Biological Basis of Depression in Adults with Diabetes
Current Diabetes ReportsPublished 27 September 2010
Shivam Champaneri, Gary S. Wand, Saurabh Malhotra, Sarah Stark Casagrande, Sherita Hill Golden
Citations191
SJR quartileQ1
SJR score2.16
SNIP1.80
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Recent evidence showing alterations of these three biological systems—HPA axis, SNS, and inflammatory cascade—in depression, diabetes, and diabetes-related risk factors is reviewed.
Abstract
Diabetes and depression are common comorbid conditions. Although certain health behaviors and risk factors partially explain the association of depression and diabetes, other potential mechanisms have yet to be elucidated. Certain neuroendocrine alterations such as activation of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) may contribute to the association. Additionally, presence of a proinflammatory state shown in recent literature in both diabetes and depression may contribute to this as well. The objectives of this review are to summarize and review the recent evidence showing alterations of these three biological systems-HPA axis, SNS, and inflammatory cascade--in depression, diabetes, and diabetes-related risk factors.
Keywords
Medicine
NeuropsychobiologyThe ‘Trier Social Stress Test’ – A Tool for Investigating Psychobiological Stress Responses in a Laboratory Setting
6,140 Citations2008Clemens Kirschbaum, Karl‐Martin Pirke +1 more
The results suggest that gender, genetics and nicotine consumption can influence the individual's stress responsiveness to psychological stress while personality traits showed no correlation with cortisol responses to TSST stimulation.
Annals of EpidemiologyThe cardiovascular health study: Design and rationale
3,638 Citations1991Linda P. Fried, Nemat O. Borhani +13 more
These examinations in CHS permit evaluation of CVD risk factors in older adults, particularly in groups previously under-represented in epidemiologic studies, such as women and the very old.
Diabetes CareDepression and Type 2 Diabetes Over the Lifespan
1,545 Citations2008Briana Mezuk, William W. Eaton +2 more
Depression is associated with a 60% increased risk of type 2 diabetes, and Type 2 diabetes isassociated with only modest increasedrisk of depression.
Life SciencesFree Cortisol Levels after Awakening: A Reliable Biological Marker for the Assessment of Adrenocortical Activity
1,434 Citations1997Jens C. Pruessner, Oliver T. Wolf +6 more
Early morning cortisol levels can be a reliable biological marker for the individual's adrenocortical activity when measured repeatedly with strict reference to the time of awakening, in contrast to single assessments at fixed times.
Biological PsychologyCortisol awakening response and psychosocial factors: A systematic review and meta-analysis
1,026 Citations2008Yoichi Chida, Andrew Steptoe
It is found that the increase in cortisol following waking (CARi), and the integrated volume of cortisol released over the waking period (CARauc), was positively associated with job stress and general life stress and negatively related to posttraumatic stress syndrome.
PsychoneuroendocrinologyAssessing salivary cortisol in large-scale, epidemiological research
917 Citations2009Emma K. Adam, Meena Kumari
Examples of choices made, response rates obtained, and examples of results obtained from existing epidemiological cortisol studies are offered, as are suggestions for the modeling and interpretation of salivary cortisol data obtained in large-scale epidemiological research.
CirculationVisceral and Subcutaneous Adipose Tissue Volumes Are Cross-Sectionally Related to Markers of Inflammation and Oxidative Stress
891 Citations2007Karla M. Pou, Joseph M. Massaro +12 more
The present cross-sectional data support an association between both SAT and VAT with inflammation and oxidative stress and suggest that the contribution of visceral fat to inflammation may not be completely accounted for by clinical measures of obesity.
The Journal of Clinical Endocrinology & MetabolismThe Pathogenetic Role of Cortisol in the Metabolic Syndrome: A Hypothesis
608 Citations2009Panagiotis Anagnostis, Vasilios G. Athyros +3 more
The present review summarizes the evidence on the potential role of cortisol in the pathogenesis of MetS and discusses new therapeutic approaches for patients with MetS, which may be partly associated with chronic stress and/or low birth weight.
Psychosomatic MedicineDepression, the Autonomic Nervous System, and Coronary Heart Disease
580 Citations2005Robert M. Carney, Kenneth E. Freedland +1 more
Research is needed to determine whether ANS dysfunction mediates the effects of depression on the course and outcome of CHD, and to develop clinical interventions that improve cardiovascular autonomic regulation while relieving depression in patients with CHD.
