Abstract
Purpose
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).
Design and Methods
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.
Results
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/m2, 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.
Conclusion
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.
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Acknowledgments
JF conceived the study. BJ developed the chart review questionnaire which was reviewed and agreed upon by all study sites. Institutional review board approval was obtained at each institution. BJ and TC analyzed the data. BJ wrote the paper with assistance from all authors who had final approval of the submitted manuscript.
Conflict of Interest
There are no disclosures related specifically to this report. BJ reports no conflict of interest. TC reports personal fees from Corcept Therapeutics. NT has consulted for Pfizer and Corcept Therapeutics and has received grant support from Ipsen and Pfizer. RS reports grants and personal fees from Novartis, grants and personal fees from Ipsen, and grants and personal fees from Pfizer. AH reports no conflict of interest. MF reports grants and personal fees from Novartis, grants and personal fees from Ipsen, and grants from Corcept Therapeutics. BB reports grants and personal fees from Novartis, personal fees from HRA Pharma, and grants from Cortendo and Corcept Therapeutics. JF reports personal fees from Corcept Therapeutics and Novartis.
Ethical Approval
Institutional review board approval for this retrospective study was obtained at each institution. For this type of study, formal consent is not required.
Informed Consent
Informed consent for this article does not apply.
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Javorsky, B.R., Carroll, T.B., Tritos, N.A. et al. Discovery of Cushing’s Syndrome After Bariatric Surgery: Multicenter Series of 16 Patients. OBES SURG 25, 2306–2313 (2015). https://doi.org/10.1007/s11695-015-1681-z
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DOI: https://doi.org/10.1007/s11695-015-1681-z