Endocrine Abstracts

Background

Patients with Subclinical Cushing’s Syndrome (SCS) share many similarities with those of metabolic syndrome. Several studies have shown variable prevalence of SCS in patients with diabetes and obesity of up to 9% suggesting that it may be more common in these patients. Our study aims to explore the prevalence of SCS in Malaysians with metabolic syndrome and examine any possible predicting factors.

Methods

This is a cross-sectional single center study at a tertiary referral hospital of 147 patients in outpatient diabetes and obesity clinics who fulfil the criteria for metabolic syndrome and do not have any discriminatory features of Cushing’s syndrome (facial plethora, easy bruising, proximal myopathy and reddish or purple striae measuring b 1 cm). Patients were screened with the 1 mg overnight dexamethasone test (ODST), followed by the 48-h 2 mg low dose dexamethasone test (LDDST), using cut-offs of 50 nmol/l for both tests.

Results

Six patients had a non-suppressed ODST result and only 1 patient had both non-suppressed ODST and LDDST. Hence, the prevalence of SCS was 0.7% in this study. There were no statistically significant differences between suppressors and non-suppressors on ODST testing.

Conclusion

Based on the results of this study we do not recommend routine screening for SCS in patients with metabolic syndrome in absence of clinical suspicion.