Psychological MedicineAssociations of C-reactive protein and interleukin-6 with cognitive symptoms of depression: 12-year follow-up of the Whitehall II study
565 Citations2008David Gimeno, Mika Kivimäki +9 more
inflammation precedes depression at least with regard to the cognitive symptoms of depression, according to a prospective occupational cohort study of British white-collar civil servants.
Diabetes Research and Clinical PracticeValidation of the insulin sensitivity index (ISI0,120): comparison with other measures
475 Citations2000M. Gutt, Catherine L. Davis +7 more
Data show that ISI(0,120) correlates well, when applied prospectively in comparative studies, with the insulin sensitivity index obtained from the euglycemic hyperinsulinemic clamp, and performed comparably to the computerized HOMA index.
StressHuman models in acute and chronic stress: Assessing determinants of individual hypothalamus–pituitary–adrenal axis activity and reactivity
401 Citations2010Brigitte M. Kudielka, Stefan Wüst
Findings on two HPA axis measures are focused on, namely the cortisol-awakening response (CAR) to assess HPA Axis basal activity and the Trier social stress test (TSST) to investigate HPAaxis stress reactivity.
Brain Behavior and ImmunityA prospective evaluation of the directionality of the depression–inflammation relationship
390 Citations2009Jesse C. Stewart, Kevin L. Rand +2 more
It is indicated that depressive symptoms may precede and augment some inflammatory processes relevant to coronary artery disease among healthy, older adults and that inflammation may be one of the mechanisms through which depression contributes to cardiovascular risk.
Journal of HypertensionThe sympathetic nervous system and the metabolic syndrome
383 Citations2007Giuseppe Mancia, Pascal Bousquet +6 more
The behaviour of the sympathetic nervous system in the metabolic syndrome as well as the mechanisms potentially responsible for this neurogenic abnormality are examined.
Annals of the New York Academy of SciencesSympathetic System Activity in Obesity and Metabolic Syndrome
259 Citations2006Nikolaοs Tentolouris, Stavros Liatis +1 more
Intervention studies showed that the disturbances of the autonomic nervous system seen in the metabolic syndrome are reversible, and weight loss reduces SNS overactivity in obesity.
Diabetes CareCortisol Secretion in Patients With Type 2 Diabetes
244 Citations2006Iacopo Chiodini, Guido Adda +10 more
In type 2 diabetic subjects, hypothalmic-pituitary-adrenal activity is enhanced in patients with diabetes complications and the degree of cortisol secretion is related to the presence and number of diabetes complications.
Journal of Affective DisordersAlteration of cardiac autonomic functions in patients with major depression: A study using heart rate variability measures
227 Citations2006Kaviraja Udupa, Talakad N. Sathyaprabha +5 more
Depression is associated with alteration of cardiac autonomic tone towards decreased parasympathetic activity and an increased sympathetic activity, and it is possible that a common neurobiological dysfunction contributes to both depression and heart autonomic changes in the illness.
Current Diabetes ReviewsA Review of the Evidence for a Neuroendocrine Link Between Stress, Depression and Diabetes Mellitus
221 Citations2007Sherita Hill Golden
The metabolic impact of HPA axis and SNS dysfunction induced by depression and stress is summarized and the evidence of the impact of stress reduction, by cognitive behavior therapy (CBT), on neuroendocrine factors and on outcomes in diabetes and obesity is summarized.
Diabetes CareInflammation and the Incidence of Type 2 Diabetes
201 Citations2010Alain G. Bertoni, Gregory L. Burke +7 more
Higher levels of inflammation predict short-term incidence of type 2 diabetes in a multiethnic American sample and in stratified analyses, similar associations were observed among white, black, and Hispanic participants.
Journal of Psychiatric ResearchClinical characteristics and treatment outcome in a representative sample of depressed inpatients – Findings from the Munich Antidepressant Response Signature (MARS) project
193 Citations2008Johannes M. Hennings, Toshimi Owashi +19 more
It is demonstrated that this subgroup of inpatients suffering from depression can be characterized by a set of demographic, clinical and neuroendocrine variables allowing to predict unfavorable outcome at an early stage of treatment.
The Journal of Clinical Endocrinology & MetabolismHypothalamic-Pituitary-Adrenal Axis Dysregulation and Memory Impairments in Type 2 Diabetes
182 Citations2007Hannah Bruehl, Melanie Rueger +7 more
HPA hyperactivity and declarative memory deficits are present in type 2 diabetes mellitus and both alterations may reflect the negative impact of poor glycemic control on the hippocampal formation.
