Abstract
IntroductionObesity is a chronic disease present in the 15% of the population. An endocrinological cause is rare, but it should be ruled out. EtiologyThe endocrine diseases associated with obesity are mainly hypothyroidism, polycystic ovary syndrome (PCOS) and Cushing's syndrome (CS). All of them have typical signs and symptoms (but not pathognomonic), so it is necessary to proceed with a complete anamnesis and a detailed physical examination. DiagnosisPrimary hypothyroidism occurs with elevated levels of TSH and normal/decreased levels of FT4, and also with elevated antiperoxidase/antitihyroglubulin antibodies in autoimmune hypothyroidism. Central hypothyroidism has low FT4 and low / normal / slightly elevated TSH. There are necessary two determinations of urinary free cortisol (24h urine test) or a positive Nugent test in the CS screening. The suppression of cortisol and ACTH (8am) confirms the presence of exogenous hypercortisolism. For the diagnosis of PCOS it is indicated to perform a measurement of serum androgens, gonadotropins, estradiol, prolactin in follicular phase; an ovarian ultrasound and a menstrual calendar.
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