肥胖症患者在减肥手术前进行1毫克地塞米松抑制试验的评估。
Assessment of 1 mg Dexamethasone Suppression Test in Patients with Obesity Before Bariatric Surgery.
作者信息
Yavuz Dilek Gogas, Apaydin Tugce, Gunhan Hatice Gizem, Uygur Meliha Melin
机构信息
Department of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey.
Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey.
出版信息
Obes Surg. 2020 Dec;30(12):4981-4985. doi: 10.1007/s11695-020-04865-x. Epub 2020 Aug 15.
PURPOSE
This study aims to examine the prevalence of Cushing's syndrome (CS) in class 3 obese patients before bariatric surgery.
MATERIALS AND METHODS
The data of 1037 class 3 obese patients admitted to the endocrinology outpatient clinic for endocrinological evaluation before bariatric surgery between 2012 and 2019were reviewed retrospectively. One milligram dexamethasone suppression test (DST) was used for the evaluation of hypercortisolism in all cases and cutoff accepted as 1.8 μg/dL.
RESULTS
The mean body mass index (BMI) was 48 ± 8.9 kg/m and age was 42 ± 10 years with female preponderance (F/M: 799/238] being observed in this cohort. Insufficient cortisol suppression was found in 40 patients; confirmed hypercortisolemia was detected in 8 patients. The prevalence of pathologic DST was 3.85% and 0.77% in confirmed hypercortisolism. The specificity for 1-mg DST with the cutoff 1.8 μg/dL was calculated as 96.8%.
CONCLUSION
Hypercortisolism prevalence was found to be low, and 1 mg DST is a sufficient test for the screening of CS in class 3 obese patients evaluated before bariatric surgery.
目的
本研究旨在调查肥胖症手术前3级肥胖患者库欣综合征（CS）的患病率。
材料与方法
回顾性分析了2012年至2019年间因肥胖症手术前在内分泌门诊接受内分泌评估的1037例3级肥胖患者的数据。所有病例均采用1毫克地塞米松抑制试验（DST）评估皮质醇增多症，临界值设定为1.8μg/dL。
结果
该队列中，平均体重指数（BMI）为48±8.9kg/m²，年龄为42±10岁，女性占优势（女/男：799/238）。40例患者出现皮质醇抑制不足；8例患者检测到确诊的高皮质醇血症。确诊的高皮质醇血症中病理性DST的患病率分别为3.85%和0.77%。1毫克DST以1.8μg/dL为临界值时的特异性计算为96.8%。
结论
发现皮质醇增多症患病率较低，1毫克DST对于肥胖症手术前评估的3级肥胖患者筛查CS是一种充分的检测方法。
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