Adrenal gland size in obstructive sleep apnea: Morphological assessment of hypothalamic pituitary adrenal axis activity


Autoři: Takuma Minami aff001;  Ryo Tachikawa aff001;  Takeshi Matsumoto aff001;  Kimihiko Murase aff002;  Kiminobu Tanizawa aff002;  Morito Inouchi aff002;  Tomohiro Handa aff001;  Toru Oga aff003;  Toyohiro Hirai aff001;  Kazuo Chin aff002
Působiště autorů: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan aff001;  Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan aff002;  Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan aff003
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0222592

Souhrn

Objectives

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.

Methods

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] <15, n = 75), moderate (AHI 15 to 30, n = 80), and severe OSA (AHI ≥30, n = 129). Widths of adrenal body and limbs were measured by abdominal CT.

Results

Adrenal size was greater in participants with severe OSA than in those with none/mild or moderate OSA (adrenal body width: 6.03 mm, none/mild OSA; 6.09 mm, moderate OSA; 6.78 mm, severe OSA; p <0.001; adrenal limb width: 3.75 mm, none/mild OSA; 3.95 mm, moderate OSA; 4.26 mm, severe OSA, p <0.001). Multivariate regression analysis showed that not the 3% oxygen desaturation index and time of SpO2 <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.

Conclusions

Results indicated that adrenal glands may enlarge in response to longstanding sleep fragmentation, suggesting the involvement of OSA in HPA axis augmentation.

Klíčová slova:

Research and analysis methods – Imaging techniques – Biology and life sciences – Neuroscience – Neuroimaging – Anatomy – Endocrine system – Adrenal glands – Physiology – Physiological parameters – Obesity – Physiological processes – Sleep – Biochemistry – Lipids – Fats – Hormones – Lipid hormones – Cortisol – Steroid hormones – Medicine and health sciences – Diagnostic medicine – Diagnostic radiology – Tomography – Computed axial tomography – Radiology and imaging – Body weight – Metabolic disorders – Metabolic syndrome – Neurology – Sleep disorders


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