Serum cortisol level after low dose dexamethasone suppression test may be predictive for diabetes mellitus and hypertension presence in obese patients: A retrospective study
Serum cortisol level after low dose dexamethasone suppression test may be predictive for diabetes mellitus and hypertension presence in obese patients: A retrospective study
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DOI：
10.1016/j.diabres.2020.108081
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发表时间：
2020-03-01
影响因子：
5.1
通讯作者：
Cakal, Erman
中科院分区：
文献类型：
--
作者：
Hepsen, Sema;Sencar, Erkam;Cakal, Erman
目的：肥胖是一个显著增加的健康问题，伴随着包括2型糖尿病（DM）、高血压和心血管疾病在内的疾病。下丘脑-垂体-肾上腺（HPA）轴的改变被认为在肥胖的背景下是有效的，甚至伴随着糖尿病和高血压。我们的目的是评估HPA轴的负反馈机制，通过过夜1毫克地塞米松抑制试验（DST）和1毫克DST后皮质醇水平与DM和高血压存在的肥胖症。方法：本研究包括402肥胖患者谁提供抑制DST后。评价了1 mg DST后皮质醇水平及其与其他变量的相关性，包括人体测量、实验室检查结果、高血压、前驱糖尿病和DM存在。研究了1 mg DST后对高血压和糖尿病的预测性。结果：与有糖尿病和无糖尿病患者、无糖尿病和糖尿病前期患者、糖尿病前期和糖尿病患者相比，1 mg DST后皮质醇水平存在显着差异（分别为p < 0.001和p = 0.003和p = 0.022）。高血压患者DST 1 mg后皮质醇水平显著升高（p < 0.001）。1 mg DST后皮质醇水平与年龄（r = 0.319，p < 0.001）、空腹血糖（r = 0.168，p = 0.001）、糖化血红蛋白（r = 0.278，p < 0.001）呈正相关。Logistic回归分析显示，DST 1 mg后皮质醇水平是糖尿病和高血压的独立预测因子。结论：肥胖合并高血压和糖尿病患者皮质醇负反馈机制可能发生改变。因此，1 mg DST后皮质醇水平可以预测肥胖患者的高血压和DM存在。(C)2020爱思唯尔B. V.保留所有权利。
Aims: Obesity, a remarkably increased healthcare problem, accompanies with morbidities including type 2 diabetes mellitus (DM), hypertension, and cardiovascular diseases. Hypothalamic-pituitary-adrenal (HPA) axis alteration is thought to be effective on the background of obesity, even concomitant with DM and hypertension. We aimed to evaluate the negative feedback mechanism of the HPA axis via overnight 1 mg dexamethasone suppression test (DST) and the association of post-1 mg DST cortisol level with DM and hypertension presence in obesity.Methods: This study consisted of 402 obese patients who provide suppression after DST. Post-1 mg DST cortisol level and its association with other variables including anthropometric measurements, laboratory test results, hypertension, prediabetes, and DM presence were evaluated. Predictivity of post-1 mg DST for hypertension and DM was investigated.Results: We established a significant difference in post-1 mg DST cortisol level when compared patients with and without DM, patients without DM and with prediabetes, patients with prediabetes and DM (p < 0.001 vs. p = 0.003 vs. p = 0.022 respectively). Post-1 mg DST cortisol level was significantly higher in hypertensive patients (p < 0.001). Post-1 mg DST cortisol level had positive correlation with age (r = 0.319, p < 0.001), fasting plasma glucose (r = 0.168, p = 0.001), and HbA1c (r = 0.278, p < 0.001) levels. Logistic regression analyses demonstrated that post-1 mg DST cortisol level is an independent predictor of DM and hypertension presence.Conclusion: Cortisol negative feedback mechanism may be altered in obese patients who are complicated with hypertension and DM. Therefore, post-1 mg DST cortisol level can be predictive for hypertension and DM presence in obesity. (C) 2020 Elsevier B.V. All rights reserved.