PMID- 34467828
OWN - NLM
STAT- MEDLINE
DCOM- 20221101
LR  - 20221222
IS  - 1814-1412 (Electronic)
IS  - 1562-2975 (Linking)
VI  - 23
IP  - 4
DP  - 2022 Mar-Apr
TI  - Cortisol awakening response in bipolar patients with comorbid type 2 diabetes 
      mellitus.
PG  - 278-286
LID - 10.1080/15622975.2021.1973280 [doi]
AB  - OBJECTIVES: Bipolar disorder (BD) is frequently associated with type 2 diabetes 
      mellitus (T2DM). The functioning of the hypothalamic-pituitary-adrenal (HPA) axis 
      has been never investigated in BD with respect to the glucose metabolic status. 
      Therefore, we assessed the cortisol awakening response (CAR) in bipolar patients 
      with or without comorbid T2DM. METHODS: Twenty euglycemic bipolar patients [12 
      males and eight females; mean age (+/-SD): 47.4 +/- 14.4 years; mean (+/-SD) duration 
      of illness: 18.3 +/- 12.1 years], 16 BD patients with T2DM [11 males and five 
      females; mean age (+/-SD): 63.6 +/- 12.8 years; mean (+/-SD) duration of bipolar 
      illness: 17.1 +/- 10.8 years; mean (+/-SD) duration of T2DM: 5.2 +/- 5.3 years], 18 
      healthy subjects [seven males and 11 females; mean age (+/-SD): 45.0 +/- 12.1 years] 
      and 12 non-psychiatric subjects with T2DM [eight males and four females; mean age 
      (+/-SD): 56.7 +/- 11.2 years; mean (+/-SD) duration of T2DM: 5.2 +/- 3.5 years] were 
      recruited. Saliva cortisol was measured at awakening and after 15, 30, and 
      60 min. RESULTS: With respect to both healthy controls and controls with T2DM, 
      euglycemic and diabetic BD patients exhibited a CAR occurring at significantly 
      lower levels. No significant difference emerged in the CAR between the two groups 
      of bipolar patients. Controls with T2DM had an overall post-awakening cortisol 
      production significantly higher than healthy controls. CONCLUSIONS: Our results 
      show that the CAR of patients with BD is reduced in terms of overall cortisol 
      production but normal in terms of cortisol reactivity independently from the 
      occurrence of comorbid T2DM. The dampened CAR points to a tuning down of the 
      functioning of the HPA axis. in both euglycemic and diabetic BD patients, which 
      may be a factor of vulnerability, since a preserved HPA axis functioning is 
      essential to deal with stressors, which may precipitate affective episodes.
FAU - Monteleone, Alessio Maria
AU  - Monteleone AM
AD  - Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, 
      Italy.
FAU - D'Agostino, Giulia
AU  - D'Agostino G
AD  - Section of Neurosciences, Department of Medicine, Surgery and Dentistry 'Scuola 
      Medica Salernitana', University of Salerno, Baronissi, Italy.
FAU - Cascino, Giammarco
AU  - Cascino G
AD  - Section of Neurosciences, Department of Medicine, Surgery and Dentistry 'Scuola 
      Medica Salernitana', University of Salerno, Baronissi, Italy.
FAU - Marciello, Francesca
AU  - Marciello F
AD  - Section of Neurosciences, Department of Medicine, Surgery and Dentistry 'Scuola 
      Medica Salernitana', University of Salerno, Baronissi, Italy.
FAU - Monteleone, Palmiero
AU  - Monteleone P
AUID- ORCID: 0000-0002-5287-3829
AD  - Section of Neurosciences, Department of Medicine, Surgery and Dentistry 'Scuola 
      Medica Salernitana', University of Salerno, Baronissi, Italy.
FAU - Maj, Mario
AU  - Maj M
AD  - Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, 
      Italy.
LA  - eng
PT  - Journal Article
DEP - 20211028
PL  - England
TA  - World J Biol Psychiatry
JT  - The world journal of biological psychiatry : the official journal of the World 
      Federation of Societies of Biological Psychiatry
JID - 101120023
RN  - WI4X0X7BPJ (Hydrocortisone)
SB  - IM
MH  - Male
MH  - Female
MH  - Humans
MH  - Hydrocortisone/metabolism
MH  - Hypothalamo-Hypophyseal System/metabolism
MH  - Pituitary-Adrenal System/metabolism
MH  - *Bipolar Disorder/metabolism
MH  - *Diabetes Mellitus, Type 2/epidemiology
MH  - Saliva
OTO - NOTNLM
OT  - Bipolar disorder
OT  - comorbidity
OT  - cortisol
OT  - diabetes mellitus
OT  - hypothalamus-pituitary-adrenal axis
EDAT- 2021/09/02 06:00
MHDA- 2022/11/02 06:00
CRDT- 2021/09/01 08:40
PHST- 2021/09/02 06:00 [pubmed]
PHST- 2022/11/02 06:00 [medline]
PHST- 2021/09/01 08:40 [entrez]
AID - 10.1080/15622975.2021.1973280 [doi]
PST - ppublish
SO  - World J Biol Psychiatry. 2022 Mar-Apr;23(4):278-286. doi: 
      10.1080/15622975.2021.1973280. Epub 2021 Oct 28.