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.

中文翻译：

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一项回顾性研究：低剂量地塞米松抑制试验后的血清皮质醇水平可预测肥胖患者的糖尿病和高血压。

AIMS肥胖症是一个严重增加的医疗保健问题，并伴有2型糖尿病（DM），高血压和心血管疾病等疾病。下丘脑-垂体-肾上腺（HPA）轴改变被认为在肥胖的背景下是有效的，甚至与DM和高血压同时发生。我们旨在通过过夜1 mg地塞米松抑制试验（DST）评估HPA轴的负反馈机制，以及肥胖后1 mg DST皮质醇水平与DM和高血压的相关性。方法该研究由402名DST后提供抑制的肥胖患者组成。评估了1 mg DST后皮质醇的水平及其与其他变量的关系，包括人体测量，实验室检查结果，高血压，糖尿病前期和DM的存在。研究了1 mg DST后对高血压和DM的预测性。结果与有和没有DM的患者，无DM和有糖尿病的患者，糖尿病前和DM的患者相比，我们在1 mg DST皮质醇水平上存在显着差异（分别为p <0.001 vs. p = 0.003 vs. p = 0.022） 。高血压患者服用1 mg DST后的皮质醇水平显着更高（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）和HbA1c（r = 0.278，p <0.001）水平呈正相关。Logistic回归分析表明1 mg DST后皮质醇水平是DM和高血压存在的独立预测因子。结论肥胖合并高血压和糖尿病的患者可能会改变皮质醇的负反馈机制。因此，1 mg DST后的皮质醇水平可以预测肥胖中的高血压和DM的存在。