Work

Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus

Year: 2016

Type: review

Abstract: Controversy exists over the role of stress and depression in the pathophysiology of type 2 diabetes mellitus. Depression has been shown to increase the risk for progressive insulin resistance and incident type 2 diabetes mellitus in multiple studies, whereas the association of stress with diabetes is less clear, owing to differences in study designs and in forms and ascertainment of stress. The biological systems involved in adaptation that mediate the link between stress and physiological functions include the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous and immune systems. The HPA axis is a tightly regulated system that represents one of the body's mechanisms for responding to acute and chronic stress. Depression is associated with cross-sectional and longitudinal alterations in the diurnal cortisol curve, including a blunted cortisol awakening response and flattening of the diurnal cortisol curve. Flattening of the diurnal cortisol curve is also associated with insulin resistance and type 2 diabetes mellitus. In this article, we review and summarize the evidence supporting HPA axis dysregulation as an important biological link between stress, depression, and type 2 diabetes mellitus.

Source: Annals of the New York Academy of Sciences

DOI: 10.1111/nyas.13217

Authors: Joshua J. Joseph, Sherita H. Golden

Institutions: Johns Hopkins University, Johns Hopkins Medicine

Language: English

Topic: Stress Responses and Cortisol

Subfield: Behavioral Neuroscience

Field: Neuroscience

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: green

Funders: National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute on Drug Abuse, National Institute of Diabetes and Digestive and Kidney Diseases