ECEESPE2025 Poster Presentations MTEabolism, Nutrition and Obesity (125 abstracts)
Relationship between body mass index and 1 mg dexamethasone suppression test in obese patients
Beril Turan Erdogan 1 , Ekin Yiğit Köroğlu 1 , Muhammed Sacikara 1 , Neslihan Çuhacı Seyrek 2 , Cevdet Aydin 2 , Oya Topaloglu 2 , Reyhan Ersoy 2 & Bekir Cakir 2
1Ankara Bilkent City Hospital, Department of Endocrinology and Metabolism, Ankara, Türkiye; 2Ankara Yildirim Beyazit University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Türkiye
JOINT3511
Background: The dexamethasone suppression test (DST) assesses hypothalamic-pituitary-adrenal (HPA) axis function. Obesity affects cortisol metabolism, but its relationship with body mass index (BMI) and DST response remains unclear. This study examines the association between BMI and 1 mg DST results in obese patients.
Methods: This retrospective study included 352 obese individuals (BMI ≥30 kg/m2) from an endocrinology clinic. Data collected included age, gender, BMI, hip and waist circumference, comorbidities, and laboratory values (ACTH, basal cortisol, and 1 mg DST). DST suppression levels were compared across BMI groups using statistical analyses.
Results: Participants ranged from 18 to 69 years, with a mean age of 40.37 ± 11.51 years. Of the 352 individuals, 80.7% were female and 19.3% were male. BMI distribution was: 30-39.9 kg/m2 (18.2%), 40-50 kg/m2 (57.4%), and >50 kg/m2 (24.4%). DST suppression levels differed significantly across BMI groups (P = 0.038), with altered DST response in higher BMI categories. ACTH levels also showed significant variations (P = 0.018), while cortisol levels did not (P = 0.081). These findings suggest BMI-related changes in HPA axis function.
| BMI Class | p | |||||||||||||
| 30-39.9 kg/m2 (n = 64) | 40-49.9 kg/m2 (n = 202) | >50 kg/m2 (n = 86) | ||||||||||||
| Mean | Min | Max | Std. Dev. | Mean | Min | Max | Std. Dev. | Mean | Min | Max | Std. Dev | |||
| Waist circumference (cm) | 116, 56 | 96 | 133 | 8, 15 | 128, 87 | 102 | 160 | 11, 34 | 143, 15 | 118 | 193 | 13, 96 | 0, 001 | |
| Hip circumference (cm) | 125, 23 | 105 | 141 | 6, 93 | 137, 5 | 118 | 198 | 9, 6 | 152, 43 | 128 | 183 | 10, 53 | 0, 001 | |
| 1 mg dst (µg/dl) | 0, 79 | 0, 5 | 1, 7 | 0, 29 | 0, 77 | 0, 5 | 2, 7 | 0, 29 | 0, 88 | 0, 5 | 3, 3 | 0, 41 | 0, 038 | |
| ACTH (pg/mL) | 24, 75 | 6, 5 | 123 | 16, 58 | 22, 04 | 5, 9 | 63, 2 | 10, 74 | 25, 36 | 7, 1 | 58, 5 | 10, 7 | 0, 018 | |
| Cortisol (µg/dl) | 15, 04 | 6, 1 | 28, 8 | 5, 52 | 13, 62 | 6, 3 | 27, 7 | 4, 08 | 13, 87 | 6, 7 | 26, 3 | 4, 15 | 0, 081 | |
| DST: Dexamethasone suppression test, ACTH: Adrenocorticotropic hormone | ||||||||||||||
Discussion: BMI influences DST suppression and ACTH levels, indicating a potential role in HPA axis dysregulation. The non-linear association suggests that both lower and higher BMI levels contribute to altered DST response. Obesity may affect cortisol metabolism and feedback sensitivity, explaining these variations. However, the lack of significant basal cortisol differences suggests other regulatory mechanisms. Elevated ACTH levels in extreme obesity may represent a compensatory response.
Conclusion: BMI modulates DST suppression and ACTH secretion, with variations in HPA axis function across BMI categories. Further studies are required to understand the physiological mechanisms and clinical significance of these associations.
Volume 110
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Endocrine Abstracts
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