MON-328 Disorders of Glucose Metabolism in Cushing Syndrome in Uzbekistan

Abstract

Relevance. Cushing’s Syndrome (CS) is a serious risk factor for developing impaired glucose tolerance disorder (GTD) and a manifestation of secondary diabetes mellitus (DM). On the other hand, the development of impaired glucose metabolism affects not only the course but also the outcome of SC. Moreover, their frequency varies from 10% to 45% of all cases of SC. The aim of investigation - to evaluate the frequency of various forms of impaired glucose metabolism in patients with SC according to the national registry in the Republic of Uzbekistan. Materials and methods. The object of the study was 264 patients included in the register, 182 women (68.9%); men 82 (31.1%) aged 16 to 49 years. Including ACTH dependent CS (ACTH-DS) 219 (82.9%), ACTH independent CS (ACTH-IS) 41 (15.5%), ACTH ectopic CS (ACTH-ES) 4 (1.5%). The levels of ACTH, cortisol, insulin, glucose, glycated hemoglobin were studied, tests with dexamethasone and an oral glucose tolerance test (OGTT) were performed; MSCT of the adrenal gland and MRI of the pituitary gland. Fasting glucose (IH), NTG and diabetes were determined according to international criteria (EASD 2019, IDF 2018) Results. It was found that out of 264 patients with SC, 136 (51.5%) had various disorders of carbohydrate metabolism (CM), including diabetes in 32.6 ± 2.9% (86 bp), GTD in 18, 6 ± 2.4% (49 bp) and NGN - in 0.4 ± 0.4% (1 bp). At the same time, diabetes developed in 33.3% of cases in patients with ACTH-DS, 24.4% of ACTH-IS and 75% with ACTH-ESC (p˂ 0.01; p˂ 0.001). Cases of prediabetes were mainly found in the form of NTG in 17.4% of ACTH-DS and 26.8% in ACTH-IS. Conclusions. In the Republic of Uzbekistan, CM took place in the overwhelming majority of patients with CS (51.5%) and clearly depended on the type of CS (ACTH-ES, AKTG-DS, AKTG-IS) and correlated with the degree of hypercortisolism.