Endocrine Abstracts

JOINT190

Background: Studies have suggested possible link between diabetic kidney disease (DKD) and cortisol levels. Relationship between DKD and triglyceride-glucose (TyG) index is currently investigating. However sole relationship between cortisol, TyG index and microalbuminuria in diabetic population is unknown. This study aims to investigate the potential association and interplay between microalbuminuria, cortisol, and TyG index in DMT2 patients.

Material and Methods: One hundred and seventy participants were enrolled in this study, comprising one hundred patients with DMT2 and seventy healthy volunteers. Anthropometric and biochemical characteristics were evaluated in all participants. Parameters measured included fasting blood glucose, HbA1c, 8h cortisol, cortisol after low-dose overnight dexamethasone suppression test (DEX cortisol), ACTH, urinary albumin-to-creatinine ratio (UACR), Trygliceride Glucose Index (TyG) (calculated as TYG = ln (fasting triglycerides × fasting glucose/2)). Microalbuminuria is defined as UACR> 30-≤ 300mg/g. Statistical analyses included correlation analysis, multiple regression, and subgroup analysis. The study protocol was approved by the Ethical Committee of the University Clinical Centre Tuzla, under the number 02-09/2-50/14.

Results: ROC analysis showed that cortisol (AUC: 0. 733, p < 0. 001) and TyG index (AUC: 0. 968, p < 0. 001) effectively discriminate between T2DM patients and controls, with optimal cut-off values of >342 for cortisol and >8. 49 for TyG. Strong correlations were found between TyG index and microalbuminuria (r = 0. 7463, p < 0. 0001) and cortisol and microalbuminuria (r = 0. 5151, p < 0. 0001), suggesting that higher levels of TyG index and cortisol are associated with more pronounced microalbuminuria. Median cortisol levels increased from 324. 0 (IQR: 233. 0–400. 0) in the normoalbuminuria group to 518. 7 (IQR: 424. 0–593. 2) in the microalbuminuria group, while the Tyg values increased from 8. 5 (IQR: 8. 2–8. 9) in normoalbuminuria to 10. 2 (IQR: 9. 8–10. 5) in microalbuminuria. Additionally, the TYG index showed a correlation with cortisol (r = 0. 4071, p < 0. 0001), suggesting that higher cortisol levels are associated with higher TYG index values. We did not find a significant association of DEX cortisol and ACTH with the TyG index and microalbumin.

Conclusion: Elevated cortisol levels and the TyG index are strong predictors of microalbuminuria in patients with type 2 diabetes mellitus. Additionally, a higher TyG index is associated with higher cortisol levels. This connection is particularly important as it establishes a foundation for further research on how reducing the Tyg index may influence cortisol levels and decrease the risk of microalbuminuria.

Key-words: cortisol, TYG Index, Microalbuminuria