Síndrome de Cushing subclínica em populações de risco

Caetano, Maria Silvia S.; Vilar, Lúcio; Kater, Cláudio E.

doi:10.1590/s0004-27302007000800003

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…Some studies evaluated the prevalence of occult CS in overweight and obese patients with uncontrolled diabetes and it was found to be 0–9.4% in different studies [5, 15, 18, 19]. In all the studies, the first screening step was performed with the 1 mg DST, but the cutoff values for the suppression of cortisol were different (from 1.8 to 5 μ g/dL).…”

Section: Discussionmentioning

confidence: 99%

Routine Screening for Cushing's Syndrome Is Not Required in Patients Presenting with Obesity

et al. 2013

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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 37.8 ± 13.4 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 102.4 ± 20.1 kg and BMI 40 ± 7.35 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: 9.28 ± 3.53 μg/dL and 17.02 ± 10.43 pg/mL. Seven patients failed to suppress plasma cortisol to less than 1.8 μg/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.

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Section: Discussionmentioning

confidence: 99%

Routine Screening for Cushing's Syndrome Is Not Required in Patients Presenting with Obesity

et al. 2013

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Increased expression of CYP17 and CYP11B1 in subclinical Cushing's syndrome due to adrenal adenomas

Cao¹,

Yang

Li³

et al. 2011

Int J of Urology

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Objectives: To determine whether steroidogenic enzyme expression is associated with the steroid secretory pattern of subclinical Cushing's syndrome (SCS) by investigating the mRNA and protein expression of CYP17 and CYP11B1 in SCS adenomas, normal adrenal cortices (NA), non-functional adrenal adenomas (NFA) and cortisol-producing adenomas (CPA). Methods: Total RNA and protein were extracted from 20 CPA, six SCS, 15 NFA, and eight NA. Real-time quantitative polymerase chain reaction (PCR) and western blotting analysis were performed to determine the mRNA and protein expression of CYP17 and CYP11B1 in different tissues. The expression of CYP17 and CYP11B1 in the adrenocortical tumors was compared expression in NA. Results: Expression of both CYP11B1 and CYP17 mRNA and protein was detected in all samples tested. The expression of CYP11B1 mRNA and protein was significantly higher in the CPA group than in the other groups and was slightly higher in SCS samples compared with NA and NFA samples (all P < 0.05). There was no significant difference in CYP11B1 mRNA and protein expression between NA and NFA samples (P > 0.05). The expression of CYP17 mRNA and protein in different tissues was similar to that of CYP11B1. Neither CYP11B1 nor CYP17 mRNA and protein expression was correlated with plasma cortisol or adrenocorticotrophin levels (all P > 0.05). Conclusions: In conclusion, CYP11B1 and CYP17 are overexpressed in subclinical CPA and their overexpression accounts for the increased production of cortisol that is characteristic of CPA.

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Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism

Karaca

Acmaz

Açmaz

et al. 2013

European Journal of Endocrinology

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Context: Prevalence of Cushing's syndrome (CS) in patients presenting with hirsutism is not well known. Objective: Screening of CS in patients with hirsutism. Setting: Referral hospital. Patients and other participants: This study was carried out on 105 patients who were admitted to the Endocrinology Department with the complaint of hirsutism. Intervention: All the patients were evaluated with low-dose dexamethasone suppression test (LDDST) for CS. Main outcome measure: Response to LDDST in patients presenting with hirsutism. Results: All the patients had suppressed cortisol levels following low-dose dexamethasone administration excluding CS. The etiology of hirsutism was polycystic ovary syndrome in 79%, idiopathic hirsutism in 13%, idiopathic hyperandrogenemia in 6%, and nonclassical congenital hyperplasia in 2% of the patients. Conclusion: Routine screening for CS in patients with a referral diagnosis of hirsutism is not required. For the time being, diagnostic tests for CS in hirsute patients should be limited to patients who have accompanying clinical stigmata of hypercortisolism.

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Síndrome de Cushing subclínica em populações de risco

Cited by 3 publications

References 30 publications

Routine Screening for Cushing's Syndrome Is Not Required in Patients Presenting with Obesity

Routine Screening for Cushing's Syndrome Is Not Required in Patients Presenting with Obesity

Increased expression of CYP17 and CYP11B1 in subclinical Cushing's syndrome due to adrenal adenomas

Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism

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