Hypertension predicts cortisol secretion after menopause

  • Chiodini I & al.
  • J Clin Endocrinol Metab
  • 21 May 2019

  • International Clinical Digest
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Takeaway

  • Hypertension is associated with glucocorticoid (GC) suppressibility, sensitivity, and activity in postmenopausal people aged 50-80 years.

Why this matters

  • Studies have suggested that GC suppressibility and peripheral activation/sensitivity can predict type 2 diabetes and fragility fractures.

Key results

  • Hypertension was associated with cortisol after 1-mg overnight dexamethasone (OR, 3.29; P=.004) and ratio of free cortisol to cortisone (OR, 125.9; P=.01).
  • Progressive increase in the number of conditions potentially linked to cortisol excess (hypertension, type 2 diabetes, and fragility fractures) was associated with cortisol after 1-mg overnight dexamethasone (P=.04), ratio of free cortisol to cortisone (P=.02), and with prevalence of the GC receptor N363S heterozygous variant (P=.015).
  • Simultaneous hypertension, type 2 diabetes, and fragility fractures were independently associated with cortisol after 1-mg overnight dexamethasone (OR, 5; P=.005), ratio of free cortisol to cortisone (OR, 131.6; 95% CI, 2.3-7417.8), and N363S heterozygous variant (OR, 12.4; 95% CI, 2.9-53.1).

Study design

  • 216 postmenopausal participants (age, 50-80 years) without hypercortisolemia, 108 with hypertension, were included.
  • 68 participants had fragility fractures and 99 patients had type 2 diabetes.
  • Funding: Istituto Auxologico Italiano.

Limitations

  • Plasma Dex concentration not measured.

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