scholarly journals Comparison of adipose tissue derived genes in endogenous Cushing’s syndrome versus diet-induced obesity

2019 ◽  
Vol 70 (2) ◽  
pp. 131-134
Author(s):  
Judit Denes ◽  
Adrienn Zsippai ◽  
Laszlo Kovacs ◽  
Zoltan Gorombey ◽  
Gabor L. Kovacs ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Diet Induced Obesity

Subclinical Cushing’s Syndrome in women with adrenal incidentalomas is associated with adipose tissue dysfunction

2016 ◽  
Vol 62 (5) ◽  
pp. 72-73
Author(s):  
Stavroula A. Paschou ◽  
Markella Nezi ◽  
Fotini Dimitropoulou ◽  
Dimitrios Ioannidis ◽  
Argyro Panagiotakou ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Cushing’S Syndrome ◽  
Clinical Signs ◽  
Cushing's Syndrome ◽  
Visceral Adiposity Index ◽  
Adrenal Incidentalomas ◽  
Subclinical Cushing’S Syndrome ◽  
Adipose Tissue Dysfunction ◽  
Mass Size ◽  
And Function

Introduction. The visceral adiposity index (VAI) is a mathematical formula based on simple anthropometric and biochemical parameters and reflects the distribution and function of the adipose tissue.Aim: to investigate the possible association between the presence of subclinical Cushing’s syndrome (SCS) and VAI in patients with adrenal incidentalomas.Patients and methods. We studied 258 patients with adrenal incidentalomas. The diagnosis of SCS was based on a post-LDDST cortisol level ≥1.8 mg/dl combined with an abnormal result of at least one other test of the HPA axis, in the absence of clinical signs. The VAI index was calculated as following: Women VAI= [WC/36.58+(1.89×BMI)] ×(TG/0.81)×(1.52/HDL), Men VAI= [WC/39.68+(1.88×BMI)] ×(TG/1.03)×(1.31/HDL).Results. 122 patients were excluded from the analysis due to overt metabolic problems (8 with BMI>39, 82 with metabolic syndrome and 34 with type 2 diabetes). Among 136 patients who were included in the analysis (42M/94W, 56.9±9.7 y), SCS was diagnosed in 24 (17.6%). Patients with SCS presented with significantly higher levels of insulin (12.4±4.6 vs 9.9±3.2 μIU/ml, p=0.036) and triglycerides (114±36 vs 97±34 mg/dl, p=0.023), larger size of tumors (3.26±0.88 vs 2.28±1.06 cm, p<0.001) and higher calculated VAI (1.77±0.83 vs 1.39±0.69, p=0.045). Regression analysis revealed that the presence of SCS was positively associated with VAI [OR (95% CI) 1.888 (1.051–3.394), p=0.034] but when gender subgroup analysis followed, this was shown only in women [OR (95% CI) 2.284 (1.135–4.595), p=0.021]. Another important prognostic factor for the probability of SCS was the mass size [OR (95% CI) 2.237 (1.441–3.472), p<0.001].Conclusion. SCS in women with adrenal incidentalomas is associated with adipose tissue dysfunction.

scholarly journals Changes in Adenosine 5′-Monophosphate-Activated Protein Kinase as a Mechanism of Visceral Obesity in Cushing’s Syndrome

2008 ◽  
Vol 93 (12) ◽  
pp. 4969-4973 ◽  
Author(s):  
Blerina Kola ◽  
Mirjam Christ-Crain ◽  
Francesca Lolli ◽  
Giorgio Arnaldi ◽  
Gilberta Giacchetti ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Protein Kinase ◽  
Abdominal Surgery ◽  
Visceral Adipose Tissue ◽  
Cushing’S Syndrome ◽  
Central Obesity ◽  
Cushing's Syndrome ◽  
Metabolic Effects ◽  
Ampk Activity ◽  
Visceral Adipose

