INS and metabolic syndrome: For instance, urinary glucocorticoid excretion is linked to aspects of metabolic syndrome, including BP, fasting glucose, insulin, and WC.129 The role of cortisol in mediating visceral fat accumulation, insulin resistance, and T2DM has been elegantly demonstrated by transgenic knockout and overexpression models of 11β-HSD1.130,131 It appears that some individuals are high responders to stress stimuli and demonstrate higher cortisol secretion.