Psychosomatic MedicineDepression and C-Reactive Protein: Population-Based Health 2000 Study
161 Citations2009Marko Elovainio, Anna‐Mari Aalto +5 more
Depressive symptoms may be partly responsible for inflammatory processes, and inflammatory processes may induce depressive symptoms in men, according to the Health 2000 Study.
American Journal of Physiology-Endocrinology and MetabolismLower growth hormone and higher cortisol are associated with greater visceral adiposity, intramyocellular lipids, and insulin resistance in overweight girls
160 Citations2008Madhusmita Misra, Miriam A. Bredella +4 more
The data indicate that lower peak GH and higher UFC in overweight girls are associated with visceral adiposity, insulin resistance, and lipids.
Diabetic MedicineThe relationship of heart rate and heart rate variability to non‐diabetic fasting glucose levels and the metabolic syndrome: The Cardiovascular Health Study
159 Citations2007Phyllis K. Stein, Joshua I. Barzilay +5 more
The hypotheses that increased HR and diminished HRV are present in people with increased fasting glucose levels not in the range of diabetes mellitus and people with the metabolic syndrome independent of elevated FG levels were tested.
Biological PsychologySymptoms of depression and cardiovascular reactions to acute psychological stress: Evidence from a population study
155 Citations2006Douglas Carroll, Anna C. Phillips +2 more
Depression scores were negatively associated with systolic blood pressure and heart rate reactions, after adjustment for likely confounders such as sex, cohort, occupational status, body mass index, stress task performance score, baseline cardiovascular activity, antidepressant, and antihypertensive medication.
PsychoneuroendocrinologyThe cortisol awakening response is blunted in psychotherapy inpatients suffering from depression
152 Citations2006Thomas J. Huber, Katharina Issa +2 more
The ACR was found to be attenuated in depressed as compared to non-depressed patients and suggests a blunted rather than an exacerbated HPA reactivity, which will be needed to disentangle the complex relationship between depression and the ACR.
PsychoneuroendocrinologyA blunted cortisol awakening response and hippocampal atrophy in type 2 diabetes mellitus
140 Citations2009Hannah Bruehl, Oliver T. Wolf +1 more
Across all subjects, fasting insulin and hippocampal volume were associated with the CAR, independent of diagnosis, and support the hypothesis that hippocampal integrity is an important predictor of the CAR.
The Journal of Clinical Endocrinology & MetabolismImprovement of Insulin Sensitivity after Adrenalectomy in Patients with Pheochromocytoma
139 Citations2003Tobias Wiesner, Matthias Blüher +2 more
The effect of high catecholamine plasma concentrations on glucose metabolism and insulin resistance in patients with diabetes mellitus by the euglycemic hyperinsulinaemic clamp technique is characterized.
The American Journal of the Medical SciencesCytokine Biomarkers, Endothelial Inflammation, and Atherosclerosis in the Metabolic Syndrome: Emerging Concepts
138 Citations2009Ali A. Rizvi
Unraveling the role of emerging proinflammatory markers has the promising potential to shed light into the underlying pathophysiology of the epidemic of obesity and the metabolic syndrome and thus help devise effective therapies.
ObesityBaroreflex Sensitivity in Obesity: Relationship With Cardiac Autonomic Nervous System Activity
137 Citations2007Ioanna Skrapari, Nikolaοs Tentolouris +4 more
Test the hypothesis that baroreflex sensitivity (BRS), assessed by indirect measurement of aortic pressure, is blunted in obesity by investigating the potential effect of cardiac autonomic nervous system activity, aorta compliance, and metabolic parameters on BRS of obese subjects.
The Journal of Clinical Endocrinology & MetabolismAssociation between the Metabolic Syndrome and Serum Cortisol in Overweight Latino Youth
127 Citations2008Marc J. Weigensberg, Claudia M. Toledo‐Corral +1 more
In overweight, Latino youth, MS is associated with higher morning serum cortisol levels, independent of body fat and insulin sensitivity, and more studies are needed to investigate the role of relative hypercortisolism and chronic stress in obesity-related metabolic disorders in children.
