Metabolic effects of short-term elevations of plasma cortisol are more pronounced in the evening than in the morning
Metabolic effects of short-term elevations of plasma cortisol are more pronounced in the evening than in the morning
复制标题
DOI：
10.1210/jc.84.9.3082
复制
发表时间：
1999-09-01
影响因子：
5.8
通讯作者：
Van Cauter, E
中科院分区：
文献类型：
--
作者：
Plat, L;Leproult, R;Van Cauter, E
为了确定皮质醇水平的升高是否对晚上（每日节律的低谷）或早晨（节律的高峰）的血糖水平和胰岛素分泌产生更明显的影响，九名正常男性每人参加了四项随机顺序的研究。在所有研究中，内源性皮质醇水平均被美替拉酮抑制，并且热量摄入完全以恒定葡萄糖输注的形式进行。通过在 0500 小时或 1700 小时施用氢化可的松（或安慰剂）恢复每日皮质醇升高。在每项研究中，在 32 小时内以所有分钟间隔测量血糖、胰岛素、C 肽和皮质醇的血浆水平。氢化可的松诱导的皮质醇脉冲的初始效果是短期抑制胰岛素分泌，而不会伴随血糖变化，并且在晚上和早上的效果相似。在一天中的两个时间，从摄入氢化可的松后 4-6 小时开始，血糖水平都会升高，并在至少 12 小时内保持高于安慰剂组的水平。这种延迟性高血糖效应在早上最小，但在晚上更为明显，此时血清胰岛素和胰岛素分泌急剧增加，胰岛素清除率下降 30%。因此，夜间皮质醇水平升高可能导致糖耐量、胰岛素敏感性和胰岛素分泌的改变。
To determine whether elevations of cortisol levels have more pronounced effects on glucose levels and insulin secretion in the evening (at the trough of the daily rhythm) or in the morning (at the peak of the rhythm), nine normal men each participated in four studies performed in random order. In all studies, endogenous cortisol levels were suppressed by metyrapone administration, and caloric intake was exclusively under the form of a constant glucose infusion. The daily cortisol elevation was restored by administration of hydrocortisone (or placebo) either at 0500 h or at 1700 h. In each study, plasma levels of glucose, insulin, C-peptide, and cortisol were measured at all-min intervals for 32 h.The initial effect of the hydrocortisone-induced cortisol pulse was a short-term inhibition of insulin secretion without concomitant glucose changes and was similar in the evening and in the morning. At both times of day, starting 4-6 h after hydrocortisone ingestion, glucose levels increased and remained higher than under placebo for at least 12 h. This delayed hyperglycemic effect was minimal in the: morning but much more pronounced in the evening, when it was associated with robust increases in serum insulin and insulin secretion and with a 30% decrease in insulin clearance.Thus, elevations of evening cortisol levels could contribute to alterations in glucose tolerance, insulin sensitivity, and insulin secretion.