Type 2 Diabetes, Obesity and Cortisol Excess

NCT ID: NCT05759637

Last Updated: 2025-03-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

3200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-05-06

Study Completion Date

2025-12-06

Brief Summary

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The present observational cross-sectional study is aimed to assess: the hidden hypercortisolism (HidHyCo) prevalence in a sample of Type 2 diabetes (T2D) patients and the clinical characteristics more frequently associated with the HidHyCo presence and the HidHyCo prevalence in an adequate sample of obese patients without T2D and the clinical characteristics more frequently associated with the HidHyCo presence.

Detailed Description

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Mild and asymptomatic hypercortisolism has been described to be associated with increased prevalence of chronic complications of cortisol excess, such as osteoporosis, hypertension, type 2 diabetes (T2D) and obesity and with increased mortality. In patients with osteoporosis, hypertension, T2D or obesity, this form of hypercortisolism may remain occult (hidden hypercortisolism, HidHyCo), until its presence is suspected on the basis of particular characteristics of the underlying diseases. The HidHyCo prevalence in the general population is estimated to be 0.2-2%, but it has been suggested to be even higher (up to 10%) in some specific populations as for example in patients T2D. Data regarding the prevalence of HidHyCo in obese populations are limited, Therefore, the issue of which diabetic or obese patient has to be screened for HidHyCo has recently become a widely debated topic. Therefore, the aims of the present study protocol are to assess: i) the HidHyCo prevalence in a sample of T2D patients and the clinical characteristics more frequently associated with the HidHyCo presence; ii) the HidHyCo prevalence in an adequate sample of obese patients without T2D and the clinical characteristics more frequently associated with the HidHyCo presence.

All T2D and obese-without T2D patients between 18 and 75 years of age, consecutively referred to the out-patient clinics for Diabetes and Obesity of our center will be assessed for possible inclusion. At the enrolment in all patients anthropometric e biochemical variables will be recorded. At the enrolment we will evaluate cortisol levels after dexamethasone suppression test (F-1mgDST) in all T2D and obese-without T2D patients, who have been included in the study and who have given the informed consent to participate in the study. In all subjects with F-1mgDST \>1.8 μg/dL, cortisol levels after two-day low dose (2 mg/day) dexamethasone suppression test (F-2mgx2dDST) will be performed. Patients with F-2mgx2dDST above \>1.8 μg/dL will be considered affected with possible HidHyCo and will be studied following the available guidelines for the diagnosis of hypercortisolism.

Conditions

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Diabetes Mellitus, Type 2 Obesity Cortisol; Hypersecretion

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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T2D

patients with Type2 diabetes (T2D)

1mg DST

Intervention Type DIAGNOSTIC_TEST

measurement of cortisol levels after 1 mg of dexamethasone (DST) at 11 pm

obese without T2D

obese patients without Type 2 diabetes (T2D)

1mg DST

Intervention Type DIAGNOSTIC_TEST

measurement of cortisol levels after 1 mg of dexamethasone (DST) at 11 pm

Interventions

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1mg DST

measurement of cortisol levels after 1 mg of dexamethasone (DST) at 11 pm

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

patients with T2D and Obesity

Exclusion Criteria

* pregnancy/breast feeding,
* sleep apnea,
* prepuberal onset of hypertension, hormonal hypersecreting adrenal mass,
* symptoms of hypercortisolism;
* already known secondary hypertension;
* conditions associated with increased hypothalamic-pituitary-adrenal (HPA) axis activity, -severe autoimmune/rheumatologic and hematologic diseases, alcoholism, kidney disease (glomerular filtration rate \<60)
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Siena

OTHER

Sponsor Role collaborator

Niguarda Hospital

OTHER

Sponsor Role collaborator

Campus Bio-Medico University

OTHER

Sponsor Role collaborator

Azienda Ospedaliero Universitaria, Santa Maria della Misericordia di Udine, Italy

OTHER

Sponsor Role collaborator

Istituto Auxologico Italiano

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Istituto Auxologico Italiano

Milan, , Italy

Site Status RECRUITING

Niguarda Hospital

Milan, , Italy

Site Status RECRUITING

Campus Bio-Medico University

Roma, , Italy

Site Status RECRUITING

University of Siena

Siena, , Italy

Site Status RECRUITING

Azienda Ospedaliero Universitaria, Santa Maria della Misericordia di Udine

Udine, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Valentina Morelli, PhD

Role: CONTACT

02619112547

Facility Contacts

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Valentina Morelli

Role: primary

02619112547

Iacopo Chiodini, Prof

Role: primary

+39026444.3376

Nicola Napoli, Prof

Role: primary

(+39) 06. 22541 697

Luigi Gennari, Prof

Role: primary

+39 0577585364

Fabio Vescini, Prof

Role: primary

(+39) 0432 552540

Other Identifiers

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05J101

Identifier Type: -

Identifier Source: org_study_id

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