American Journal of Physiology-Endocrinology and MetabolismEnhanced cortisol production rates, free cortisol, and 11β-HSD-1 expression correlate with visceral fat and insulin resistance in men: effect of weight loss
112 Citations2008Jonathan Q. Purnell, Steven E. Kahn +4 more
The data support a model in which increased hypothalamic-pituitary-adrenal activity in men promotes selective visceral fat accumulation and insulin resistance and may promote weight regain after diet-induced weight loss, whereas 11beta-HSD-1 gene expression in SQF is a consequence rather than cause of adiposity.
Brain Behavior and ImmunityThe relationships among heart rate variability, inflammatory markers and depression in coronary heart disease patients
110 Citations2009Nancy Frasure‐Smith, François Lespérance +3 more
HRV independently accounted for at least 4% of the variance in CRP in the depressed, more than any factor except BMI, and relationships between measures of inflammation and autonomic function are stronger among depressed than non-depressed cardiac patients.
Biological PsychologyNeurohormonal and inflammatory hyper-responsiveness to acute mental stress in depression☆
109 Citations2010Ali A. Weinstein, Patricia A. Deuster +4 more
It is concluded that depressed individuals display hyper-reactivity of neuroimmunological markers in response to acute negative emotions, which may serve a pathologic role in the elevated morbidity and mortality risk associated with depression.
Journal of Psychosomatic ResearchDepression is associated with flatter cortisol rhythms in patients with coronary artery disease
102 Citations2008Mimi R. Bhattacharyya, Gerard J. Molloy +1 more
The flatter cortisol rhythms of more depressed CAD patients may contribute to the progression of coronary atherosclerosis, and this study evaluated cortisol output in patients with suspected CAD in relation to depressive symptoms.
NeuropsychopharmacologyRisk Markers for Depression in Adolescents: Sleep and HPA Measures
97 Citations2009Uma Rao, Constance Hammen +1 more
The findings that REM sleep abnormalities and elevated HPA activity occur before the onset of depression in at-risk adolescents suggest that these variables serve as vulnerability markers for the illness.
PsychoneuroendocrinologyDecreased cortisol response to awakening is associated with cognitive vulnerability to depression in a nonclinical sample of young adults
93 Citations2007Christine Kuehner, Susanne Holzhauer +1 more
It is concluded that the two variables apparently share specific vulnerability qualities towards depression by hampering the adaptive shift of attention to external cues during dysphoric moods, probably involving lowered disinhibition of task-irrelevant negative emotional processing.
Psychosomatic MedicinePsychophysiological and Cortisol Responses to Psychological Stress in Depressed and Nondepressed Older Men and Women With Elevated Cardiovascular Disease Risk
92 Citations2006C. Barr Taylor, Ansgar Conrad +10 more
In this sample, older depressed subjects with elevated risk for CVD exhibited a hypocortisol response to acute stress, which might contribute to chronic inflammation and in other ways increase CVD risk.
Hormones and BehaviorSelf-reported symptoms of depressed mood, trait anxiety and aggressive behavior in post-pubertal adolescents: Associations with diurnal cortisol profiles
87 Citations2008Bea Van den Bergh, Ben Van Calster +2 more
ObesityAwakening Cortisol Response in Lean, Obese, and Reduced Obese Individuals: Effect of Gender and Fat Distribution
85 Citations2007Fanny Therrien, Vicky Drapeau +5 more
The aim was to assess the awakening cortisol response (ACR) in obese and reduced obese men and women and to establish a baseline level for this response and determine its importance in obesity.
The Journal of Clinical Endocrinology & MetabolismAssociations among Metabolic Syndrome, Ischemia, Inflammatory, Oxidatives, and Lipids Biomarkers
82 Citations2009Maria Gabriela Valle Gottlieb, Ivana Beatrice Mânica da Cruz +5 more
An association between ischemia-modified albumin (IMA) and MS was found and was independent of sex, age, diabetes mellitus 2, and hypercholesterolemia.
Clinical EndocrinologyCortisol levels and measures of body composition in middle‐aged and older men
80 Citations2007Thomas G. Travison, Amy B. O’Donnell +3 more
An analysis to determine both cross‐sectional and longitudinal associations between body composition and serum cortisol concentrations in a randomly chosen group of 999 community‐dwelling men, aged 40–79 years finds similarities in the symptomatic expressions of excess adiposity and hypercortisolaemic conditions suggest that elevated glucocorticoid exposure may influence the pathogenesis of obesity.
