Discovery of Cushing's Syndrome After Bariatric Surgery: Multicenter Series of 16 Patients

作者：Javorsky Bradley R^*; Carroll Ty B; Tritos Nicholas A; Salvatori Roberto; Heaney Anthony P; Fleseriu Maria; Biller Beverly M K; Findling James W

来源：Obesity Surgery, 2015, 25(12): 2306-2313.

DOI：10.1007/s11695-015-1681-z

• Cushing's syndrome
• Hypercortisolism
• Preoperative screening for bariatric surgery
• Hormonal causes of weight gain
• Weight regain after surgery
• Causes of surgical failure

The aim of this study is to demonstrate the importance of considering Cushing's syndrome (CS) as a potential etiology for weight gain and metabolic complications in patients undergoing bariatric surgery (BS).
This is a retrospective chart review case series of patients (n = 16) with CS from five tertiary care centers in the USA who had BS.
Median age at BS surgery was 35.5 years (median 2.5 years between BS and CS surgery). CS was not identified in 12 patients prior to BS. Four patients had CS surgery prior to BS, without recognition of recurrent or persistent CS until after BS. Median body mass index (BMI) values before BS, nadir after BS, prior to surgery for CS, and after surgery for CS were 47, 31, 38, and 35 kg/m(2), respectively. Prior to BS, 55 % of patients had hypertension and 55 % had diabetes mellitus. Only 17 % had resolution of hypertension or diabetes mellitus after BS.
CS may be under-recognized in patients undergoing BS. Testing for CS should be performed prior to BS in patients with features of CS and in post-operative BS patients with persistent hypertension, diabetes mellitus, or excessive weight regain. Studies should be conducted to determine the role of prospective testing for CS in subjects considering BS.

• 出版日期2015-12