Body Composition is Different After Surgical or Pharmacological Remission of Cushing’s Syndrome: A Prospective DXA Study

Ceccato, Filippo; Boccato, Michela; Zilio, Marialuisa; Barbot, Mattia; Frigo, Anna Chiara; Luisetto, Giovanni; Boscaro, Marco; Scaroni, Carla; Camozzi, Valentina

doi:10.1055/s-0043-115008

Cited by 7 publications

(3 citation statements)

References 36 publications

(61 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Likewise, pubertal development and BMI improved. These results may catch with data recently published by Ceccato et al , illustrating an improvement of body composition after remission of CD in adults, fat mass reduction being higher after surgical remission ( 38 ). In addition, mitotane may facilitate an increase in adenoma volume through the stimulation of pituitary ACTH secretion driven by the adrenal insufficiency.…”

Section: Discussionsupporting

confidence: 92%

Mitotane (op’DDD) restores growth and puberty in nine children with Cushing’s disease

Motte

Rothenbühler

Gaillard

et al. 2018

Endocrine Connections

View full text Add to dashboard Cite

To investigate whether low-dose mitotane (up to 2 g/day) could be a temporary therapeutic alternative to transsphenoidal surgery (TSS) in pediatric Cushing’s disease (CD). Twenty-eight patients with CD aged 12.2 years (± 2.2) were referred to our center. We compared nine patients treated with mitotane alone for at least 6 months to 13 patients cured after surgery. Primary outcomes were changes in growth velocity, BMI and pubertal development. The following results were obtained: (1) Mitotane improved growth velocity z-scores (−3.8 (±0.3) vs −0.2 (±0.6)), BMI z-scores (2.1 (±0.5) vs 1.2 (±0.5) s.d.) and pubertal development. After 1 year on mitotane, the mean BMI z-score was not significantly different in both groups of patients. (2) Control of cortisol secretion was delayed and inconsistent with mitotane used as monotherapy. (3) Side effects were similar to those previously reported, reversible and dose dependent: unspecific digestive symptoms, concentration or memory problems, physical exhaustion, adrenal insufficiency and hepatitis. (4) In one patient, progressive growth of a pituitary adenoma was observed over 40 months of mitotane treatment, allowing selective adenomectomy by TSS. In conclusions, low-dose mitotane can restore growth velocity and pubertal development and decrease BMI in children with CD, even without optimal control of cortisol secretion. It may promote pituitary tumor growth thus facilitating second-line TSS. However, given its possibly life-threatening side effects (transient adrenal insufficiency and hepatitis), and in the absence of any reliable follow-up procedures, this therapy may be difficult to manage and should always be initiated and monitored by specialized teams.

show abstract

Section: Discussionsupporting

confidence: 92%

Mitotane (op’DDD) restores growth and puberty in nine children with Cushing’s disease

Motte

Rothenbühler

Gaillard

et al. 2018

Endocrine Connections

View full text Add to dashboard Cite

show abstract

“…CS body composition after remission was similar to the matched control group, especially for FM analysed overall in the trunk and R1 box. This change in body composition was accompanied by a decrease in serum glucose levels and a reduction in hypertension and symptoms of metabolic syndrome [73].…”

Section: Fat Tissue Applicationmentioning

confidence: 99%

The Significance of Dual-Energy X-ray Absorptiometry (DXA) Examination in Cushing’s Syndrome—A Systematic Review

Radecka

Lubkowska

2023

Diagnostics

View full text Add to dashboard Cite

In recent years, the usefulness of dual-energy X-ray absorptiometry (DXA) as a valuable complementary method of assessing the content and distribution of adipose and lean tissue as well as bone mineral density and estimating the risk of fractures has been increasingly confirmed. The diagnosis and treatment of Cushing’s syndrome remain challenging, and monitoring the effects of treatment is often necessary. DXA tests offer a potential solution to many problems related to the availability of a quick, detailed, and reliable analysis of changes in the content and distribution of individual body composition components. The article discusses total body DXA scans (FMI, VAT, ALMI), lumbar spine scans (VFA, TBS), and osteoporosis scans (BMD, T-score, Z-score)—all are of potential interest in Cushing’s syndrome. The article discusses the use of the most important indicators obtained from a DXA test (FMI, VAT, ALMI, BMD, T-score, Z-score, VFA, TBS) and their clinical significance in Cushing’s syndrome was verified. The literature from the last decade was used for the study, available in MEDLINE, Web of Science, and ScienceDirect.

