Division of Endocrinology and Metabolism, Department of Internal Medicine,
Cerrahpasa Medical Faculty - Sivas, Turkey.
Tel: 90 216 4623114
Received for publication on September 11, 2009
Accepted for publication on October 08, 2009
SCREENING FOR CUSHING’S SYNDROME IN OBESE
Ozay Tiryakioglu, Serdal Ugurlu, Serap Yalin, Sibel Yirmibescik, Erkan Caglar,
Demet Ozgil Yetkin, Pinar Kadioglu
Tiryakioglu O, Ugurlu S, Yalin S, Yirmibescik S, Caglar E, Yetkin DO et al. Screening for Cushing’s Syndrome in obese
patients. Clinics. 2010;65(1):9-13.
OBJECTIVES: The aim of this study was to examine the frequency of Cushing’s syndrome (CS) in obese patients devoid of
specific clinical symptoms of Cushing’s syndrome.
METHODS: A total of 150 obese patients (129 female, 21 male; mean age 44.41 ± 13.34 yr; mean BMI 35.76 ± 7.13) were in-
cluded in the study. As a first screening step, we measured 24-h urinary free cortisol (UFC). An overnight 1-mg dexamethasone
suppression test was also performed on all patients. Urinary free cortisol levels above 100 µg/24 h were considered to be abnormal.
Suppression of serum cortisol <1.8 µg/dL after administration of 1 mg dexamethasone was the cut-off point for normal suppression.
The suppression of the serum cortisol levels failed in all of the patients.
RESULTS: Measured laboratory values were as follows: ACTH, median level 28 pg/ml, interquartile range (IQR) 14-59 pg/ml;
fasting glucose, 100 (91-113) mg/dL; insulin, 15.7 (7.57-24.45) mU/ml; fT
, 1.17 (1.05-1.4) ng/dL; TSH, 1.70 (0.91-2.90) mIU/L;
total cholesterol, 209 (170.5-250) mg/dL; LDL-c, 136 (97.7-163) mg/dL; HDL-c, 44 (37.25-50.75) mg/dL; VLDL-c, 24 (17-36)
mg/dL; triglycerides, 120.5 (86-165) mg/dL. The median UFC level of the patients was 30 µg/24 h (IQR 16-103). High levels of
UFC (>100 µg/24 h) were recorded in 37 patients (24%). Cushing’s syndrome was diagnosed in 14 of the 150 patients (9.33%).