Persistent Body Fat Mass and Inflammatory Marker Increases after Long-Term Cure of Cushing’s Syndrome

Barahona, María José; Sucunza, Nuria; Resmini, Eugenia; Fernández-Real, José Manuel; Ricart, Wifredo; Moreno-Navarrete, José María; Puig, Teresa; Farrerons, Jordi; Webb, Susan M.

doi:10.1210/jc.2009-0766

Cited by 146 publications

(143 citation statements)

References 29 publications

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“…Adipose tissue mass decreases after treatment for CS (4,7,8,9,10), but whether complete normalisation occurs at long-term follow-up is not fully explored. One previous cross-sectional study found an increased total and abdominal fat mass in patients with CS after a mean time of 11 years in remission in comparison with age-, gender-and BMI-matched controls (11). Our results also indicate that the central obesity associated with long-term hypercortisolism in CS is not completely reversible after treatment.…”

Section: Discussionsupporting

confidence: 62%

“…Our results also indicate that the central obesity associated with long-term hypercortisolism in CS is not completely reversible after treatment. Previous studies on the reversibility of reduced LBM and skeletal muscle mass have demonstrated either unchanged (4,8,9,10) or reduced LBM after treatment (7,11). In our study, after adjustment for various confounders, no difference in skeletal muscle mass was observed between patients and controls.…”

Section: Discussioncontrasting

confidence: 59%

“…The median (interquartile rage) time in remission was 13 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) years. Nineteen (38%) patients were receiving GC replacement therapy: ten after bilateral adrenalectomy, seven due to pituitary insufficiency after transsphenoidal pituitary surgery and/or radiotherapy and two after unilateral adrenalectomy.…”

Section: Hormonal Statusmentioning

confidence: 99%

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Body composition and bone mineral density in women with Cushing's syndrome in remission and the association with common genetic variants influencing glucocorticoid sensitivity

Ragnarsson

Glad

Bergthorsdottir

et al. 2015

European Journal of Endocrinology

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Objective: Adverse body compositional features and low bone mineral density (BMD) are the characteristic of patients with active Cushing's syndrome (CS). The aim of this study was to evaluate body composition and BMD in women with CS in long-term remission and the influence of polymorphisms in genes affecting glucocorticoid (GC) sensitivity on these end-points. Design, patients and methods: This was a cross-sectional, case-controlled study, including 50 women previously treated for CS and 50 age and gender-matched controls. Median (interquartile range) remission time was 13 (5-19) years. Body composition and BMD were measured with dual-energy X-ray absorptiometry. Five polymorphisms in four genes associated with GC sensitivity were analysed using TaqMan or Sequenom single-nucleotide polymorphism genotyping. Results: Patients with CS in remission had increased abdominal fat mass (P!0.01), whereas BMD was not significantly different at any site between patients and controls. In patients, the NR3C1 Bcl1 polymorphism was associated with reduced total (P!0.05) and femur neck BMD (P!0.05). The polymorphism rs1045642 in the ABCB1 gene was associated with increased abdominal fat mass (P!0.05) and decreased appendicular skeletal muscle mass (P!0.05). GC replacement was associated with reduced total BMD (P!0.01), BMD at lumbar spine (P!0.05) and increased abdominal fat (P!0.01). Conclusion: Ongoing GC replacement therapy together with polymorphisms in two genes related with GC sensitivity is associated with abdominal obesity and adverse skeletal health in patients with CS in long-term remission.

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Section: Discussionsupporting

confidence: 62%

Section: Discussioncontrasting

confidence: 59%

Section: Hormonal Statusmentioning

confidence: 99%

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Body composition and bone mineral density in women with Cushing's syndrome in remission and the association with common genetic variants influencing glucocorticoid sensitivity

Ragnarsson

Glad

Bergthorsdottir

et al. 2015

European Journal of Endocrinology

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“…This might be attributable to the persistence of hypercortisolemia for parts of each day, and to persistently higher visceral fat mass after the treatment. In human studies, subjects with Cushing's syndrome have persistent central fat mass, higher leptin concentrations, and other abnormal adipokines, even after long‐term cure 35, 36. Therefore, it is possible that the maintenance of hyperleptinemia might have been the result of secretion of leptin by the persistent central fat mass in dogs with PDH.…”

Section: Discussionmentioning

confidence: 99%

Serum Adipokine Concentrations in Dogs with Naturally Occurring Pituitary‐Dependent Hyperadrenocorticism

Cho

Paek

Kang

et al. 2013

Veterinary Internal Medicne

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BackgroundAn excess of intra‐abdominal fat is observed frequently in dogs with hyperadrenocorticism (HAC). Adipokine dysregulation is a possible cause of complications related to visceral obesity, but little information is available on adipokine in dogs with naturally occurring HAC.ObjectivesTo examine the differences in the circulating adipokines concentrations in overweight dogs with and without pituitary‐dependent HAC (PDH).AnimalsThirty healthy dogs and 15 client‐owned dogs with PDH.MethodsCase–controlled observational study, which enrolled 15 overweight dogs diagnosed with PDH and 30 otherwise healthy dogs of similar body condition score. Nine of 15 dogs with PDH were treated with low‐dose trilostane twice daily and reassessed after treatment.ResultsThe serum leptin (P < .0001) and insulin (P < .0001) concentrations were significantly higher in the PDH group (leptin, 22.8 ± 8.8 [mean ± SD]; insulin, 9.1 ± 6.1) than the healthy group (leptin, 4.9 ± 3.7; insulin, 1.9 ± 0.9). However, there were no significant differences in the adiponectin, resistin, tumor necrosis factor (TNF)‐α, interleukin (IL)‐1β, IL‐6, IL‐10, and IL‐18 levels between the 2 groups. In the PDH group, the serum cortisol concentrations had a linear association with the leptin concentrations, and there were significant decreases in the leptin (P = .0039) and insulin (P = .0039) levels after trilostane treatment. However, the leptin and insulin levels remained higher after trilostane treatment than in healthy control dogs with similar body condition score.Conclusions and Clinical ImportanceHypercortisolemia in dogs with PDH might upregulate the circulating leptin levels. However, a large population‐based study will be necessary to determine whether the upregulation of leptin is involved directly with the complications caused by HAC.

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“…Both hypertension and central obesity are more prevalent in active CS patients than in remission, and they tend to persist for long term, for a mean of eleven years (37). Elevated total trunk fat mass and low lean body mass are characteristics of active CS.…”

Section: Metabolic Syndromementioning

confidence: 99%

Cardiovascular complications of cushing’s syndrome

Senevirathna

2017

Sri Lanka J. Diabetes Endocrinol. Metab.

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Persistent Body Fat Mass and Inflammatory Marker Increases after Long-Term Cure of Cushing’s Syndrome

Cited by 146 publications

References 29 publications

Body composition and bone mineral density in women with Cushing's syndrome in remission and the association with common genetic variants influencing glucocorticoid sensitivity

Body composition and bone mineral density in women with Cushing's syndrome in remission and the association with common genetic variants influencing glucocorticoid sensitivity

Serum Adipokine Concentrations in Dogs with Naturally Occurring Pituitary‐Dependent Hyperadrenocorticism

Cardiovascular complications of cushing’s syndrome

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