Prediabetes May Alter HPA Axis Activity and Regulation: A Study on Patients with Prediabetes

Abstract

A dysregulated hypothalamic-pituitary-adrenal (HPA) axis in patients with type 2 diabetes (T2D), a condition preceded by prediabetes, has been shown to exacerbate the hyperglycaemic state, increasing the risk of depression. However, HPA axis activity in a prediabetic state-as well as whether the prediabetic state affects HPA axis regulation-is not fully understood. This study investigated the activity of the HPA axis in selected biomarkers and hormones related to HPA axis regulation in individuals with prediabetes. The study used samples obtained from adults aged between 25 and 45 of all ethnicities from the King Edward VIII Hospital. The samples were divided into three groups-non-prediabetic (NPD) (<i>n</i> = 40), prediabetic (PD) (<i>n</i> = 40), and T2D (<i>n</i> = 40)-based on the participant's glycated haemoglobin percentage. The cortisol (CORT), adrenocorticotropic hormone (ACTH), insulin, epinephrine (EPI), and norepinephrine (NE) concentrations of the samples were measured. The plasma CORT and ACTH concentrations in the PD group were higher compared to the NPD group. Plasma insulin concentration was increased only in the T2D group. There was also an increase in the plasma epinephrine concentration in the T2D group as compared to the NPD and PD groups. These observations collectively suggest that prediabetes is associated with heightened HPA axis activity and may alter HPA axis regulation, which may cause an altered stress response.