Persistent body fat mass and inflammatory marker increases after long-term cure of Cushing's syndrome.
OBJECTIVE
Although increased central fat mass is characteristic of active Cushing's syndrome (CS), little is known about body composition and secretion of adipokines after long-term recovery of CS. The aim of this study was to evaluate central fat mass and its correlation with adipokines and cardiovascular risk factors in patients after long-term remission of CS.


METHODS
Thirty-seven women with CS in remission (27 of pituitary and 10 of adrenal origin; mean age, 50 +/- 14 yr; mean time of hormonal cure, 11 +/- 6 yr) were enrolled and compared to 14 women with active CS and 85 gender-, age-, and body mass index-matched healthy controls. Total and trunk fat mass were measured by dual-energy x-ray absorptiometry scanning. Laboratory parameters and adipokine levels [including adiponectin, visfatin, soluble TNFalpha-receptor 1 (sTNF-R1), sTNF-R2, and IL-6] were measured.


RESULTS
Cured CS patients had more total and trunk fat mass than controls. Cured and active CS had higher levels of sTNF-R1 and IL-6 and lower adiponectin levels than controls. Higher insulin levels and blood pressure in both groups of CS patients and higher apolipoprotein B in cured CS were observed compared to controls. sTNF-R1 correlated positively with percentage of trunk fat mass and remained significant after adjusting for anthropometric parameters.


CONCLUSIONS
Despite long-term cure, patients who have suffered CS exhibit persistent accumulation of central fat, as in active hypercortisolemia, with the consequent unfavorable adipokine profile, leading to a state of low-grade inflammation. This situation determines a persistent and increased cardiovascular risk in these patients.
Barahona
María-José
MJ
Department of Endocrinology, Hospital Mútua de Terrassa, Pl Dr Robert 5, 08221 Terrassa, Barcelona, Spain. 33962mbc@comb.cat
Sucunza
Nuria
N
Resmini
Eugenia
E
Fernández-Real
José-Manuel
JM
Ricart
Wifredo
W
Moreno-Navarrete
José-María
JM
Puig
Teresa
T
Farrerons
Jordi
J
Webb
Susan M
SM
D052242:Adiponectin / Q000097:blood; D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology; D003480:Cushing Syndrome / Q000150:complications / Q000378:metabolism*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood; D012307:Risk Factors
C499918:ADIPOQ protein, human; D052242:Adiponectin; D015850:Interleukin-6; D047888:Receptors, Tumor Necrosis Factor, Type I