Glucose metabolism in patients with Cushing's syndrome.
Glucose intolerance, sometimes severe enough to cause frank diabetes mellitus, is a frequent feature of Cushing's syndrome. The primary cause of the hyperglycaemia, whether due to glucose over-production or under-utilization, remains unresolved. We therefore measured glucose turnover using an intravenous bolus of 3-3H glucose in 14 normoglycaemic patients with Cushing's syndrome and 14 control subjects. Seven of the patients with Cushing's syndrome were also restudied post-operatively. Plasma glucose concentrations were similar in all three groups whereas glucose metabolic clearance rate (MCR) (1.80 +/- 0.06 ml/min/kg) and glucose turnover rate (9.09 +/- 0.36 mumol/min/kg) were significantly reduced in patients with Cushing's syndrome compared to normal subjects (2.21 +/- 0.1; P less than 0.001; 10.90 +/- 0.50; P less than 0.01) and rose post-operatively to normal values (2.35 +/- 0.14 ml/min/kg; 11.07 +/- 0.48 mumol/min/kg). We conclude from these results that the hyperglycaemia sometimes found in Cushing's syndrome may be primarily due to decreased utilization rather than increased glucose production.
Bowes
S B
SB
Division of Medicine, United Medical School, Guy's Hospital, London, UK.
Benn
J J
JJ
Scobie
I N
IN
Umpleby
A M
AM
Lowy
C
C
Sönksen
P H
PH
D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003480:Cushing Syndrome / Q000378:metabolism* / Q000601:surgery; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism*; D006801:Humans; D007016:Hypophysectomy; D007275:Injections, Intravenous; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011184:Postoperative Period
D001786:Blood Glucose; D005947:Glucose