Body Composition After Endogenous (Cushing's Syndrome) and Exogenous (Rheumatoid Arthritis) Exposure to Glucocorticoids

E. Resmini; C. Farkas; B. Murillo; M. J. Barahona; A. Santos; M. A. Martínez-Momblán; O. Roig; J. Ybarra; C. Geli; S. M. Webb

doi:10.1055/s-0030-1255032

Hormone and Metabolic Research, Inhaltsverzeichnis

Horm Metab Res 2010; 42(8): 613-618
DOI: 10.1055/s-0030-1255032

Humans, Clinical

Body Composition After Endogenous (Cushing's Syndrome) and Exogenous (Rheumatoid Arthritis) Exposure to Glucocorticoids

E. Resmini¹ , C. Farkas¹ , B. Murillo¹ , M. J. Barahona¹ ^, ² , A. Santos¹ , M. A. Martínez-Momblán¹ , O. Roig¹ , J. Ybarra¹ , C. Geli³ , S. M. Webb¹

¹Instituto de Investigación Biomédica (IIB)-Sant Pau, Endocrinology/Medicine Department and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unidad 747) ISCIII; Universitat Autonoma de Barcelona, Spain
²Endocrinology Department, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
³Rheumatology Department, Hospital Sant Pau, Barcelona, Spain

Abstract

Exposure to chronic glucocorticoid (GC) excess determines changes in body composition. The aim of the study was to compare body composition in women exposed to endogenous hypercortisolism (Cushing's syndrome, CS), exogenous glucocorticoid treatment (rheumatoid arthritis, RA) and controls. Fifty-one CS women, 26 RA women treated with low-dose prednisone (5 mg/day or 10 mg/2 days), and 78 female controls were included. Fourteen CS patients were hypercortisolemic, 37 in remission (10 required hydrocortisone substitution after surgery). Body composition parameters were measured by dual-energy X-ray absorptiometry scanning (DEXA). RA patients had a greater waist-hip ratio (WHR) (p<0.01), less lean body mass (LBM) (p<0.01), and lumbar bone mineral density (BMD) (p<0.01) than controls. CS patients, globally and those with cured disease, had more total fat (both percentage and kg) and trunk fat percentage, and less whole body-BMD than RA patients (p<0.05, p<0.01, p<0.05, respectively). Active CS patients had less whole body-BMD and more LBM than RA patients (p<0.05, p=0.01, respectively). Cured CS patients not taking hydrocortisone had more total fat [both percentage (p<0.05) and kg (p<0.05)], trunk fat percentage (p<0.05), lumbar BMD (p<0.01) than RA patients. Cured CS patients requiring hydrocortisone only differed from RA patients by smaller WHR (p<0.01). All the differences in BMD disappeared when the data were reanalyzed including only the estrogen-deficient groups. Hypercortisoliof CS determines an irreversible increase in body fat, greater than in RA. Endogenous and exogenous exposure to GC negatively affects body composition by increasing the WHR. There appears to be no additional effect on BMD in estrogen-deficient women.

Key words

body composition - Cushing's syndrome - rheumatoid arthritis - glucocorticoids

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Referenzen

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Correspondence

E. ResminiMD

Department of Endocrinology

Hospital de Sant Pau

C. S. Antoni Maria Claret n.167

08025 Barcelona

Spain

Telefon: +34/9355/37 917

Fax: +34/9355/65 602

eMail: eresmini@santpau.cat