Letters to the Editor |
Diabetes and depression—is there a link to the HPA axis?
Dear Sir,It was with much interest that I read the article by Cosgrove et al. [1] about increased risk of developing Type 2 diabetes in people with depression.
It has been shown that in depression, there is an increased activity of hypothalamopituitary adrenal (HPA) axis, resulting in increased cortisol [2]. It is well-known that patients with Cushing's disease can commonly develop depression and they are also prone to develop diabetes. Studies by Lac and Chamoux [3] have shown that sleep deprivation in shift workers increased levels of salivary cortisol. Meerlo et al. [4] showed that sleep restriction alters the HPA response to stress. Overactivity of the HPA axis can cause stress initially and later on a depressive disorder. It would be interesting to look at the patients in your study as to whether they had any history of sleep deprivation causing increased cortisol levels and whether this could be the link between the diabetes and depression.
Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
e-mail: annaalexander{at}doctors.org.uk
References
- Cosgrove MP, Sargeant LA, Griffin SJ. Does depression increase the risk of developing type 2 diabetes? Occup Med (Lond) (2008) 58:7–14.[CrossRef][Medline]
- Pitchot W, Herrera C, Ansseau M. HPA axis dysfunction on major depression: relationship to 5-HT (1A) receptor activity. Neuropsychobiology (2001) 44:74–77.[CrossRef][Web of Science][Medline]
- Lac G, Chamoux A. Elevated salivary cortisol levels as a result of sleep deprivation in a shift worker. Occup Med (Lond) (2003) 53:143–145.[CrossRef][Medline]
- Meerlo P, Koehl M, van der Borght K, Turek FW. Sleep restriction alters the hypothalamo-pituitary-adrenal response to stress. J Neuroendocrinol (2002) 14:397–402.[CrossRef][Web of Science][Medline]
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