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School of Medicine
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Sherita Golden, MD, MHS
Ciccarone Center Research
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- Meet the Authors
Health disparities in endocrine disorders: Biological, clinical, and nonclinical factors — an Endocrine Society Scientific Statement.There is little evidence that genetic differences contribute significantly to race/ethnic disparities in the endocrine disorders examined. Multilevel interventions have reduced disparities in diabetes care, and these successes can be modeled to design similar interventions for other endocrine diseases.Read on Pubmed
Associations of salivary cortisol levels with inflammatory markers: the Multi-Ethnic Study of Atherosclerosis.
Socioeconomic and psychosocial factors have been found to be associated with systemic inflammation. Although stress is often proposed as a contributor to these associations, no population studies have investigated the links between inflammation and biomarkers of stress. The current study examines associations between daily cortisol profiles and inflammatory markers interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor (TNF-a) in a population-based sample of 869 adults with repeat measures of cortisol over multiple days. Persons with higher levels of IL-6 had a less pronounced cortisol awakening response, a less steep daily decline, and higher cortisol area under the curve for the day with associations persisting after controls for risk factors and other cytokines. Persons with higher levels of TNF-a had lower cortisol levels upon waking, and flatter daily decline, although associations with decline were attenuated when controlling for inflammatory risk factors. Higher levels of IL-10 were associated with marginally flatter daily cortisol decline (p<.10). This study is the first to identify associations of basal cortisol activity and inflammatory markers in a population based sample. Findings are consistent with the possibility that HPA axis activity may mediate associations between psychosocial stressors and inflammatory processes. Additional prospective data are necessary to clarify the directionality of associations between cortisol and inflammatory markers.
There is little evidence that genetic differences contribute significantly to race/ethnic disparities in the endocrine disorders examined. Multilevel interventions have reduced disparities in diabetes care, and these successes can be modeled to design similar interventions for other endocrine diseases.
Implementing and evaluating a multicomponent inpatient diabetes management program: putting research into practice.
Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives.
Association of baseline sex hormone levels with baseline and longitudinal changes in waist-to-hip ratio: Multi-Ethnic Study of Atherosclerosis.
Sex hormones are associated with waist-to-hip ratio at baseline and also during follow-up above and beyond their baseline association. Future research is needed to determine if manipulation of hormones is associated with changes in central obesity.
Associations of salivary cortisol levels with metabolic syndrome and its components: the multi-ethnic study of atherosclerosis.
Our findings do not support the hypothesis that differences in level or diurnal pattern of salivary cortisol output are associated with metabolic syndrome among persons without clinical diabetes.
Emerging therapeutic approaches for the management of diabetes mellitus and macrovascular complications.
Type 2 DM affects an estimated 26 million people in the U.S. and is the 7th leading cause of death. While effective therapy can prevent or delay the complications that are associated with diabetes, according to the Center for Disease Control, 35% of Americans with DM are undiagnosed, and another 79 million Americans have blood glucose levels that greatly increase their risk of developing DM in the next several years. This article reviews established and emerging therapeutic approaches for managing DM and prevention of macrovascular complications.
Reliability of hypothalamic-pituitary-adrenal axis assessment methods for use in population-based studies.
Population-based studies have been hampered in exploring hypothalamic-pituitary-adrenal axis (HPA) activity as a potential explanatory link between stress-related and metabolic disorders due to their lack of incorporation of reliable measures of chronic cortisol exposure. The purpose of this review is to summarize current literature on the reliability of HPA axis measures and to discuss the feasibility of performing them in population-based studies.
Biological basis of depression in adults with diabetes.
Diabetes and depression are common comorbid conditions. Although certain health behaviors and risk factors partially explain the association of depression and diabetes, other potential mechanisms have yet to be elucidated. The objectives of this review were to summarize and review the recent evidence showing alterations of these three biological systems—HPA axis, SNS, and inflammatory cascade—in depression, diabetes, and diabetes-related risk factors.
Life course socioeconomic conditions and metabolic syndrome in adults: the Atherosclerosis Risk in Communities (ARIC) Study.
Black and white women with low childhood socioeconomic status (SES), early adult SES, mature adult SES or cumulative SES were more likely to have the metabolic syndrome (MetS) than those with high SES. These associations remained after adjustment for physical activity, smoking status, and drinking status. In contrast, there was no association of SES with MetS in men. Our findings suggest that socioeconomic disadvantage early in life and across the life course influences risk of the MetS in black and white women.