ArticlePsychoneuroendocrinology2021
The association of cortisol curve features with incident diabetes among whites and African Americans: The CARDIA study.
Article in Psychoneuroendocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 12 citations in OpenAlex.
- Identifying sleep patterns as a synthetic signature in metabolic comorbidities using a stratified medicine approach.BMC public health · 2025Article
- The Association of Adiposity and RAAS With Incident Diabetes in African Americans: The Jackson Heart Study.The Journal of clinical endocrinology and metabolism · 2024Article
- Childhood environment early life stress, caregiver warmth, and associations with the cortisol diurnal curve in adulthood: The coronary artery risk development in young adults (CARDIA) study.Psychoneuroendocrinology · 2023Article
- Cortisol and cardiometabolic disease: a target for advancing health equity.Trends in endocrinology and metabolism: TEM · 2022Review
- Advancing health equity through integrated biology and population health research: A community-based sample cortisol feasibility and exploratory study.Comprehensive psychoneuroendocrinology · 2022Article
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Authors and funding
15 authors at 8 institutions in 2 countries.
Funding
Abstract
introductionA flatter diurnal cortisol curve has been associated with incident diabetes among older white adults. However, this relationship has not been examined among middle-aged individuals or African Americans [AA]. We analyzed the longitudinal association of baseline diurnal cortisol curve features with incident diabetes over a 10 year period in a cohort of AA and white participants who were, on average, 40 years old.
methodsSalivary cortisol was collected immediately post-awakening, then subsequently 45 min, 2.5 h, 8 h, and 12 h later, as well as at bedtime. Cortisol curve features included wake-up cortisol; cortisol awakening response (CAR); early, late, and overall decline slopes; bedtime cortisol; and 16 -h area under the curve (AUC). Salivary cortisol (nmol/L) was log-transformed due to positively skewed distributions. Diabetes was defined as fasting plasma glucose ≥ 126 mg/dL or taking diabetes medication. Logistic regression models were used to investigate the association of log-transformed cortisol curve features with incident diabetes. The analysis was stratified by race and adjusted for age, sex, education, depressive symptoms, smoking status, beta-blocker and steroid medication use and BMI.
resultsAmong 376 AA and 333 white participants (mean age 40 years), 67 incident diabetes cases occurred over 10 years. After full adjustment for additional covariates, a 1-unit log increase in CAR was associated with a 53 % lower odds of incident diabetes among whites (Odds Ratio [OR] 0.47, 95 % CI: 0.24, 0.90). A 1-SD increase in late decline slope was associated with a 416 % higher odds of incident diabetes among whites (OR 5.16, 95 % CI: 1.32, 20.20). There were no significant associations in AAs.
conclusionA robust CAR and flatter late decline slope are associated with lower and higher odds of incident diabetes, respectively, among younger to middle-aged whites and may provide a future target for diabetes prevention in this population.
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