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Glucocorticoids associate with cardiometabolic risk factors in black South Africans

Lookup NU author(s): Professor Brian WalkerORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Circulating glucocorticoids are associated with metabolic syndrome and related cardiometabolic risk factors in non-Africans. This study investigated these associations in Africans, whose metabolic phenotype reportedly differs from Europeans. Adiposity, blood pressure, glycaemia, insulin resistance, and lipid profile, were measured in 316 African men and 788 African women living in Soweto, Johannesburg. The 2009 harmonized criteria were used to define metabolic syndrome. Serum glucocorticoids were measured using liquid chromatography-mass spectrometry. Cortisol was associated with greater odds presenting with metabolic syndrome (odds ratio (95% CI) =1.50 (1.04, 2.17) and higher systolic (beta coefficient, β (95% CI) =0.04 (0.01, 0.08)) and diastolic (0.05 (0.02, 0.09)) blood pressure, but higher HDL (0.10 (0.02, 0.19)) and lower LDL (−0.14 (−0.24, −0.03)) cholesterol concentrations, in the combined sample of men and women. In contrast, corticosterone was only associated with higher insulin sensitivity (Matsuda index; 0.22 (0.03, 0.41)), but this was not independent of BMI. Sex-specific associations were observed, such that both cortisol and corticosterone were associated with higher fasting glucose (standardized β (95% CI): 0.24 (0.12, 0.36) for cortisol and 0.12 (0.01, 0.23) for corticosterone) and HbA1c (0.13 (0.01, 0.25) for cortisol and 0.12 (0.01, 0.24) for corticosterone) in men only, but lower HbA1c (0.10 (−0.20, −0.01) for cortisol and −0.09 (−0.18, −0.03) for corticosterone) in women only. Our study reports for the first time that associations between circulating glucocorticoid concentrations and key cardiometabolic risk factors exhibit both glucocorticoid- and sex-specificity in Africans.

Publication metadata

Author(s): Dlamini SN, Lombard Z, Micklesfield LK, Crowther N, Norris SA, Snyman T, Crawford AA, Walker BR, Goedecke JH

Publication type: Article

Publication status: Published

Journal: Endocrine Connections

Year: 2021

Volume: 10

Issue: 8

Pages: 873–884

Online publication date: 02/08/2021

Acceptance date: 14/07/2021

Date deposited: 13/08/2021

ISSN (print): 2049-3614

Publisher: BioScientifica


DOI: 10.1530/EC-21-0195


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