Adrenal gland size in obstructive sleep apnea: Morphological assessment of hypothalamic pituitary adrenal axis activity
Open Access
- 20 September 2019
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 14 (9), e0222592
- https://doi.org/10.1371/journal.pone.0222592
Abstract
The association of obstructive sleep apnea (OSA) with hypothalamic pituitary adrenal (HPA) axis activation has not been fully understood from results of previous studies using hormonal assessments. We aimed to investigate the relationship between adrenal size, a potential marker reflecting HPA axis activity, and sleep parameters related to OSA. We retrospectively reviewed data on 284 consecutive adult patients aged 20 to 80 y who had undergone polysomnography and abdominal computed tomography (CT). OSA was defined as none/mild (apnea-hypopnea index [AHI] 2 <90% but a higher arousal index was the only determinant factor for increased adrenal limb width (β = 0.27, p <0.001) after adjusting for other variables that could affect adrenal size. Neither the arousal index nor hypoxic parameters were associated with adrenal body width. Results indicated that adrenal glands may enlarge in response to longstanding sleep fragmentation, suggesting the involvement of OSA in HPA axis augmentation.Keywords
This publication has 52 references indexed in Scilit:
- Is obstructive sleep apnea associated with cortisol levels? A systematic review of the research evidenceSleep Medicine Reviews, 2012
- Insulin resistance and daytime sleepiness in patients with sleep apnoeaThorax, 2008
- Chronic intermittent hypoxia sensitizes acute hypothalamic–pituitary–adrenal stress reactivity and Fos induction in the rat locus coeruleus in response to subsequent immobilization stressNeuroscience, 2008
- Depression and anxiety in obstructive sleep apnea syndrome: a reviewActa Neurologica Scandinavica, 2007
- Metabolic Syndrome in Japanese Patients with Obstructive Sleep Apnea SyndromeHypertension Research, 2006
- Investigation of the Hypothalamo-pituitary-adrenal Axis and Changes in the Size of Adrenal Glands in Acute BrucellosisEndocrine Journal, 2005
- Changes in the Size of Adrenal Glands in Acute Pulmonary Tuberculosis with Therapy.Endocrine Journal, 1996
- The Hospital Anxiety and Depression ScaleActa Psychiatrica Scandinavica, 1983
- THE HUMAN ADRENAL GLAND WITH SPECIAL REFERENCE TO THE VASCULATUREJournal of Endocrinology, 1966
- A Syndrome produced by Diverse Nocuous AgentsNature, 1936