ECE2009 Poster Presentations Adrenal (54 abstracts)
Dr Dragisa Misovic-Dedenje, Clinical-Hosopital Center, Belgrade, Serbia.
The metabolic syndrome resembles Cushings syndrome in several clinical aspects. Main characteristic of both syndromes is obesity assessed by the body mass index (BMI) or waist circumference (WC).
The aim of this study was to investigate cortisol dynamics in 20 healthy volunteers (BMI<27 kg/m2; 13 females, 7 males, age 42.1+12.39 years) and 20 obese patients (BMI≥27 kg/m2; 13 females, 7 males, age 49.25+15.52 years). Screening tests included: 1) late-night (23:00 h) salivary cortisol; 2) morning to late-night (08:00/23:00 h) salivary cortisol ratio; 3) salivary cortisol response to 1 mg overnight dexamethasone suppression (post-DXM), and 4) basal morning to post-suppression (08:00 h/post-DMX) salivary cortisol ratio. Results are given in following Table.
Normal controls | Obese patients | P | |
23:00 h | 3.83 | 6.11 | 0.0016 |
08:00/23:00 h ratio | 5.23 | 3.76 | 0.0232 |
Post-DXM | 2.39 | 6.45 | 0.0001 |
08:00 h/post-DMX | 8.45 | 4.28 | 0.0003 |
In obese patients, late-night (23:00 h) salivary cortisol as well as the post-dexamethasone level was significantly higher than in age and gender-matched healthy controls. Consequences of these alterations in cortisol dynamics were significantly lower morning to late-night (08:00/23:00 h) as well as basal morning to post-suppression (08:00 h/post-DMX) salivary cortisol ratios observed in obese patients.
It could be concluded that some subtle alterations in salivary cortisol dynamics exist in obese patients. This observation is in accordance with the literature data on the incidence of subclinical Cushings syndrome in patients with Metabolic Syndrome that is not negligible.