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1 UMR 626, INSERM, Marseille, France; Université de la Méditerranée, Marseille, France; Department of Endocrinology and Nutrition, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Marseille, France
2 UMR 626, INSERM, Marseille, France; Department of Endocrinology and Nutrition, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Marseille, France
3 UMR 626, INSERM, Marseille, France; Université de la Méditerranée, Marseille, France
4 Center for the Study of Sleep, Department of Clinical Neurophysiology, Hôpital de la Timone, Assistance Publique - Hôpitaux de Marseille, Marseille, France
5 Université de la Méditerranée, INSERM, UMR 626, France
* To whom correspondence should be addressed. E-mail: anne.dutour{at}ap-hm.fr.
It has been hypothesized that sleep apnoea syndrome (SAS) increase hypothalamic-pituitary-adrenal axis activity and, through increased cortisol levels, participate in the pathophysiology of metabolic and cardiovascular complications. We compared the circadian profiles of cortisol in obese men with (obSAS+; apnoea hypopnoea index AHI≥20/hour) and without SAS (obSAS-; AHI≤5/hour). 1) salivary cortisol (5 samples: before/30min after dinner, 21:00, upon/30min after awakening) was measured in 15 obSAS+, 19 obSAS- and 19 normal-weight controls (NWC); 2) plasma cortisol (every 30min, for 24h under highly controlled conditions and portable EEG device) was measured in 9 obSAS+, 8 obSAS- and 10 NWC. Visceral adipose tissue surface was measured by CT-scan. In both studies, obSAS+ and obSAS- were comparable for age, BMI, waist circumference and waist-to-hip ratio. Firstly, no difference was found between obSAS+ and obSAS- for any salivary cortisol measurement, nor using ANOVA for repeated measures. No correlation was found between salivary cortisol, and AHI or nocturnal SaO2. Similarly, obSAS+ and obSAS- showed no difference in plasma cortisol rhythmicity: 24-hour minimum, maximum and mean, ANOVA for repeated measures, mathematical modeling of cortisol rhythm (COSINOR) and morning secretory peak. Conversely, ANOVA for repeated measures showed decreased cortisol levels in obese men versus NWC, both during the trough (22:00h-01:30h) and the peak (06:00h-09:00h), independently of SAS status. We show that SAS per se, is not associated with any change of the level, nor of the features of salivary and plasma cortisol rhythmicity, and confirm that men with visceral obesity display lower plasma cortisol levels than NWC.
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