Hypothalamic-pituitary-adrenal axis activity is associated with the prevalence of chronic kidney disease in diabetic patients
Progression of chronic kidney disease (CKD) in diabetic patients can occur through enhanced hypothalamic-pituitary-adrenal (HPA) axis activity. The purpose of our study was to determine whether HPA axis activity influences the prevalence of CKD in patients with type 2 diabetes mellitus. Seventy-seve...
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| Veröffentlicht in: | Endocrine Journal 2016, Vol.63(2), pp.119-126 |
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| creator | Asao, Takako Oki, Kenji Yoneda, Masayasu Tanaka, Junko Kohno, Nobuoki |
| description | Progression of chronic kidney disease (CKD) in diabetic patients can occur through enhanced hypothalamic-pituitary-adrenal (HPA) axis activity. The purpose of our study was to determine whether HPA axis activity influences the prevalence of CKD in patients with type 2 diabetes mellitus. Seventy-seven diabetic patients (mean age, 60 years) were enrolled. CKD was defined by K/DOQI criteria, and serum cortisol level was measured after the 1 mg overnight dexamethasone suppression test (F-DST). F-DST values were significantly negatively correlated with estimated glomerular filtration rate (eGFR), and significantly positively correlated with cystatin C level and spot urine albumin to creatinine ratio in simple and multiple regression analyses. The subjects were divided into 3 groups (low, middle, and high) according to the F-DST, and the odds for CKD were 8.7-fold (95% confidence interval 2.56 to 29.6, P=0.01) and 12.5-fold (95% confidence interval 3.3 to 47.9, P |
| doi_str_mv | 10.1507/endocrj.EJ15-0360 |
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The purpose of our study was to determine whether HPA axis activity influences the prevalence of CKD in patients with type 2 diabetes mellitus. Seventy-seven diabetic patients (mean age, 60 years) were enrolled. CKD was defined by K/DOQI criteria, and serum cortisol level was measured after the 1 mg overnight dexamethasone suppression test (F-DST). F-DST values were significantly negatively correlated with estimated glomerular filtration rate (eGFR), and significantly positively correlated with cystatin C level and spot urine albumin to creatinine ratio in simple and multiple regression analyses. The subjects were divided into 3 groups (low, middle, and high) according to the F-DST, and the odds for CKD were 8.7-fold (95% confidence interval 2.56 to 29.6, P=0.01) and 12.5-fold (95% confidence interval 3.3 to 47.9, P<0.001) higher in subjects in the middle and high groups than those in the low group, respectively. In multivariate regression analysis, subjects in the middle group and high group (compared to those in the low group) had 13.0-fold (95% confidence interval, 2.9 to 58.8 and P=0.001) and 14.7-fold (95% confidence interval, 2.8 to 78.5 and P=0.002), respectively, higher risk for CKD. In conclusion, F-DST values have a relationship with decreased eGFR and increased cystatin C or albumin excretion involved in CKD, and enhanced HPA axis activity may be an independent risk factor for CKD in patients with type 2 diabetes mellitus.</description><identifier>ISSN: 0918-8959</identifier><identifier>EISSN: 1348-4540</identifier><identifier>DOI: 10.1507/endocrj.EJ15-0360</identifier><identifier>PMID: 26537094</identifier><language>eng</language><publisher>Japan: The Japan Endocrine Society</publisher><subject>11β-hydroxysteroid dehydrogenase type 2 ; Adult ; Aged ; Biomarkers - blood ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - physiopathology ; Diabetic kidney disease ; Diabetic Nephropathies - blood ; Diabetic Nephropathies - epidemiology ; Diabetic Nephropathies - physiopathology ; Disease Progression ; Female ; Glomerular Filtration Rate ; Humans ; Hydrocortisone - blood ; Hypercortisolism ; Hypothalamic-pituitary-adrenal axis ; Hypothalamo-Hypophyseal System - metabolism ; Hypothalamo-Hypophyseal System - physiopathology ; Male ; Middle Aged ; Pituitary-Adrenal System - metabolism ; Pituitary-Adrenal System - physiopathology ; Prevalence ; Renal Insufficiency, Chronic - blood ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - physiopathology</subject><ispartof>Endocrine Journal, 2016, Vol.63(2), pp.119-126</ispartof><rights>The Japan