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Barwich, D., G. Klett, W. Eckert, and H. Weicker. Exercise-Induced Lipolysis with Central Cushing's Disease, mt J Sports Med, Vol 1, No. 3, pp. 120-126, 1980. The hormonal regulation of exercise-induced lipolysis was investigated in patients with a central Cushing's syndrome compared to a healthy control group. Ten of these patients were adrenalectomized and four of them additionally hypophysectomized after having developed a Nelson's tumor. Blood was taken at rest, after a moderate long-term test of 20 mm at a work load of 70% 'TO2max, and 30 and 60 mm after work.The hormone levels of epinephrine and norepinephrine, cortisol, HGH (human growth hormone), insulin, and ACTI-I (adrenocorticotropic hormone) were determined while the substrates FFA (free fatty acids), 13-OFIB (13-hydroxybutyrate), AcAc (acetoacetate), glycerol, and lactate were also measured.The subjects' anaerobic thresholds were determined during a maximal ergometer test.The main findings were that in the patients exercise-induced lipolysis was accompanied by only basal epinephrine levels throughout the test and high ACTH levels that could be related to high FFA and glycerol values both at rest and after exercise. The results suggest that adrenal medullary stimulation of lipolysis during exercise is replaced by ACTH and synaptic n':3Dinephrine impulses.

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Approximately 10% of all patients with untreated central Cushing's syndromes have clinically verifiable tumours of the pituitary. After bilateral adrenalectomy 10 to 20% of patients with apparently normal pre-operative pituitary glands develop clinically and roentgenologically demonstrable pituitary tumours, of the so called Nelson type. These are usually very active chromophobe adenomas which are dangerous because they expand rapidly. They secretee considerable amounts of ACTH and MSH. A typical case is described.