Lipid Abnormalities in Patients With Cushing’s Disease and Its Relationship With Impaired Glucose Metabolism

Sun, Xiaolin; Feng, Ming; Lü, Lin; Zhao, Zixuan; Bao, Xinjie; Deng, Kan; Yao, Yong; Zhu, Huijuan; Wang, Renzhi

doi:10.3389/fendo.2020.600323

Cited by 12 publications

(9 citation statements)

References 50 publications

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“…In our research, TC and LDL-c levels were statistically lower after surgery. Similar results we found in Sun et al [44] study in the adult population. TC and LDL-c levels decreased after surgery, and the prevalence of hypertriglyceridemia was unchanged.…”

Section: Dyslipidemiasupporting

confidence: 92%

“…Activated lipase lipoprotein causes increased triglyceride hydrolysis in adipose tissues and FFA turnover. On the other hand, GCS stimulates lipogenesis in the liver and VLDL production [43,44]. The mechanism can be mediated by AMP-activated protein kinase (AMPK), which is involved in metabolic changes observed in CS.…”

Section: Dyslipidemiamentioning

confidence: 99%

“…GCS suppresses AMPK activity in visceral adipose tissue, causing an increase in lipogenesis, while in the liver, they stimulate AMPK activity. Kola et al [44] revealed that the patients with CS exhibited 70% lower AMPK activity in visceral adipose tissue than control subjects increasing fatty acid synthase expression. Hypercortisolism was proportional to the inhibition of AMPK activity [45].…”

Section: Dyslipidemiamentioning

confidence: 99%

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Metabolic status in children with Cushing’s disease and its relationship with remission

Moszczyńska¹,

Baszyńska-Wilk²,

Bogusz-Wójcik³

et al. 2023

pedm

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Introduction: Complications of Cushing disease (CD), like diabetes and lipid disturbances, are the risk factors for higher morbidity and mortality.The study aimed to compare the metabolic status of patients with CD with obese children and assessed the impact of remission on metabolic consequences. Material and methods: This retrospective study analyzed 32 patients (aged 5 to 17 years) with CD. We evaluated anthropometric data and laboratory parameters -cholesterol fractions, glucose, and insulin levels in an oral glucose tolerance test (OGTT). Results were obtained at the moment of diagnosis and after transsphenoidal pituitary surgery (TSS), leading to remission. The data were compared with the age-matched and body mass index-matched control groups. Results: At diagnosis, 40% of patients had impaired glucose tolerance (IGT), 6.7% diabetes (DM), and 3% impaired fasting glucose (IFG). In the lipids profile, 81% of patients presented elevated total cholesterol (TC), 66.7% low-density lipoprotein (LDL-c), and 64% triglycerides (TG). After TSS, we detected only one child with IGT. Patients had lower glucose levels in 0 minutes ('), 30', 90',120', insulin levels in 0', 30', and 90' of OGTT, and lower TC and LDL-c than before TSS. There were statistically significant differences between the study and the control group in insulin levels at all-time points of the OGTT, fasting glucose levels, and 90' of the test. TC, LDL-c, and TG were statistically higher in the CD group. Conclusions: Remission significantly impacts improving metabolic parameters. Patients with CD require a higher insulin level to maintain normoglycemia than patients with obesity.

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Section: Dyslipidemiasupporting

confidence: 92%

Section: Dyslipidemiamentioning

confidence: 99%

Section: Dyslipidemiamentioning

confidence: 99%

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Metabolic status in children with Cushing’s disease and its relationship with remission

Moszczyńska¹,

Baszyńska-Wilk²,

Bogusz-Wójcik³

et al. 2023

pedm

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“…Obwohl die Prävalenz einer ACS wesentlich höher ist als die des AC, ist eine klinische Diagnose aufgrund der fehlenden typischen Symptome des Hyperkortisolismus sehr unwahrscheinlich. Patient*innen mit ACS weisen allerdings häufig eine oder mehrere Komponenten des metabolischen Syndroms auf und haben damit ein erhöhtes kardiovaskuläres Risiko [14][15][16]. Dementsprechend ist auch ein milder chronischer Hyperkortisolismus durch entsprechende Veränderungen gekennzeichnet, etwa durch eine gewisse Immunkompromittierung sowie die Entwicklung von Übergewicht und Adipositas, Diabetes mellitus Typ 2, arterielle Hypertonie, Hyperkoagulabilität, Myopathie und neuropsychiatrische Störungen [15,17].…”

