title: Persistent body fat mass and inflammatory marker increases after long-term cure of Cushing's syndrome.
abstract: 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.
authors.affiliation: Department of Endocrinology, Hospital Mútua de Terrassa, Pl Dr Robert 5, 08221 Terrassa, Barcelona, Spain. 33962mbc@comb.cat
authors.forename: María-José
authors.initials: MJ
authors.lastname: Barahona
authors.forename: Nuria
authors.initials: N
authors.lastname: Sucunza
authors.forename: Eugenia
authors.initials: E
authors.lastname: Resmini
authors.forename: José-Manuel
authors.initials: JM
authors.lastname: Fernández-Real
authors.forename: Wifredo
authors.initials: W
authors.lastname: Ricart
authors.forename: José-María
authors.initials: JM
authors.lastname: Moreno-Navarrete
authors.forename: Teresa
authors.initials: T
authors.lastname: Puig
authors.forename: Jordi
authors.initials: J
authors.lastname: Farrerons
authors.forename: Susan M
authors.initials: SM
authors.lastname: Webb
mesh_terms: 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
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015850:Interleukin-6; D047888:Receptors, Tumor Necrosis Factor, Type I