Ｇｌｕｃｏｓｅ　ｃｌａｍｐ法により副腎摘除術治療前後にインスリン抵抗性を評価し得たＣｕｓｈｉｎｇ症候群およびｐｒｅｃｌｉｎｉｃａｌ　Ｃｕｓｈｉｎｇ症候群の２症例

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  • Insulin Resistance in Cushing's Syndrome and in Preclinical Cushing's Syndrome Evaluated by Euglycemic Hyperinsulinemic Glucose Clamping Befor and After Adrenalectomy in 2 Cases.
  • ショウレイ ホウコク Glucose clampホウ ニ ヨリ フクジンテキジョジュツ チリョウ ゼンゴ ニ インスリン テイコウセイ オ ヒョウカ シエタ Cushing ショウコウグン オヨビ preclinical Cushing ショウコウグン ノ 2 ショウレイ

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We report 2 patients with hypercortisolism, 1 induced by Cushing's syndrome and the other by preclinical Cushing's syndrome.<BR>Case 1: A 65-year-old woman admitted for evaluation of a left adrenal tumor discovered by computed tomography (CT) for the further study of hypertension showed no clinical evidence of Cushing's syndrome.<BR>Case 2: A 66-year-old woman admitted for leg fatigue and edematous face had moon face, central obesity, and ecchymosis.<BR>In both patients, the diurnal rhythm of plasma cortisol was absent, an overnight 8 mg dexamethasone test showed no suppression of the plasma cortisol level, and plasma ACTH was supressed. From these findings and imaging examinations, we diagnosed the patients as preclinical Cushing's syndrome (Case 1) and Cushing's syndrome (Case 2) due to left adrenal adenoma. In both patients, 75g OGIT administered before and after surgical treatment showed improved glucose tolerance from DM to IGT. In the insulin resistance evaluation with euglycemic hyperinsulinemic glucose clamping, the metabolic clearance rate (MCR) for glucose improved from 4.2 to 10.1ml/kg/min (Case 1) and from 3.8 to 5.4ml/kg/min (Case2).

収録刊行物

  • 糖尿病

    糖尿病 45 (4), 237-244, 2002

    一般社団法人 日本糖尿病学会

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