Active Cushing syndrome patients have increased ectopic fat deposition and bone marrow fat content compared to cured patients and healthy subjects: a pilot 1H-MRS study

Maurice, F.; Dutour, Anne; Vincentelli, Clara; Abdesselam, Inès; Bernard, Monique; Dufour, Henry; Lefur, Yann; Graillon, Thomas; Kober, Frank; Cristofari, Pierre; Jouve, Élisabeth; Pini, Lauriane; Fernández, Rebeca Martínez; Chagnaud, Christophe; Brue, Thierry; Castinetti, Frédéric; Gaborit, Bénédicte

doi:10.1530/eje-18-0318

Cited by 19 publications

(11 citation statements)

References 39 publications

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“…Our observation of no difference in BMA between CD and controls agrees with a previous study of adults with IBD in remission [55]. BMA has been reported to be increased at diagnosis of Cushing's disease [56,57], however it normalizes following treatment of the GC excess [57].…”

Section: Discussionsupporting

confidence: 93%

Muscle deficits with normal bone microarchitecture and geometry in young adults with well-controlled childhood-onset Crohn’s disease

Steell

Johnston²,

Dewantoro

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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Muscle-bone deficits are common in children with Crohn's disease (CD); however, few studies have assessed long-term musculoskeletal outcomes in adults with childhood onset CD. This study assessed the prevalence of musculoskeletal deficits in a cohort of young adults with childhood onset CD in comparison with healthy age and sex matched controls.This case-control study used 3-Tesla MRI and MRS to assess bone microarchitecture, cortical geometry and muscle area and adiposity at distal femur, and bone marrow adiposity of the lumbar spine, together with functional muscle tests and biochemical markers of the musclebone unit.Twenty-seven adults with CD with median (range) age 23.2 years (18.0, 36.1) and 27 controls with median age 22.9 years (18.2, 37.0) were recruited. Trabecular microarchitecture and cortical geometry of the distal femur and bone marrow adiposity of the lumbar spine were not different between CD and controls (p > 0.05 for all). Muscle cross sectional area was lower (p = 0.01) and muscle fat fraction was higher (p = 0.04) at the distal femur in CD compared to controls. CD participants had significantly lower grip strength (-4.3 kg [95% CI: -6.8, -1.8], p = 0.001) and lower limb muscle power relative to bodyweight (-5.0 W/kg [95% CI: -8.8, -1.2], p = 0.01). CD activity scores were negatively associated with trabecular bone volume (r = -0.40, p = 0.04) and muscle area (r = -0.41, p = 0.03).Young adults with well controlled CD managed with contemporary treatment strategies do not display abnormal bone microarchitecture or geometry at the distal femur but exhibit muscle deficits. The observed muscle deficits may predispose to musculoskeletal morbidity in future and interventions to improve muscle mass and function should be investigated.

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Section: Discussionsupporting

confidence: 93%

Muscle deficits with normal bone microarchitecture and geometry in young adults with well-controlled childhood-onset Crohn’s disease

Steell

Johnston²,

Dewantoro

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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“…A recent work of Maurice and collaborators measured BMF content in CS patients by using MRS, which is considered the best available method for BMF quantification. They found that CS patients had increased BMF content compared to cured patients and healthy subjects (95). However further studies are required in order to clarify the precise link between BMF and bone microarchitecture in hypercortisolism.…”

Section: Hypercortisolismmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: Evaluation of bone fragility in endocrine disorders

Eller-Vainicher

Falchetti

Gennari

et al. 2019

European Journal of Endocrinology

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An underlying disease affecting bone health is present in up to 40 and 60% of osteoporotic postmenopausal women and men respectively. Among the disorders leading to a secondary form of osteoporosis, the endocrine diseases are highly represented. A frequent finding in patients affected with an endocrine-related forms of bone disease is that the skeletal fragility is partially independent of the bone density, since the fracture risk in these patients is related more to a reduction of bone quality than to a decrease of bone mass. As a consequence, bone mineral density evaluation by dual-X-ray absorptiometry may be inadequate for establishing the risk of fracture in the setting of the endocrine-related forms of osteoporosis. In the recent years, several attempts to non-invasively estimating bone quality have been done. Nowadays, some new tools are available in the clinical practice for optimising the fracture risk estimation in patients with endocrine disorders. The aim of this review is to summarise the evidence regarding the role of the different imaging tools for evaluating bone density and bone quality in the most frequent forms of endocrine-related osteoporosis, such as obesity, diabetes, acromegaly, thyrotoxicosis, primary hyperparathyroidism, hypercortisolism and hypogonadism. For each of these disorders, data regarding both the current available tools and the future possible new techniques for assessing bone fragility in patients with endocrine diseases are reported.

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“…37 On the other hand, accumulation of bone marrow fat returned to normal levels during remission. 36 These data suggest that long-term monitoring of body fat and metabolic factors is important after cure of Cushing's syndrome.…”

Section: Adipose Tissue After Cure Of Cushing's Syndromementioning

confidence: 93%

“…Patients with Cushing's syndrome also develop ectopic fat deposition. Increased epicardial and pericardial fat accumulation was observed without myocardial steatosis, whereas bone marrow also showed increased adiposity 36,37 …”

Section: Effects Of Gc Excess On Adipose Tissuementioning

confidence: 99%

Glucose and lipid metabolism abnormalities in Cushing's syndrome

Salehidoost

Korbonits

2022

J Neuroendocrinology

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Prolonged excess of glucocorticoids (GCs) has adverse systemic effects leading to significant morbidities and an increase in mortality. Metabolic alterations associated with the high level of the GCs are key risk factors for the poor outcome. These include GCs causing excess gluconeogenesis via upregulation of key enzymes in the liver, a reduction of insulin sensitivity in skeletal muscle, liver and adipose tissue by inhibiting the insulin receptor signalling pathway, and inhibition of insulin secretion in beta cells leading to dysregulated glucose metabolism. In addition, chronic GC exposure leads to an increase in visceral adipose tissue, as well as an increase in lipolysis resulting in higher circulating free fatty acid levels and in ectopic fat deposition.Remission of hypercortisolism improves these metabolic changes, but very often does not result in full resolution of the abnormalities. Therefore, long-term monitoring of metabolic variables is needed even after the resolution of the excess GC levels.

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Active Cushing syndrome patients have increased ectopic fat deposition and bone marrow fat content compared to cured patients and healthy subjects: a pilot 1H-MRS study

Abstract: Accumulation of BMF is induced by hypercortisolism. In remission patients BMF reached values of controls. Further studies are needed to determine whether this increase in marrow adiposity in CS is associated with bone loss.

Cited by 19 publications

References 39 publications

Muscle deficits with normal bone microarchitecture and geometry in young adults with well-controlled childhood-onset Crohn’s disease

Muscle deficits with normal bone microarchitecture and geometry in young adults with well-controlled childhood-onset Crohn’s disease

DIAGNOSIS OF ENDOCRINE DISEASE: Evaluation of bone fragility in endocrine disorders

Glucose and lipid metabolism abnormalities in Cushing's syndrome

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