Objective: Features of the metabolic syndrome such as central obesity with insulin resistance and dyslipidemia are typical signs of Cushing’s syndrome and common side effects of prolonged glucocorticoid treatment. AMP-activated protein kinase (AMPK), a key regulatory enzyme of lipid and carbohydrate metabolism as well as appetite, is involved in the development of the deleterious metabolic effects of excess glucocorticoids, but no data are available in humans. In the current study, we demonstrate the effect of high glucocorticoid levels on AMPK activity of human adipose tissue samples from patients with Cushing’s syndrome. Methods: AMPK activity and mRNA expression of genes involved in lipid metabolism were assessed in visceral adipose tissue removed at abdominal surgery of 11 patients with Cushing’s syndrome, nine sex-, age-, and weight-matched patients with adrenal incidentalomas, and in visceral adipose tissue from four patients with non-endocrine-related abdominal surgery. Results: The patients with Cushing’s syndrome exhibited a 70% lower AMPK activity in visceral adipose tissue as compared with both incidentalomas and control patients (P = 0.007 and P &lt; 0.001, respectively). Downstream targets of AMPK fatty acid synthase and phosphoenol-pyruvate carboxykinase were up-regulated in patients with Cushing’s syndrome. AMPK activity was inversely correlated with 0900 h serum cortisol and with urinary free cortisol. Conclusions: Our data suggest that glucocorticoids inhibit AMPK activity in adipose tissue, suggesting a novel mechanism to explain the deposition of visceral adipose tissue and the consequent central obesity observed in patients with iatrogenic or endogenous Cushing’s syndrome.

scholarly journals Adipose tissue 11β-hydroxysteroid dehydrogenase type 1 expression in obesity and Cushing’s syndrome

2006 ◽  
Vol 155 (3) ◽  
pp. 435-441 ◽  
Author(s):  
Barbara Mariniello ◽  
Vanessa Ronconi ◽  
Silvia Rilli ◽  
Paolo Bernante ◽  
Marco Boscaro ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Western Blot ◽  
Cushing’S Syndrome ◽  
Blot Analysis ◽  
Plasma Cortisol ◽  
Cushing's Syndrome ◽  
Normal Weight ◽  
Omental Adipose Tissue ◽  
Obese Subjects

Objective: To evaluate the expression of 11β-hydrxysteroid dehydrogenase type 1 (11β-HSD1) in omental adipose tissue of patients with Cushing’s syndrome and simple obesity, compared with normal weight controls. Design and methods: We have performed a case-control study and studied omental adipose tissue from a total of 24 subjects (eight obese subjects, ten patients with Cushing’s syndrome due to adrenal adenoma, and six normal weight controls). Body mass index, blood pressure, plasma glucose, plasma insulin, plasma cortisol, urinary free cortisol and post dexamethasone plasma cortisol were measured with standard methods. 11β-HSD1 mRNA and protein expression were evaluated in real-time PCR and western blot analysis respectively. Results: 11β-HSD1 mRNA was 13-fold higher in obese subjects compared with controls (P=0.001). No differences were found between Cushing’s patients and controls. Western blot analysis supported the mRNA expression results. Conclusions: Our data show the involvement of 11β-HSD1 enzyme invisceral obesity, which is more evident in severely obese patients than in Cushing’s syndrome patients. The lack of increase of 11β-HSD1 expression in Cushing’s syndrome could suggest downregulation of the enzyme as a result of long-term overstimulation.

Decreased insulin binding and antilipolytic response in adipocytes from patients with Cushing's syndrome

1987 ◽  
Vol 7 (9) ◽  
pp. 713-719 ◽  
Author(s):  
C. Calle ◽  
M. C. Carranza ◽  
M. A. Simón ◽  
A. Torres ◽  
P. Mayor
Keyword(s):  
Adipose Tissue ◽  
Cushing’S Syndrome ◽  
Insulin Receptors ◽  
Human Adipose Tissue ◽  
Insulin Binding ◽  
Cushing's Syndrome ◽  
Human Adipocytes ◽  
Receptor Affinity ◽  
Endogenous Regulation

Human adipocytes from patients with chronic endogenous hypercortisolism (Cushing's syndrome) showed a statistically significant decrease in insulin binding at low unlabelled-insulin concentrations but no change in receptor numbers (Cushing's 180,000±48,000 (3) receptors/cell and controls 189,000±30,000 (7)) together with a fourfold decrease in apparent receptor affinity (ED50: Cushing's 2.25×10−9 M and controls 0.57×10−9 M) and a decreased sensitivity to the antilipolytic effect of insulin. These events could represent the final situation of a chronic and endogenous regulation by high levels of cortisol of insulin receptors in human adipose tissue.

