Endocrine Abstracts

Aim of this study was to investigate the incidence of Cushing’s syndrome (CS) in women with polycystic ovary syndrome.

Materials and methods: The study involved 35 women from 17 to 39 years with verified diagnosis of PCOS according to the Rotterdam Consensus (2003). First group – 26 women with PCOS and BMI≥25 kg/m² and second group – control – nine women with PCOS and BMI≤25−18 kg/m². Investigated endocrine and gynecological status, levels of LH, FSH, DHEAS, cortisol, ACTH, testosterone, prolactin, progesterone, estradiol, performed ultrasound of the ovaries and uterus, pituitary MRI and CT adrenals. At higher levels of cortisol or ACTH determined the rhythm of cortisol secretion.

Results and discussion: In first group in 72.3% the disease began from increase in body weight, 21.3% with menstrual dysfunction (MD), 6.4% is not installed. The main complains of patients was an increase in body weight (86.2%), MD (91.2%), increased hair growth on the body (45.7%), greasiness of the skin and hair (32.6%), the appearance of stretch marks on the skin (28.6%). Objectively 23.5% of patients with established obesity, striae – 33.5%, greasiness of the skin and acne rash – in 13.5% of patients.

In second group the main complaints were MD (78.3%), hirsutism-31.7%, and infertility (10.4%). By ultrasound follicle persistence occurs in 65% of patients. Ultrasound picture of ovarian/uterine shows that in 36% increase ovarian volume, in 12% uterine hypoplasia, 32% small cystic structure, 25% polycystic structure, 43% multifollicle structure, 47% the persistence of the follicle, the follicle atresia 32%.

In first group patients in four women found increased levels of cortisol. In further examination, three of them had ACTH-dependent CS, in one case makronodular adrenal hyperplasia.

Conclusion: Patients with PCOS are at risk for the development of the CS. Frequency of CS in women with PCO 4/35, is 11.1%, much higher than expected frequency in the general population.