title: Anthropometric measures and fasting insulin levels in children before and after cure of Cushing syndrome.
abstract: OBJECTIVE
  Children with Cushing syndrome present with growth delay and excess adiposity that tends to be generalized rather than centripetal. There are no prospective studies of this phenotype as it evolves before and after treatment in children. The aims of this study were to evaluate children prior to and one-year after surgical cure compared to controls and to determine fasting insulin levels and their possible association with waist circumference and waist-height ratio, pre- and post-cure of Cushing syndrome.
  
  
  METHODS
  30 children with Cushing syndrome were evaluated prior to and one-year post-treatment and compared to 14 age and body mass index-matched controls.
  
  
  RESULTS
  Only triceps skin fold z- score showed a significant difference between patients with active Cushing syndrome and controls. A positive correlation between fasting insulin levels and waist circumference z- score was found for children with Cushing syndrome; this association persisted one-year following cure.
  
  
  CONCLUSIONS
  Unlike adults affected with Cushing syndrome, upper arm muscle area of children with Cushing syndrome did not differ from obese children without Cushing syndrome. The persistence of a positive correlation between waist circumference and fasting insulin despite remission of Cushing syndrome suggests that children with a history of Cushing syndrome may have an increased risk for adverse long-term effects of increased abdominal fat mass.
authors.affiliation: Section on Endocrinology Genetics, Program on Developmental Endocrinology Genetics (PDEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA. keilm@mail.nih.gov
authors.forename: Margaret F
authors.initials: MF
authors.lastname: Keil
authors.forename: Jennifer
authors.initials: J
authors.lastname: Graf
authors.forename: Nirmal
authors.initials: N
authors.lastname: Gokarn
authors.forename: Constantine A
authors.initials: CA
authors.lastname: Stratakis
mesh_terms: D050153:Abdominal Fat; D050154:Adiposity; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000503:physiopathology / Q000601:surgery; D000315:Adrenalectomy; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D003480:Cushing Syndrome / Q000097:blood* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007016:Hypophysectomy; D007328:Insulin / Q000097:blood*; D008297:Male; D056128:Obesity, Abdominal / Q000209:etiology*; D010911:Pituitary Neoplasms / Q000503:physiopathology / Q000601:surgery; D012074:Remission Induction; D012885:Skinfold Thickness; D055105:Waist Circumference
chemical_list: D007328:Insulin