(P104) Characteristics of CATALYST Participants Across Different Post-DST Cortisol Levels

This poster gives an overview of results from Part 1 of the CATALYST study, the largest prospective study to date to assess the prevalence of endogenous hypercortisolism in participants with difficult-to-control type 2 diabetes (T2D), which found a hypercortisolism prevalence of 23.8% in this population. In CATALYST, hypercortisolism was defined as post-1-mg dexamethasone suppression test (DST) cortisol >1.8 μg/dL with dexamethasone ≥140 ng/dL. As the 95th percentile value for post-DST cortisol in normal controls is 1.2 µg/dL, this report summarizes and compares the characteristics of CATALYST study participants with post-DST cortisol levels <1.2 μg/dL, 1.2–1.8 μg/dL, and >1.8 μg/dL using univariate and multivariate logistic regression analyses. Increasing post-DST cortisol levels were associated with greater prevalence of cardiac comorbidities and greater utilization of cardiovascular, analgesic, lipid-modifying, and psychiatric medications. Factors independently associated with post-DST cortisol >1.8 μg/dL versus 1.2–1.8 μg/dL included ethnicity and greater use of fibrates and blood pressure medication classes (all P<0.01). Factors independently associated with post-DST cortisol 1.2–1.8 μg/dL versus <1.2 μg/dL included ethnicity, age, and taking ≥4 antihyperglycemic classes of medications. These findings suggest that cardiometabolic risk may vary as a function of nonsuppressible cortisol and that individuals with post-DST cortisol 1.2–1.8 μg/dL should be further studied.