A 44-year-old woman complains of general weakness, heart pain, significant increase of body weight. Objectively: moon face, hirsutism, AP is 165/100 mm Hg, height - 164 cm, weight - 103 kg; the fat is mostly accumulated on her neck, thoracic girdle, belly. What is the main pathogenetic mechanism of obesity?

Answer options

1. Increased mineralocorticoid production
2. Increased production of glucocorticoids
3. Reduced production of thyroid hormones
4. Increased insulin production
5. Reduced glucagon production

Explanation

This is typical of Cushing's disease which is caused by a pituitary gland tumor (usually benign) that over-secretes the hormone ACTH, thus overstimulating the adrenal glands' cortisol production (glucocorticoids). Cushing syndrome refers to the signs and symptoms associated with excess cortisol in the body, regardless of the cause. Findings: hypertension, weight gain, moon-like face, truncal obesity, buffalo hump, skin changes (thinning striae), osteoporosis, hyperglycemia, amenorrhea, immunosuppression, etc.