Abstract Title:

Alterations of cortisol homeostasis may link changes of the sociocultural environment to an increased diabetes and metabolic risk in developing countries.

Abstract Source:

J Clin Endocrinol Metab. 2015 Mar ;100(3):E482-6. Epub 2014 Dec 18. PMID: 25522263

Abstract Author(s):

Peter Herbert Kann, Mark Münzel, Peyman Hadji, Hanna Daniel, Stephan Flache, Peter Nyarango, Anneke Wilhelm

Article Affiliation:

Peter Herbert Kann


CONTEXT: Diabetes mellitus is increasingly affecting Africa.

OBJECTIVE: Urbanization of the Ovahimba people in Namibia is associated with an increased prevalence of disorders of glucose metabolism, and may thus be attributed to changes of cortisol homeostasis.

DESIGN: A prospective, cross-sectional, diagnostic study was applied.

SETTING: The study was conducted in the field. Location of the Diabetes Epidemic: Africa and Namibia.

PARTICIPANTS: Ovahimba people: group 1"urban"n = 60, 42 females, 46.3± 11.3 years (town); group 2"rural"n = 63, 44 females, 51.1± 12.0 years (seminomadic).

INTERVENTIONS: oGTT, sunrise and sunset saliva cortisol, metabolic parameters, questionnaire.

MAIN OUTCOME MEASURE: The prevalence of disorders of glucose metabolism (DM, IGT, IFT).

RESULTS: The prevalence of disorders of glucose metabolism differed significantly: urban group n = 17(28.3%) vs rural group n = 8(12.7%)(P = 0.04). The saliva cortisol concentrations also differed significantly: sunrise 0.34± 0.18 vs 0.12 ± 0.15 μg/dL, sunset 0.18 ± 0.20 vs 0.07 ± 0.09 μg/dL, area under the curve 6.16 ± 3.48 vs 2.28 ± 2.56 μg/dL * 24 h (all P<0.001). Further metabolic parameters were unfavorably changed in the urban group: hip circumference (P<0.001), waist circumference (P<0.001), body mass index (P = 0.014), systolic BP at rest (P<0.001), diastolic BP at rest (P = 0.002), systolic BP after exercise (P<0.001), heart rate after exercise (P = 0.007), fasting glucose (P<0.001), 2-h-glucose by OGTT (P = 0.002), triglycerides (P = 0.04), HDL-cholesterol (P = 0.014), prevalence of the metabolic syndrome (P<0.001). Physical activity was higher in the rural group, and intake of fast food and sweets were higher in the urban group.

CONCLUSIONS: Urbanization of the Ovahimba people is associated with an increasing prevalence of disorders of glucose metabolism and other unfavorable metabolic parameters. Besides changes of lifestyle, this may be attributed to an increased cortisol exposure of the Ovahimba people living in an urban environment.

Study Type : Human Study

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