosterone levels have been linked to insulin secretion and resistance in participants without type 2 diabetes, their role in patients with type 2 diabetes remains unclear. In this study, we aimed to investigate the relationships among insulin secretion, insulin resistance, and cortisol or aldosterone levels in patients with untreated type 2 diabetes. Methods We retrospectively reviewed 121 patients with untreated type 2 diabetes mellitus. We analyzed the relationships between various clinical parameters, including adrenal hormones, and insulin secretion (homeostatic model assessment [HOMA2-%B]) or insulin resistance (HOMA2-IR). Multiple regression analysis was performed to identify parameters associated with HOMA2-%B or HOMA2-IR. Results Spearman’s rank correlation coefficient revealed that body weight (BW); body mass index (BMI); estimated glomerular filtration rate; and serum creatinine, uric acid, total cholesterol, high-density lipoprotein cholesterol (HDL-C), sodium, potassium, chloride, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum C-peptide, and cortisol levels were significantly correlated with HOMA2-%B. Similarly, BW, BMI, aspartate transaminase levels, alanine transaminase (ALT) levels, triglyceride levels, HDL-C levels, FBG levels, serum C-peptide levels, renin activity, and plasma aldosterone concentration (PAC) were significantly correlated with HOMA2-IR. Multiple regression analysis revealed BMI, HbA1c levels, and cortisol levels as predictors of HOMA2-%B, whereas ALT levels and the PAC were predictors of HOMA2-IR. Conclusion Serum cortisol levels are associated with insulin secretion, and the PAC is associated with insulin resistance in patients with untreated type 2 diabetes. These findings suggest that aldosterone blockade may represent a potential therapeutic approach for reducing insulin resistance in patients with type 2 diabetes.https://doi.org/10.1186/s13098-025-01706-8CortisolAldosteroneInsulin secretionInsulin resistanceUntreated type 2 diabetes
spellingShingle Masahiro Ohira
Naoyuki Kawagoe
Chisato Kameyama
Yuko Kondou
Madoka Igarashi
Hajime Ueshiba
Association of serum cortisol with insulin secretion and plasma aldosterone with insulin resistance in untreated type 2 diabetes: a cross-sectional study
Diabetology & Metabolic Syndrome
Cortisol
Aldosterone
Insulin secretion
Insulin resistance
Untreated type 2 diabetes
title Association of serum cortisol with insulin secretion and plasma aldosterone with insulin resistance in untreated type 2 diabetes: a cross-sectional study
title_full Association of serum cortisol with insulin secretion and plasma aldosterone with insulin resistance in untreated type 2 diabetes: a cross-sectional study
title_fullStr Association of serum cortisol with insulin secretion and plasma aldosterone with insulin resistance in untreated type 2 diabetes: a cross-sectional study
title_full_unstemmed Association of serum cortisol with insulin secretion and plasma aldosterone with insulin resistance in untreated type 2 diabetes: a cross-sectional study
title_short Association of serum cortisol with insulin secretion and plasma aldosterone with insulin resistance in untreated type 2 diabetes: a cross-sectional study
title_sort association of serum cortisol with insulin secretion and plasma aldosterone with insulin resistance in untreated type 2 diabetes a cross sectional study
topic Cortisol
Aldosterone
Insulin secretion
Insulin resistance
Untreated type 2 diabetes
url https://doi.org/10.1186/s13098-025-01706-8
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