Section: Hyperkortisolismus Adrenales Cushing-syndrom Und Autonome Kortisolsekretionunclassified

Praktische Empfehlungen zum Screening und Management von Funktionsstörungen der Nebennierenrinde bei einer akuten SARS-CoV-2-Infektion

et al. 2021

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ZusammenfassungErkrankungen der Nebennierenrinde erfordern im Rahmen der Severe-acute-respiratory-syndrome-coronavirus-2(SARS-CoV-2)-Pandemie eine besondere Aufmerksamkeit. Zum einen können SARS-CoV-2-Infektionen sich auch extrapulmonal manifestieren und endokrine Störungen – insbesondere im Bereich der Nebennierenrinde – verursachen. Zum anderen sind Patienten mit einer vorbestehenden Nebennierenrindeninsuffizienz oder einem Hyperkortisolismus durch eine schwerwiegende Infektion wie etwa mit SARS-CoV‑2 besonders gefährdet, zusätzliche Komplikationen oder einen schwerwiegenderen Verlauf einer akuten SARS-CoV-2-Infektion mit erhöhter Mortalität zu erleiden. Insbesondere bei hämodynamisch instabilen Patienten mit SARS-CoV-2-Infektion müssen deshalb auch Erkrankungen der Nebennieren differenzialdiagnostisch erwogen und gegebenenfalls abgeklärt werden, falls diese nicht bereits anamnestisch bekannt sind. Weiterhin kann auch die Therapie einer SARS-CoV-2-Infektion mit hohen Glukokortikoiddosen über einen längeren Zeitraum eine sekundäre Nebennierenrindeninsuffizienz verursachen. Wir stellen hier deshalb eine Praxisempfehlung zur Erkennung und Therapie von Nebennierenfunktionsstörungen bei Patient*innen mit SARS-CoV-2-Infektion vor.

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“…These changes may also be mediated by glucocorticoid-induced central GH suppression ( 385 ). More than one-third of Cushing’s disease patients have diabetes mellitus ( 386 ) and more than half are dyslipidemic, with elevated triglycerides and LDL cholesterol and reduced HDL cholesterol ( 387 ). Patients are often hypertensive and have left ventricular hypertrophy, heart failure, and dilated cardiomyopathy ( 388 ).…”

Section: Long-term Comorbidities and Mortality Outcomesmentioning

confidence: 99%

Clinical Biology of the Pituitary Adenoma

et al. 2022

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All endocrine glands are susceptible to neoplastic growth, yet the health consequences of these neoplasms differ between endocrine tissues. Pituitary neoplasms are highly prevalent and overwhelmingly benign, exhibiting a spectrum of diverse behaviors and impact on health. To understand the clinical biology of these common yet often innocuous neoplasms, we review pituitary physiology, and adenoma epidemiology, pathophysiology, behavior, and clinical consequences. The anterior pituitary develops in response to a range of complex brain signals integrating with intrinsic ectodermal cell transcriptional events that together determine gland growth, cell type differentiation, and hormonal production, in turn maintaining optimal endocrine health. Pituitary adenomas occur in ten percent of the population; however, the overwhelming majority remain harmless during life. Triggered by somatic or germline mutations, disease-causing adenomas manifest pathogenic mechanisms that disrupt intra-pituitary signaling to promote benign cell proliferation associated with chromosomal instability. Cellular senescence acts as a mechanistic buffer protecting against malignant transformation, an extremely rare event. It is estimated that fewer than one thousandth of all pituitary adenomas cause clinically significant disease. Adenomas variably and adversely affect morbidity and mortality depending on cell type, hormone secretory activity, and growth behavior. For most clinically apparent adenomas, multimodal therapy controlling hormone secretion and adenoma growth lead to improved quality of life and normalized mortality. The clinical biology of pituitary adenomas and particularly their benign nature stands in marked contrast to other tumors of the endocrine system such as thyroid and neuroendocrine tumors.

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Lipid Abnormalities in Patients With Cushing’s Disease and Its Relationship With Impaired Glucose Metabolism

Cited by 12 publications

References 50 publications

Metabolic status in children with Cushing’s disease and its relationship with remission

Metabolic status in children with Cushing’s disease and its relationship with remission

Praktische Empfehlungen zum Screening und Management von Funktionsstörungen der Nebennierenrinde bei einer akuten SARS-CoV-2-Infektion

Clinical Biology of the Pituitary Adenoma

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