Cushing syndrome, metabolic syndrome and inflammation: a suggested way out

Abstract

SummaryEndogenous hypercortisolism is associated with an increased cardiovascular risk. Cushing Syndrome (CS) shares many clinical features with metabolic syndrome, including abdominal obesity, systemic arterial hypertension, insulin resistance, dyslipidemia, and thrombotic diatesis. Moreover, CS represents an interesting pattern of an endocrine disorder associated with chronic lowgrade inflammation which is not blunted by the resolution of hypercortisolism. The proinflammatory state that accompanies the metabolic syndrome may provide a connection between CS, inflammation and metabolic processes, which is highly deleterious for vascular functions. There is evidence that dietary patterns similar to those of the Mediterranean-style diet exert positive effects on almost all components of the metabolic syndrome and other conditions associated with, including inflammation, insulin resistance, and endothelial dysfunction. Therefore, an intervention strategy based on lifestyle changes may play a role in patients with resolution of hypercortisolism in which the anti-inflammatory effects of cortisol are lost and cytokines levels are increased. In this setting, the Mediterranean healthy dietary pattern may represent an innovative approach in order to improve the disease course and to reduce in the long term the cardiovascular risk of people affected by CS.