Current Diabetes ReviewsThe Role of Adipocytokines and Neurohormonal Dysregulation in Metabolic Syndrome
77 Citations2006Alice P.S. Kong
The possible links between insulin and various hormones (growth hormones, catecholamines, glucocorticoids and sex hormones), partly mediated through visceral adiposity and adipocytokines in the pathogenesis of this syndrome are summarized.
PsychoneuroendocrinologyDex/CRH test cortisol response in outpatients with major depression and matched healthy controls
70 Citations2009Linda L. Carpenter, Nicole S. Ross +4 more
The results do not support the hypothesis that elevated cortisol response to the dexamethasone/corticotropin releasing hormone test represents a marker for major depressive episodes.
PsychoneuroendocrinologyDiurnal cortisol profiles and evening cortisol in post-pubertal adolescents scoring high on the Children's Depression Inventory
67 Citations2009Bea Van den Bergh, Ben Van Calster
Longitudinal repeated measurements regression revealed that the group with CDI > 18 (high depressive symptoms) clearly had a higher and flatter diurnal rhythm with elevated evening cortisol compared to either the groupwith CDI between 13 and 18 (moderate depressive Symptoms) or CDI.
Diabetes CareInflammation Markers and Metabolic Characteristics of Subjects With 1-h Plasma Glucose Levels
67 Citations2009Gianluca Bardini, Ilaria Dicembrini +2 more
Elevated 1hPG in subjects with NGT and pre-diabetes is associated with subclinical inflammation, high lipid ratios, and insulin resistance, and could be considered a new “marker” for cardiovascular risk.
Gender MedicineGender differences in adiponectin and low-grade inflammation among individuals with normal glucose tolerance, prediabetes, and type 2 diabetes
65 Citations2009Juha Saltevo, Hannu Kautiainen +1 more
Adiponectin concentrations in women decreased relatively more compared with men across individuals with normal glucose tolerance, prediabetes, and type 2 diabetes, whereas inflammatory markers increased relatively more in women.
Psychosomatic MedicineAssociations of Depressive Symptoms, Trait Hostility, and Gender With C-Reactive Protein and Interleukin-6 Response After Emotion Recall
65 Citations2010Beverly H. Brummett, Stephen H. Boyle +4 more
The findings extend prior research by suggesting that, broadly speaking, depression is related to inflammatory markers; however, this relationship seems complex.
Nutrition Metabolism and Cardiovascular DiseasesCardiovascular risk and adrenergic overdrive in the metabolic syndrome
62 Citations2007Guıdo Grassı, Fosca Quarti‐Trevano +2 more
Evidence is presented that non-pharmacologic life-style interventions as well as drug treatment procedures used in the therapeutic approach to the metabolic syndrome should be aimed at exerting not only favourable haemodynamic and metabolic effects but also pronounced sympathoinhibition.
British Journal Of NutritionGlycaemic status in relation to oxidative stress and inflammation in well-controlled type 2 diabetes subjects
61 Citations2009Elisabet Rytter, Bengt Vessby +6 more
It is indicated that glycaemic status is associated with oxidative stress even in subjects with well-controlled type 2 diabetes, and inflammation was more related to abdominal obesity than to glycaemia control.
The Journal of Clinical PsychiatryInflammatory Biomarkers in 70 Depressed Inpatients With and Without the Metabolic Syndrome
57 Citations2010Sara Zeugmann, Arnim Quante +3 more
NeuroToxicologyAssociations between immunologic, inflammatory, and oxidative stress markers with severity of depressive symptoms: An analysis of the 2005–2006 National Health and Nutrition Examination Survey
51 Citations2009Roni W. Kobrosly, Edwin van Wijngaarden
Significant elevated white blood cell counts among subjects with moderate and severe depression are observed, and oxidative stress and a medical history of inflammatory diseases do not appear to mediate this association.
Journal of Psychiatric ResearchPersistence of abnormal cortisol levels in elderly persons after recovery from major depression
50 Citations2008Isabelle Beluche, Isabelle Chaudieu +5 more
Journal of Child and Adolescent PsychopharmacologyElectroencephalographic Sleep and Hypothalamic–Pituitary–Adrenal Changes from Episode to Recovery in Depressed Adolescents
46 Citations2008Uma Rao, Russell E. Poland
The findings that EEG sleep measures are independent of clinical state, whereas HPA variables are state dependent, suggest that sleep and HPA measures make a differential contribution to the understanding of the pathophysiology and prognosis of mood disorders in adolescent patients.
