Blood Cortisol Level in Patients with Metabolic Syndrome and Its Correlation with Parameters of Lipid and Carbohydrate Metabolisms

Background and Objective: Disturbance in adrenocortical mechanisms of regulation can play a significant role in the development of metabolic syndrome (MS).

The goal of the work was to study the correlations between the glucocorticoid status of patients with metabolic syndrome and the severity of disturbances in carbohydrate and lipid metabolisms.

Materials and Methods: Our studies carried out on two groups of patients, healthy subjects (n=28) and patients with MS characterized by obesity, insulin resistance, type 2 diabetes and hypertension (n=20), provide evidence for close relationships between the level of blood cortisol and the extent of MS severity. The concentration of cortisol, glucose, triglycerols, total cholesterol, HDL and LDL was determined in blood samples.

Results: Patients with MS and low blood cortisol level showed less pronounced disturbances in lipid metabolism: The concentration of triglycerols was decreased by 30.2%, whereas that of LDL was reduced by 16.3% compared to patients with MS and normal cortisol level. The level of cortisol was correlated to the level of total cholesterol (rs= –0.3601, p=0.046). These relationships were more pronounced in patients with MS: their LDL levels highly significantly correlated to the cholesterol/cortisol ratio (rs=0.7062, p=0.01). In contrast to the higher blood glucose concentrations (>7.1 mmol/l), the low levels (<5.0) in patients with MS (and not in healthy subjects) were related to the risk of increase in morning blood cortisol concentrations in fasting patients.

Conclusion: The results obtained show that the correlations between glucocorticoids and cholesterol can play a significant role in the mechanisms of MS development, which is most probably related to dysregulation of the pituitary-adrenal system in the development of MS.