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Persistent centripetal fat distribution and metabolic abnormalities in patients in long‐term remission of Cushing's syndrome
Author(s) -
Wagenmakers Margreet,
Roerink Sean,
Gil Linda,
Plantinga Theo,
Smit Jan,
NeteaMaier Romana,
Hermus Ad
Publication year - 2015
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12639
Subject(s) - medicine , adipose tissue , endocrinology , resistin , leptin , adiponectin , waist , adipokine , obesity , gastroenterology , insulin resistance
Summary Objective Centripetal obesity is associated with systemic low‐grade inflammation and an increased cardiovascular risk. Patients in long‐term remission of Cushing's syndrome ( CS ) report persisting abdominal fat accumulation. However, this has previously not been adequately objectified. Therefore, we investigated the adipose tissue distribution and adipocytokine profiles of patients in long‐term remission of CS . Design Cross‐sectional case–control study in a tertiary referral centre. Patients Fifty‐eight patients, in remission of CS for at least 5 years, were compared to 58 age‐, gender‐ and BMI ‐matched healthy control subjects. Measurements Measures of body composition (assessed with clinical evaluation and dual‐energy X‐ray absorptiometry ( DEXA ) scanning) and serum adipocytokine profiles. Results Compared to the matched control subjects, patients in long‐term remission of CS had a greater waist circumference ( P < 0·01), a smaller thigh circumference ( P < 0·01), a higher waist‐to‐hip ratio ( P < 0·01) and a higher hip‐to‐thigh ratio ( P < 0·01). As measured with DEXA scanning, patients had a higher percentage of truncal fat mass ( P = 0·01), and the truncal fat mass to leg fat mass ratio was greater ( P < 0·01). Patients had lower adiponectin levels ( P < 0·01), higher leptin levels ( P < 0·01) and higher resistin levels ( P = 0·04) than control subjects. Conclusion Even after long‐term remission, patients who suffered from CS in the past continue to have a centripetal adipose tissue distribution and an adverse adipokine profile. This is independent of aetiology of the CS , treatment strategies, hormonal deficiencies and comorbidity, and probably contributes to the persistent increased cardiovascular risk.