Pinar Gumus Balikcioglu1, Metin Balikcioglu2, Arlette Soros3, Stuart Chalew4. 1. Division of Pediatric Endocrinology and Diabetes, Duke University, Durham, NC, USA. Electronic address: pinar.gumus@duke.edu. 2. SAS Institute Inc, Advanced Analytics Division, Cary, NC, USA. 3. Division of Pediatric Endocrinology, Boston University School of Medicine, Boston, MA, USA. 4. Division of Pediatric Endocrinology and Diabetes, Louisiana State University School of Medicine, LSU Health Sciences Center and Children's Hospital of New Orleans, New Orleans, LA, USA.
Abstract
INTRODUCTION: 24-h average (IC) plasma concentrations of cortisol and growth hormone are lower in obese youth and adults without Type 2 diabetes (T2D) compared to lean subjects. Here we examined IC-cortisol and IC-growth hormone levels in obese youth with and without T2D. METHODS: We pooled ½-hourly samples from 20 to 24-hour sampling to create an IC for cortisol, cortisone, C-peptide, insulin, growth hormone and cortisol-binding-globulin in obese African-American youth with (n = 8) and without T2D (N = 9). Analytes were assayed by standard methods. RESULTS: The groups were similar in age and sex, all participants had BMI% ≥94. T2D patients had slightly lower BMI z-score (2.25 ± 0.36 versus 2.58 ± 0.16, p = 0.0429). IC-cortisol (5.70 ± 1.8 μg/dl vs 4.18 ± 1.07 μg/dl, p = 0.0481) was higher and IC-C-peptide (2.33 ± 0.89 ng/ml vs 4.36 ± 1.12 ng/ml, p = 0.001) lower in T2D. There were no differences in cortisone/cortisol or for other analytes between groups. IC-cortisol was correlated with IC-cortisone (r = 0.46, p = 0.0471) but not with ICs of insulin, C-peptide, cortisol-binding-globulin, or growth hormone. CONCLUSIONS: IC-cortisol levels are higher and IC-C-peptide lower in obese African-American youth with T2D. Higher levels of IC-cortisol in obese youth with T2D may indicate a change in hypothalamic-pituitary-adrenal regulation which may exacerbate hyperglycemia and other metabolic complications of obesity.
INTRODUCTION: 24-h average (IC) plasma concentrations of cortisol and growth hormone are lower in obese youth and adults without Type 2 diabetes (T2D) compared to lean subjects. Here we examined IC-cortisol and IC-growth hormone levels in obese youth with and without T2D. METHODS: We pooled ½-hourly samples from 20 to 24-hour sampling to create an IC for cortisol, cortisone, C-peptide, insulin, growth hormone and cortisol-binding-globulin in obese African-American youth with (n = 8) and without T2D (N = 9). Analytes were assayed by standard methods. RESULTS: The groups were similar in age and sex, all participants had BMI% ≥94. T2D patients had slightly lower BMI z-score (2.25 ± 0.36 versus 2.58 ± 0.16, p = 0.0429). IC-cortisol (5.70 ± 1.8 μg/dl vs 4.18 ± 1.07 μg/dl, p = 0.0481) was higher and IC-C-peptide (2.33 ± 0.89 ng/ml vs 4.36 ± 1.12 ng/ml, p = 0.001) lower in T2D. There were no differences in cortisone/cortisol or for other analytes between groups. IC-cortisol was correlated with IC-cortisone (r = 0.46, p = 0.0471) but not with ICs of insulin, C-peptide, cortisol-binding-globulin, or growth hormone. CONCLUSIONS: IC-cortisol levels are higher and IC-C-peptide lower in obese African-American youth with T2D. Higher levels of IC-cortisol in obese youth with T2D may indicate a change in hypothalamic-pituitary-adrenal regulation which may exacerbate hyperglycemia and other metabolic complications of obesity.
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