show abstract

“…The function of hypothalamic-pituitary-adrenal (HPA) axis was also shown to be related to the type of BFD [8][9][10]. Thus, the hyperactivity of the axis occurred in obese women with high WHRs after the administration of CRF and ACTH [11,12].…”

Section: Introductionmentioning

confidence: 99%

Anthropometric correlates of morning plasma cortisol level and hormonal and biochemical response to fasting in obese premenopausal women

Melnikov¹,

Kim²

2017

Integr Obesity Diabetes

View full text Add to dashboard Cite

Numerous studies have established associations between hormonal parameters and body shape but they focused on the patterns of body fat distribution and, mainly, abdominal fat deposition. Based on the anthropometric features of patients with Cushing's syndrome, we hypothesized that there are somatometric predictors, other than waist-to-hip ratio, of increased cortisol production. To test this hypothesis and to identify the indicators of endocrine and metabolic responsiveness to shortterm fasting, we searched associations among 37 anthropometric traits and metabolic and hormonal parameters. An observational repeated measures study was performed on 64 moderately obese women using the partial correlation analysis. Blood glucose, serum lipids and urea concentrations, morning plasma cortisol, serum triiodthyronine (T3), thyroxin levels, and insulin activity (IRI) were examined before and after 4-and 7-day total fasting. The morning plasma cortisol level (RIA) showed the strongest correlation, independent of total fatness, with chest-hip circumference ratio (CHR) (r=0.48, p<0.005), whereas no significant association could be found with waist-hip ratio (WHR). IRI level correlated directly with WHR (r=0.47, p<0.001). The 4-day fasting significantly raised cortisol levels (+23%), free fatty acids (FFAs) (+79%), and triglyceride (TGs) (+34%) concentrations, and lowered IRI (-43%), T3 (-33%) and glucose (-27%) levels. The cortisol response to 4-day fasting tended to relate with age (r=0.25) and age-independently correlated with body height (r=-0.30) and WHR (r=-0.27). Both basal levels and fast changes in glucose and TGs concentrations correlated with age (glucose, r=0.38; TGs, r=0.24; d-glucose, r=-0.32; d-TG, r=-0.24). The relative weight loss after the 27-day weight-loss program increased with increasing basal FFAs and thyroxin levels. In conclusion, CHR was found to be a powerful predictor for morning plasma cortisol level. The relation established seems to reflect the differential sensitivity of the upper and lower body subcutaneous adipocytes to the metabolic stimuli of the hormone and/or other factors associated with glucocorticoids.level. In addition to this primary objective, there were two aims: (1) to describe anthropometric correlates for the response of endocrine variables and the patterns of protein, glucose, and lipid metabolism to short-term fasting, and (2) to verify hormonal, metabolic and somatometric predictors for the weight reduction during weight-loss program (WLP). Taking into account the sex-dependence of cortisol metabolism in obesity [18] we performed this research on obese women who were usually being investigated from the standpoint under study. Subjects and methods SubjectsThe study was undertaken on 64 Russian fertile women living in Novosibirsk city and referred to the endocrine division of the academic clinic for treatment of obesity by a WLP. The patients' free and informed consent to participate in the study was obtained. No women had signs of hirsutism, other endocrine disorders, ...

show abstract

Body Composition is Different After Surgical or Pharmacological Remission of Cushing’s Syndrome: A Prospective DXA Study

Cited by 7 publications

References 36 publications

Mitotane (op’DDD) restores growth and puberty in nine children with Cushing’s disease

Mitotane (op’DDD) restores growth and puberty in nine children with Cushing’s disease

The Significance of Dual-Energy X-ray Absorptiometry (DXA) Examination in Cushing’s Syndrome—A Systematic Review

Anthropometric correlates of morning plasma cortisol level and hormonal and biochemical response to fasting in obese premenopausal women

Contact Info

Product

Resources

About