Persistent Body Fat Mass and Inflammatory Marker Increases after Long-Term Cure of Cushing's Syndrome
Persistent Body Fat Mass and Inflammatory Marker Increases after Long-Term Cure of Cushing's Syndrome
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DOI：
10.1210/jc.2009-0766
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发表时间：
2009-09-01
影响因子：
5.8
通讯作者：
Webb, Susan M.
中科院分区：
文献类型：
--
作者：
Barahona, Maria-Jose;Sucunza, Nuria;Webb, Susan M.
目的：虽然中心脂肪量增加是活动性库欣综合征（CS）的特征，但对CS长期恢复后的身体组成和脂肪因子分泌知之甚少。本研究的目的是评估CS长期缓解后患者的中心脂肪量及其与脂肪因子和心血管危险因素的相关性。垂体源性27例，肾上腺源性10例，平均年龄50 ± 14岁;平均激素治疗时间为11 ± 6年），并与14名活动性CS患者和85名性别、年龄和体重指数匹配的健康对照组进行比较。采用双能X线吸收扫描法测量总脂肪量和躯干脂肪量。实验室参数和脂肪因子水平[包括脂联素，内脂素，可溶性肿瘤坏死因子α受体1（sTNF-R1），sTNF-R2，和IL-6]测定。与对照组相比，治愈和活动性CS的sTNF-R1和IL-6水平较高，脂联素水平较低。与对照组相比，观察到两组CS患者的胰岛素水平和血压较高，治愈CS患者的载脂蛋白B较高。sTNF-R1与躯干脂肪质量的百分比呈正相关，并保持显着调整后的人体测量parameters.Conclusion：尽管长期治愈，患有CS的患者表现出持续积累的中央脂肪，在活动性高皮质醇血症，随之而来的不利的脂肪因子配置文件，导致低度炎症状态。这种情况决定了这些患者的心血管风险持续增加。（临床内分泌代谢杂志94：3365-3371，2009）
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 TNF alpha-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.Conclusion: 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. (J Clin Endocrinol Metab 94: 3365-3371, 2009)