Endogenous hypercortisolism in the patient with obesity: the cause or a competing disorder
https://doi.org/10.14341/omet2016157-61
Abstract
Endogenous hypercortisolism (EH) is a rare endocrine disorder, one of the most frequent manifestations of which is obesity. Due to the high prevalence of the metabolic syndrome and the similarity of the clinical manifestations, EH may remain undiagnosed. However, prompt diagnosis and treatment can effectively promote complete cure of the patient. We describe the clinical case of a patient К., 58 years old, who suffered from morbid obesity, diabetes, uncontrolled hypertension and dyslipidemia. The CT examination revealed bilateral adrenal incidentalomas. The further follow-up let us to establish Cushing's disease. The adrenal tumors in this case may be the results of a long-term stimulation of the adrenal glands by ACTH. There is a possibility that the first manifestation of the disease began at the age of 30 years after the second pregnancy, when she observed weight gain and poorly controlled hypertension. When remission was achieved after neurosurgical treatment, we could observe significant improvements (reduction in body weight of 10 kg, improved glucose levels), but without the full normalization of all complications and symptoms.
Conclusion: EH may cause the development of obesity and metabolic syndrome or significantly exacerbate its course. In cases of doubt, weight gain and poorly controlled manifestations of metabolic syndrome screening is justified to exclude EH.
About the Authors
Zhanna E. BelayaRussian Federation
MD, PhD, Head of Neuroendocrinology and osteopathy Department
Aleksandr V. Vorontsov
Russian Federation
MD, PhD, Professor, Head of MRI Department
Aleksandr V. Il'in
Russian Federation
Head of clinical and diagnostic laboratory
Andrey Y. Grigor'ev
Russian Federation
MD, PhD, Head of Neurosurgery Department
Lyudmila Y. Rozhinskaya
Russian Federation
MD, PhD, Professor, leading researcher at Neuroendocrinology and osteopathy Department
Competing Interests: ФГБУ «Эндокринологический научный центр» Минздрава России
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Review
For citations:
Belaya Zh.E., Vorontsov A.V., Il'in A.V., Grigor'ev A.Y., Rozhinskaya L.Y. Endogenous hypercortisolism in the patient with obesity: the cause or a competing disorder. Obesity and metabolism. 2016;13(1):57-61. (In Russ.) https://doi.org/10.14341/omet2016157-61

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