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High sodium intake is associated with increased glucocorticoid production, insulin resistance and metabolic syndrome
Author(s) -
Baudrand R.,
Campino C.,
Carvajal C.A.,
Olivieri O.,
Guidi G.,
Faccini G.,
Vöhringer P.A.,
Cerda J.,
Owen G.,
Kalergis A.M.,
Fardella C.E.
Publication year - 2014
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12225
Subject(s) - medicine , endocrinology , adiponectin , insulin resistance , aldosterone , glucocorticoid , metabolic syndrome , insulin , sodium , urinary system , confounding , hydrocortisone , chemistry , obesity , organic chemistry
Objective High sodium ( HS ) diet is associated with hypertension ( HT ) and insulin resistance ( IR ). We evaluated whether HS diet was associated with a dysregulation of cortisol production and metabolic syndrome ( M et S ). Patients and measurements We recruited 370 adults (18–85 years, BMI 29·3 ± 4·4 kg/m 2 , 70% women, 72% HT , 61% M et S ). HS diet (urinary sodium >150 mEq/day) was observed in 70% of subjects. We measured plasma hormones, lipid profile, urinary free cortisol ( UFC ) and cortisol tetrahydrometabolites ( THM ). Results Urinary sodium was correlated with UFC ( r = +0·45, P < 0·001), cortisol THM ( r = +0·41, P < 0·001) and inversely with adiponectin, HDL and aldosterone, after adjusting by age, gender and BMI . Subjects with high, compared with adequate sodium intake (50–149 mEq/day) had higher UFC ( P < 0·001), THM ( P < 0·001), HOMA‐IR ( P = 0·04), HT (81% vs 50%, P < 0·001), M et S (69% vs 41%, P < 0·001) and lower adiponectin ( P = 0·003). A multivariate predictive model adjusted by confounders showed a high discriminative capacity for M et S ( ROC curve 0·878) using four clinical variables: HS intake [ OR = 5·6 ( CI 2·3–15·3)], HOMA ‐ IR [ OR 1·7 (1·3–2·2)] cortisol THM [ OR 1·2 (1·1–1·4)] and adiponectin [ OR = 0·9 (0·8–0·9)], the latter had a protective effect. Conclusions High sodium diet was associated with increased urinary cortisol and its metabolites. Also, HS diet was associated with HT, insulin resistance, dyslipidaemia and hypoadiponectinaemia, even when adjusting by confounding variables. Further, we observed that high salt intake, IR and higher cortisol metabolites, alone or combined in a clinical simple model, accurately predicted M et S status, suggesting an additive mechanism in obesity‐related metabolic disorders.