Hypothalamic Pituitary Adrenal Axis Activity in Relation to Obesity in Metabolic Syndrome Patients

Background and Aim: The prevalence of the metabolic syndrome is considerable among obese adolescents. There are striking similarities between Cushing's syndrome and the metabolic syndrome. Our aim was to evaluate the activity of HPA axis and serum cortisol in metabolic syndrome patients. Methods: Our study was conducted on 120 subjects divided into 2 groups : 60 of them were diagnosed with metabolic syndrome (group A) and 60 healthy non metabolic syndrome patients (group B), each group was further classified into 2 groups (I,II),(III,IV) according to obese (BMI>30) and non obese subjects(BMI<25). Full history taking , clinical evaluation, fasting blood sugar, serum insulin, HOMA-IR, lipid profile, serum cortisol before and after overnight 1 mg dexamethasone suppression test were measured in all subjects. Results: On comparing the four studied groups there was a significant statistical difference as regards serum cortisol (pretest) and serum cortisol after overnight dexamethasone suppression test, fasting blood sugar and HOMA-IR.(P=0.000,0.000, 0.000,.0026 respectively). On comparing group I and IV; group II and III: There was a non statistical significant difference as regards pretest and post suppression serum cortisol (P value > 0.05). There was none significant correlation between pretest serum cortisol and fasting blood glucose, insulin and HOMA-IR, total cholesterol and serum triglycerides (P value > 0.05). Conclusion: There was none statistical significant difference in serum cortisol before and after 1 mg over night dexamethasone suppression test in obese and non - obese patients with metabolic syndrome which implicates minor role for cortisol in obesity of metabolic syndrome.