Endocrine Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c615t-a1e77c0d04c32cf14a8076820f3d244aba96f4e19d162b3d1d1d5bbbf59217523</citedby><cites>FETCH-LOGICAL-c615t-a1e77c0d04c32cf14a8076820f3d244aba96f4e19d162b3d1d1d5bbbf59217523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1884,4025,27928,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26537094$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Asao, Takako</creatorcontrib><creatorcontrib>Oki, Kenji</creatorcontrib><creatorcontrib>Yoneda, Masayasu</creatorcontrib><creatorcontrib>Tanaka, Junko</creatorcontrib><creatorcontrib>Kohno, Nobuoki</creatorcontrib><title>Hypothalamic-pituitary-adrenal axis activity is associated with the prevalence of chronic kidney disease in diabetic patients</title><title>Endocrine Journal</title><addtitle>Endocr J</addtitle><description>Progression of chronic kidney disease (CKD) in diabetic patients can occur through enhanced hypothalamic-pituitary-adrenal (HPA) axis activity. The purpose of our study was to determine whether HPA axis activity influences the prevalence of CKD in patients with type 2 diabetes mellitus. Seventy-seven diabetic patients (mean age, 60 years) were enrolled. CKD was defined by K/DOQI criteria, and serum cortisol level was measured after the 1 mg overnight dexamethasone suppression test (F-DST). F-DST values were significantly negatively correlated with estimated glomerular filtration rate (eGFR), and significantly positively correlated with cystatin C level and spot urine albumin to creatinine ratio in simple and multiple regression analyses. The subjects were divided into 3 groups (low, middle, and high) according to the F-DST, and the odds for CKD were 8.7-fold (95% confidence interval 2.56 to 29.6, P=0.01) and 12.5-fold (95% confidence interval 3.3 to 47.9, P<0.001) higher in subjects in the middle and high groups than those in the low group, respectively. In multivariate regression analysis, subjects in the middle group and high group (compared to those in the low group) had 13.0-fold (95% confidence interval, 2.9 to 58.8 and P=0.001) and 14.7-fold (95% confidence interval, 2.8 to 78.5 and P=0.002), respectively, higher risk for CKD. In conclusion, F-DST values have a relationship with decreased eGFR and increased cystatin C or albumin excretion involved in CKD, and enhanced HPA axis activity may be an independent risk factor for CKD in patients with type 2 diabetes mellitus.</description><subject>11β-hydroxysteroid dehydrogenase type 2</subject><subject>Adult</subject><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Diabetic kidney disease</subject><subject>Diabetic Nephropathies - blood</subject><subject>Diabetic Nephropathies - epidemiology</subject><subject>Diabetic Nephropathies - physiopathology</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>Hypercortisolism</subject><subject>Hypothalamic-pituitary-adrenal axis</subject><subject>Hypothalamo-Hypophyseal System - metabolism</subject><subject>Hypothalamo-Hypophyseal System - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pituitary-Adrenal System - metabolism</subject><subject>Pituitary-Adrenal System - physiopathology</subject><subject>Prevalence</subject><subject>Renal Insufficiency, Chronic - blood</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><issn>0918-8959</issn><issn>1348-4540</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1v1DAQhi0EotuWH8AF-cglxY4_Eh9R1S9UiQs9RxN7Qrxkk2B72-6B_46jXXJFI3lG8jPvYR5CPnJ2xRWrvuDoJhu2VzffuCqY0OwN2XAh60Iqyd6SDTO8LmqjzBk5j3HLmBBKivfkrNRKVMzIDflzf5in1MMAO2-L2ae9TxAOBbiAIwwUXn2kYJN_9ulAlznGyXpI6OiLTz1NPdI54DMMOFqkU0dtH6bRW_rLuxEP1PmIEJH6MY_QYspfMySPY4qX5F0HQ8QPp35Bnm5vflzfF4_f7x6uvz4WVnOVCuBYVZY5Jq0obccl1KzSdck64UopoQWjO4ncOK7LVjieS7Vt2ylT8kqV4oJ8PubOYfq9x5ianY8WhwFGnPax4TVT0mjD6v-jlTaaG2FERvkRtWGKMWDXzMHv8vUazppFUHMS1CyCmkVQ3vl0it-3O3Trxj8jGbg7AtuY4CeuAIR8uAHXSC2acnnW6JWwPYSMib84X6n1</recordid><startdate>2016</startdate><enddate>2016</enddate><creator>Asao, Takako</creator><creator>Oki, Kenji</creator><creator>Yoneda, Masayasu</creator><creator>Tanaka, Junko</creator><creator>Kohno, Nobuoki</creator><general>The Japan Endocrine Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>2016</creationdate><title>Hypothalamic-pituitary-adrenal axis activity is associated with the prevalence of chronic kidney disease in diabetic patients</title><author>Asao, Takako ; Oki, Kenji ; Yoneda, Masayasu ; Tanaka, Junko ; Kohno, Nobuoki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c615t-a1e77c0d04c32cf14a8076820f3d244aba96f4e19d162b3d1d1d5bbbf59217523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>11β-hydroxysteroid dehydrogenase type 2</topic><topic>Adult</topic><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Diabetic kidney disease</topic><topic>Diabetic Nephropathies - blood</topic><topic>Diabetic Nephropathies - epidemiology</topic><topic>Diabetic Nephropathies - physiopathology</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Hypercortisolism</topic><topic>Hypothalamic-pituitary-adrenal axis</topic><topic>Hypothalamo-Hypophyseal System - metabolism</topic><topic>Hypothalamo-Hypophyseal System - physiopathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pituitary-Adrenal System - metabolism</topic><topic>Pituitary-Adrenal System - physiopathology</topic><topic>Prevalence</topic><topic>Renal Insufficiency, Chronic - blood</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Asao, Takako</creatorcontrib><creatorcontrib>Oki, Kenji</creatorcontrib><creatorcontrib>Yoneda, Masayasu</creatorcontrib><creatorcontrib>Tanaka, Junko</creatorcontrib><creatorcontrib>Kohno, Nobuoki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Endocrine Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Asao, Takako</au><au>Oki, Kenji</au><au>Yoneda, Masayasu</au><au>Tanaka, Junko</au><au>Kohno, Nobuoki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypothalamic-pituitary-adrenal axis activity is associated with the prevalence of chronic kidney disease in diabetic patients</atitle><jtitle>Endocrine Journal</jtitle><addtitle>Endocr J</addtitle><date>2016</date><risdate>2016</risdate><volume>63</volume><issue>2</issue><spage>119</spage><epage>126</epage><pages>119-126</pages><issn>0918-8959</issn><eissn>1348-4540</eissn><abstract>Progression of chronic kidney disease (CKD) in diabetic patients can occur through enhanced hypothalamic-pituitary-adrenal (HPA) axis activity. The purpose of our study was to determine whether HPA axis activity influences the prevalence of CKD in patients with type 2 diabetes mellitus. Seventy-seven diabetic patients (mean age, 60 years) were enrolled. CKD was defined by K/DOQI criteria, and serum cortisol level was measured after the 1 mg overnight dexamethasone suppression test (F-DST). F-DST values were significantly negatively correlated with estimated glomerular filtration rate (eGFR), and significantly positively correlated with cystatin C level and spot urine albumin to creatinine ratio in simple and multiple regression analyses. The subjects were divided into 3 groups (low, middle, and high) according to the F-DST, and the odds for CKD were 8.7-fold (95% confidence interval 2.56 to 29.6, P=0.01) and 12.5-fold (95% confidence interval 3.3 to 47.9, P<0.001) higher in subjects in the middle and high groups than those in the low group, respectively. In multivariate regression analysis, subjects in the middle group and high group (compared to those in the low group) had 13.0-fold (95% confidence interval, 2.9 to 58.8 and P=0.001) and 14.7-fold (95% confidence interval, 2.8 to 78.5 and P=0.002), respectively, higher risk for CKD. In conclusion, F-DST values have a relationship with decreased eGFR and increased cystatin C or albumin excretion involved in CKD, and enhanced HPA axis activity may be an independent risk factor for CKD in patients with type 2 diabetes mellitus.</abstract><cop>Japan</cop><pub>The Japan Endocrine Society</pub><pmid>26537094</pmid><doi>10.1507/endocrj.EJ15-0360</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 11β-hydroxysteroid dehydrogenase type 2 Adult Aged Biomarkers - blood Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - physiopathology Diabetic kidney disease Diabetic Nephropathies - blood Diabetic Nephropathies - epidemiology Diabetic Nephropathies - physiopathology Disease Progression Female Glomerular Filtration Rate Humans Hydrocortisone - blood Hypercortisolism Hypothalamic-pituitary-adrenal axis Hypothalamo-Hypophyseal System - metabolism Hypothalamo-Hypophyseal System - physiopathology Male Middle Aged Pituitary-Adrenal System - metabolism Pituitary-Adrenal System - physiopathology Prevalence Renal Insufficiency, Chronic - blood Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - physiopathology |
| title | Hypothalamic-pituitary-adrenal axis activity is associated with the prevalence of chronic kidney disease in diabetic patients |
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