The adipose visceral dysfunction plays an important role in diabetes in Cushing disease.

Risultato della ricerca: Otherpeer review


Background: Cushing disease (CD) is associated with increased morbidity and mortalitycaused by cardiometabolic alterations. Visceral Adiposity Index (VAI) expresses impairedadipose distribution and function which are related to the cardiometabolic risk. Aim: Toevaluate in a cohort of CD patients the correlation between VAI and other parameters, suchas gender, etiology, age, cortisol values measured in the morning (8 am) and at themidnight, urinary free cortisol (24h sample of urine, average of three samples) and glucosetolerance as normal glucose tolerance (NGT), impaired fasting glucose (IFG), impairedglucose tolerance (IGT), IFG+IGT and diabetes mellitus. Materials and methods: Weperformed a retrospective study in 140 CD patients consecutively afferent in outpatientsclinic of the Universities of Naples and Palermo. Patients were divided by VAI tertiles andtrend analysis was evaluated. Results: 27 men and 113 women, mean age of 40.98±16,61years and BMI of 30.86 ± 6.01 Kg/m2 were studied. 62.7% of patients had a metabolicsyndrome, 30.7% diabetes mellitus, 5.7% IFG, 12.1% IGT and 0.7% IFG+IGT. Among allparameters evaluated, only the midnight cortisol showed a significant increasing trendaccording to VAI tertiles (I tertile 172.57±77.24, II tertile 168.40±73.67, III tertile227.06±119.42; p=0.045). Significant correlations between HOMA IR increase and VAItertiles (I tertile 2.16±1.18, II tertile 3.13±1.49, III tertile 2.81±1.37 p=0.020), HbA1cincrease and VAI tertiles (I tertile 5.87±0.84%, II tertile 6.40±1.23%, III tertile 6.60±1.19%p=0.018) were found. No significant trend for HOMA-b was observed. Conclusions: CDwomen have a higher cardiometabolic risk than men and this risk becomes more highermore older is the patient. Therefore these patients have a condition of visceral adipositydysfunction that contributes to decrease of insulin sensitivity, but not at a reduction in betacellfunction, like the typical diabetes mellitus at onset. Thus, visceral fat dysfunctionseems to be a key factor not only in favouring diabetes mellitus onset but also in worseningglycaemic control in Cushing diabetic patients.
Lingua originaleEnglish
Numero di pagine1
Stato di pubblicazionePublished - 2013


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