%0 Journal Article
%T Routine Screening for Cushing's Syndrome Is Not Required in Patients Presenting with Obesity
%A Serap Baydur Sahin
%A Hacer Sezgin
%A Teslime Ayaz
%A Emine Uslu Gur
%A Kadir Ilkkilic
%J ISRN Endocrinology
%D 2013
%R 10.1155/2013/321063
%X Background. Cushing¡¯s syndrome (CS) is a relatively unusual condition that resembles many of the phenotypic features of obesity. Our aim was to evaluate the frequency of CS in obese patients. Materials and Methods. This study included 354 consecutive patients (87.9% female, age years) who presented with simple obesity. All the patients were evaluated for the clinical signs of CS. Lipid parameters, fasting glucose (FPG) and insulin, 75£¿gr oral glucose tolerance test, basal cortisol and ACTH were measured. 1£¿mg overnight DST was performed. Results. The mean weight of the patients was £¿kg and BMI £¿kg/m2. 34.5% of the patients were hypertensive. 36.2% of the patients had central obesity, 72% dorsocervical fat accumulation, 28.8% abdominal striae and 23.2% acne. 49.4% of the women had hirsutism. 46.5% had prediabetes and 12.0% had type 2 diabetes, 72.6% had dyslipidemia. The mean cortisol and ACTH levels were as follows: £¿¦Ìg/dL and £¿pg/mL. Seven patients failed to suppress plasma cortisol to less than 1.8£¿¦Ìg/dL. Biochemical confirmation tests were performed in these patients and 2 of them were diagnosed glucocorticoid-secreting adrenal adenoma. Conclusions. Routine screening for CS in obese patients is not required. 1. Introduction Cushing¡¯s syndrome (CS) is considered a contributing factor to the development of obesity. On the other hand, obesity itself might share the symptoms and signs of CS such as hirsutism, menstrual abnormalities, acne, dorsocervical fat pad (buffalo hump), supraclavicular fullness, glucose intolerance, and hypertension. Physicians may be called upon to exclude CS in obese patients, who are increasingly present in the general population. Early recognition of CS can reduce the morbidity and mortality [1]. The diagnosis of CS is often a challenge for clinicians due to the variable pattern and the nonspecificity of clinical manifestations. The diagnosis can be difficult particularly in states of mild or cyclical or periodical hypercortisolism [2¨C4]. The suspicion of CS arises in the presence of concomitant recent weight gain, impaired glucose tolerance, and high blood pressure [3]. Several studies reported a 1¨C5% prevalence of unsuspected CS in patients with poorly controlled type 2 diabetes and/or hypertension [5¨C8]. However, there are only few studies on the prevalence of CS in obese patients [9¨C13]. We therefore aimed to evaluate the frequency of CS in patients who present with obesity. The 1£¿mg overnight dexamethasone-suppression test (DST) is the most frequently used screening tool for CS [14]. Because it is easy to perform and has
%U http://www.hindawi.com/journals/isrn.endocrinology/2013/321063/