Journal of Psychiatric ResearchCircadian affective, cardiopulmonary, and cortisol variability in depressed and nondepressed individuals at risk for cardiovascular disease
43 Citations2007Ansgar Conrad, Frank H. Wilhelm +3 more
Diurnal mood variations of older individuals at risk for CVD differ from those reported for other groups and daily fluctuations in NA are not related to cardiac autonomic control in depressed individuals.
Diabetes CareDepressive Symptoms, Race, and Glucose Concentrations
42 Citations2007Stephen H. Boyle, Richard S. Surwit +5 more
It is suggested that enhanced hypothalamic pituitary adrenal activity plays an important role in the relation of depressive Symptoms to dysregulated glucose metabolism and may partially explain the differential effects of depressive symptoms on glucose levels in African-American and Caucasian male subjects.
Medical HypothesesAdipocytokines: A bridge connecting obesity and insulin resistance
41 Citations2009Xiao-Feng Zhuang, Mingming Zhao +2 more
It is hypothesised that adipocytokines may be a bridge connecting obesity and IR, and abnormal fat depot distribution or visceral fat/subcutaneous fat ratio (V/S ratio) in obesity also could be a primer for IR.
MetabolismHigh serum high-sensitivity C-reactive protein concentrations are associated with relative cardiac sympathetic overactivity during the early morning period in type 2 diabetic patients with metabolic syndrome
40 Citations2006Yoshimasa Aso, Sadao Wakabayashi +4 more
Type 2 diabetic patients with MS have elevated markers of inflammation and evidence of cardiac sympathetic predominance and high serum concentrations of hs-CRP are associated with relative cardiac sympathetic overactivity during the early morning in type 1 diabetic patients.
Journal of Endocrinological InvestigationThe potential role of increased adrenal volume in the pathophysiology of obesity-related Type 2 diabetes
39 Citations2006Amélio F. Godoy‐Matos, Andréa R. Vieira +6 more
The hypothesis that an increased activity of the HPA axis in obese subjects may be involved in the pathogenesis of Type 2 diabetes is supported.
MetabolismInsulin resistance is associated with C-reactive protein independent of abdominal obesity in nondiabetic Taiwanese
29 Citations2009Hsin‐Hua Chou, Lung‐An Hsu +4 more
It is confirmed that insulin resistance is strongly associated with CRP levels independent of abdominal obesity in nondiabetic Taiwanese, and factors other than abdominal obesity, such as polymorphisms in the CRP gene, may influence the association of insulin resistance withCRP levels in different ethnic populations.
The International Journal of Psychiatry in MedicineIncrease of Visceral Fat and Adrenal Gland Volume in Women with Depression: Preliminary Results of a Morphometric Mri Study
29 Citations2008Burkhard Ludescher, Arif Najib +6 more
The increase of adrenal volume and VAT and the correlation of BDI with VAT in the upper abdomen support the hypothesis of long-term production of stress hormones in depression.
MetabolismPlasma interleukin-1β concentrations are closely associated with fasting blood glucose levels in healthy and preclinical middle-aged nonoverweight and overweight Japanese men
27 Citations2010Yasumi Misaki, Rie Miyauchi +5 more
Results of the current study show that plasma IL-1β levels are strongly associated with fasting blood glucose concentrations in healthy and preclinical nonoverweight and overweight Japanese men.
The Journal of Clinical Endocrinology & MetabolismAdrenal Gland Volume and Dexamethasone-Suppressed Cortisol Correlate with Total Daily Salivary Cortisol in African-American Women
23 Citations2007Sherita Hill Golden, Saurabh Malhotra +4 more
A dexamethasone suppression test or adrenal gland volume may be alternative measures for characterizing subtle subclinical hypercortisolism in healthy adults.
Disease MarkersClinical Implications of Adiponectin and Inflammatory Biomarkers in Type 2 Diabetes Mellitus
19 Citations2009Menha Swellam, Magda Sayed Mahmoud +1 more
PubMedClinical implications of adiponectin and inflammatory biomarkers in type 2 diabetes mellitus.
17 Citations2009Menha Swellam, Magda Sayed Mahmoud +1 more
Elevated levels of CRP and fibrinogen and reduced level of adiponectin can be used for early diagnosis of T2DM and can predict diabetic complications.