Body Composition is Different After Surgical or Pharmacological Remission of Cushing’s Syndrome: A Prospective DXA Study

2017 ◽  
Vol 49 (09) ◽  
pp. 660-666 ◽  
Author(s):  
Filippo Ceccato ◽  
Michela Boccato ◽  
Marialuisa Zilio ◽  
Mattia Barbot ◽  
Anna Frigo ◽  
...  
Keyword(s):  
Body Composition ◽  
Adipose Tissue ◽  
Fat Mass ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Controlled Study ◽  
Sustained Remission ◽  
Late Night ◽  
Fat Reduction ◽  
Total Body

AbstractPatients with active Cushing’s syndrome (CS) exhibit an increase of the visceral adipose tissue, increasing the risk of cardiovascular events. Until now, it is not yet clear whether remission of CS leads to a normalization of body composition, or if different strategies to control hypercortisolism could result in a different clinical outcome concerning adipose tissue distribution. Therefore, we analyzed body composition changes using dual-energy X-ray absorptiometry (DXA) in patients with CS in a prospective and controlled study. We considered 23 patients with CS, whose remission was achieved after surgery in 14 or gained with pharmacological treatment in 9 subjects. Clinical and DXA data (lean and fat mass in total body, trunk, and R1 box) were collected during active hypercortisolism and after sustained remission, defined as the normalization of both late night salivary and 24-h urinary cortisol levels, at least for 6 consecutive months. Healthy subjects, matched with CS for gender, age, and BMI, were considered as controls (n=25). After remission of hypercortisolism, body compositions of patients were similar to matched controls; fat mass in total body (−7.53%), trunk (−3.24%), and R1- box (−12.82%, all p<0.01) were decreased from baseline levels. Dividing patients by type of treatment, fat mass reduction was higher in those that achieved surgical remission of CS (total body −17.26%, trunk −22.73%, and R1 box −21.21%, all p<0.05). Surgical remission of hypercortisolism is characterized by improvement of body composition, particularly fat reduction, easily detectable with DXA during routine clinical practice.

CT-based Abdominal Adipose Tissue Area Changes in Patients Undergoing Adrenalectomy Due to Cushing’s Syndrome and Non-functioning Adenomas

2021 ◽  
Author(s):  
Elif Gündoğdu ◽  
Emre Emekli
Keyword(s):  
Adipose Tissue ◽  
Cushing’S Syndrome ◽  
Statistical Significance ◽  
Treatment Method ◽  
Cushing's Syndrome ◽  
Time Interval ◽  
Adrenocortical Adenoma ◽  
Intervertebral Disc Space ◽  
Disc Space ◽  
Preoperative Ct

Abstract Background The majority of Cushing’s syndrome (CS) cases constitute patients with functional adrenal adenomas. In adrenal CS, visceral adipose tissue (VAT) area, VAT/subcutaneous adipose tissue (SAT), and VAT/total adipose tissue (TAT) ratios are expected to decrease in response to adrenalectomy, although no change is expected in non-functioning adrenal adenomas (NFA). Objective To evaluate the changes in VAT, SAT, TAT areas and VAT/SAT, VAT/TAT ratios using computed tomography (CT) in patients who underwent adrenalectomy due to adenomas. Methods Preoperative and postoperative CT of 32 patients (16 with CS and 16 with NFA) were retrospectively evaluated. The VAT, SAT, TAT areas were obtained from CT at the level of L1–2 intervertebral disc space, and the VAT/SAT, VAT/TAT ratios were calculated. The postoperative parameter changes in both groups were evaluated compared to the preoperative values. The level of statistical significance was considered as p<0.05. Results The time interval between preoperative and postoperative CT measurements were 10.37 months (6–17) in CS and 9.75 months (7–15) in NFA groups (p=073). Preoperative CT indicated that the patients with CS had larger VAT and TAT areas (p=0.03, p=0.02) but SAT remained unchanged (p=0.08). However, postoperative CT revealed that there was no difference between the two groups in terms of VAT, TAT, and SAT areas (p=0.87, p=0.36, p=0.14). Postoperatively, in patients with CS, there was a decrease in VAT and TAT areas (p=0.01 for both) and VAT/SAT and VAT/TAT ratios (p=0.03, p=0.02) but SAT remained unchanged (p=0.10). In patients with NFA, no change was detected in the postoperative SAT, TAT, and VAT areas (p=0.12, p=0.40, p=0.99) or the VAT/SAT and VAT/TAT ratios (p=0.38, p=0.62). Conclusions Adrenalectomy is an effective treatment method leading to a decrease in the VAT, TAT areas, and VAT/SAT and VAT/TAT ratios in patients with cortisol producing adrenocortical adenoma. Thus, CT facilitates quantitative demonstration of the changes while evaluating the response of these patients to treatment.

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