Diurnal Cortisol Features and Type 2 Diabetes Risk in Patients With Hypertension and Obstructive Sleep Apnea: A Cohort Study
Authors' conclusion
Steeper DCS and higher midnight cortisol levels are associated with lower and higher T2D risks in patients with hypertension and OSA, respectively, at least in men or participants with moderate to severe OSA. Diurnal cortisol features may represent an early prevention target for diabetes in this population.
Study context
- Population
- Patients with hypertension and obstructive sleep apnea (OSA) with cortisol rhythm test at baseline, Urumqi Research on Sleep Apnea and Hypertension cohort196 developed T2D
- Participants
- 1,478 patients
- Exposure
- Ln-transformed diurnal cortisol features and incident T2D
- Outcome
- Incident T2D
- Follow-up
- Median 7.0 years
Main finding
As reported in the abstract
Steep diurnal cortisol slope (DCS), per SD increase: HR (95% CI 0.79-0.97, P = .014); associated with decreased T2D risk
0.88
Midnight cortisol, per SD increase: HR (95% CI 1.08-1.45, P = .003); associated with increased T2D risk
1.25
Observational data: associations, not effects.
Further findings
Sensitivity analyses
- Sensitivity analyses showed similar results
Incident T2D in women and in participants with mild OSA
- Neither DCS nor midnight cortisol was associated with incident T2D in women or participants with mild OSA
Original publication
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