Obstructive sleep apnea syndrome causes a pseudo-Cushing’s state in Japanese obese patients with type 2 diabetes mellitus

Endocrine Journal

Michio Otsuki¹  Toshiharu Onodera¹  Daisuke Tamada¹  Ayumu Hirata¹  Susumu Kashine²  Tetsuhiro Kitamura¹  Iichiro Shimomura¹ 

[1] Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan;Department of Internal Medicine, Suita Municipal Hospital, Osaka, Japan

关键词: Obstructive sleep apnea syndrome;    Pseudo-Cushing’s syndrome;    Cushing’s disease;    Dexamethasone suppression test;   

DOI  :  10.1507/endocrj.EJ13-0255

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(23)Cited-By(1)Activation of the hypothalamic-pituitary-adrenal axis has been reported in some patients with the obstructive sleep apnea syndrome (OSAS).In current study, we investigated whether OSAS affect the screening test for subclinical Cushing’s disease using 0.5 mg overnight dexamethasone suppression test (DST) in Japanese obese diabetic patients with OSAS.Among Japanese obese patients with type 2 diabetes mellitus who had been hospitalized in our department, we selected 20 patients with moderate to severe untreated OSAS (apnea-hypoxia index, AHI, of ≥15 events/hour).All patients underwent 0.5 mg DST.The same test was repeated in patients with positive response of it within a few days after continuous positive airway pressure (CPAP) therapy.We found that five patients showed positive response of DST (25%).Three of these patients continued to use CPAP, and they showed normal response of DST after CPAP therapy.Serum cortisol after 0.5 mg DST measured before CPAP therapy correlated significantly with fasting serum cortisol level (r=0.764, pp=0.784), body mass index (p=0.984), waist circumference (p=0.957), HbA1c (p=0.261), fasting plasma glucose (p=0.420) and HOMA-IR (p=0.500).Our study show that OSAS causes a pseudo-Cushing’s syndrome in obese patients with type 2 diabetes mellitus, which phenomena can be reversed by CPAP therapy.

【 授权许可】

Unknown