Features of carbohydrate disorders in Cushing Syndrome
G. Narimovaa (Dr), S. Ergashovab (Dr), M. Narimova*c (Dr), A. Xolikovad (Dr)
a Republican Specialized scientific Practical Medical Center of Endocrinology named after Academician Y.K.Turakulov, Tashkent, UZBEKISTAN ; b Republican Specialized scientific Practical Medical Center of Endocrinology named after Academician Y.K.Turakulov, Tashkent, Tashkent, UZBEKISTAN ; c Republican Scientific Center for Emergency Medical Care, Tashkent, UZBEKISTAN ; d Republican Specialized scientific Practical Medical Center of Endocrinology named after Academician Y.K.Turakulov,, Tashkent, UZBEKISTAN
Impaired glucose metabolism (IGM) in patients with Cushing syndrome (CS) is due to a combination of several concomitant glucocorticoid (GC) related effects that directly or indirectly affect glucose homeostasis, mainly by inducing gluconeogenesis and impaired insulin receptor signaling.
Purpose: To carry out an analysis of carbohydrate metabolism disorder in patients with CS conditions registered in the CS register in Uzbekistan from 2000-2021.
Materials and methods: Analysis of glucose tolerance test in patients with CS condition was carried out from 2000-2021. The average age of patients was 33.48 ± 1.17 years. All patients underwent hormonal blood tests (determination of the level of adrenocorticotropic hormone (ACTH), cortisol secretion rhythm, daily urine cortisol, insulin) and biochemical studies (fasting glucose, glycated hemoglobin, oral glucose tolerance test) were performed. Results: Impaired glucose metabolism before treatment was in 106 (31.93%) patients; of these, impaired glucose tolerance (IGT) in 23 (6.84%) patients, DM - in 79 (23.8%) patients, impaired fasting glucose (IFG) in 4 (1.2%) patients. According to the etiological factor, patients were divided into two groups: ACTH-dependent CS-92 patients (86.8%), ACTH-ectopic CS-3 patients (2.83%) and ACTH-independent CS-14 patients (13.2%). 106 patients with CS with impaired carbohydrate metabolism, 58 (54.72%) patients are currently in remission, 17 (16.1%) are in the active phase, that is, some patients have not achieved remission or relapse, and 31 of them (29.2%) died from various complications, including purulent complications 6 (12.5%) DM. When analyzing IGM in patients with CS, depending on the form of CS ACTH-dependent CS, was more likely to have DM than in ACTH-independent CS (77.17% versus 57.14%). IGT is greater in ACTH-independent CS (42.85% versus 18.48%), IFG was detected only in patients with ACTH-independent CS (4.35%). After the main treatment, DM remained in 32 patients with ACTH-dependent CS (9.34%), of which 16 (50%) patients had active CS, in 16 (50%) patients with remission due to prolonged disease activity. Conclusion: IGM in patients with CS, depending on the type of CS, DM was more often observed in ACTH-dependent CS than in ACTH-independent CS. IGT is greater in ACTH-independent CS, IFG was detected only in patients with ACTH-independent CS.
The author has declared no conflict of interest.