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

Abstract

T he prevalence of metabolic syndrome manifestations is rapidly increasing worldwide, and is becoming an important health problem. Actually, metabolic syndrome includes a combination of clinical complications such as obesity (central adiposity), insulin resistance, glucose intolerance, dyslipidemia, non-alcoholic fatty liver disease and hypertension. All these alterations predispose individuals to type 2 diabetes and cardiovascular disease inducing earlier mortality rates among people. Metabolic syndrome identifies clinical symptoms and lab results, including abdominal obesity, insulin resistance, hyperglycemia, hyperlipidemia, and hypertension, that lead to an increased risk of cardiovascular disease (CVD). Obesity typically results in insulin and leptin resistance and a shift from expansion of subcutaneous fat to deposition of abdominal and ectopic fat. These conditions cause metabolic dysregulation. Prevalence of metabolic syndrome varies markedly from country to country. This seems to be caused by two factors: 1) Variations of lifestyle (especially, diet, smoking and level of physical exercise) between countries. 2) Variations in ethnicity. In all settings and all population, the prevalence of metabolic syndrome increase with age. The aim of this study is to evaluate role of HPA (Hypothalamic Pituitary Adrenal axis) activity in relation to obesity in metabolic syndrome patients by using the overnight 1 mg dexamethasone suppression test.