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Horm Metab Res 2017; 49(09): 660-666
DOI: 10.1055/s-0043-115008
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

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

Filippo Ceccato
1   Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
,
Michela Boccato
1   Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
,
Marialuisa Zilio
1   Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
,
Mattia Barbot
1   Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
,
Anna Chiara Frigo
2   Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University-Hospital of Padova, Padova, Italy
,
Giovanni Luisetto
1   Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
,
Marco Boscaro
1   Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
,
Carla Scaroni   *
1   Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
,
Valentina Camozzi   *
1   Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
› Author Affiliations
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Publication History

received 23 May 2017

accepted 12 June 2017

Publication Date:
17 July 2017 (online)

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Abstract

Patients with active Cushing’s syndrome (CS) exhibit an increase of the visceral adipose tissue, increasing the risk of cardiovascular events. Until now, it is not yet clear whether remission of CS leads to a normalization of body composition, or if different strategies to control hypercortisolism could result in a different clinical outcome concerning adipose tissue distribution. Therefore, we analyzed body composition changes using dual-energy X-ray absorptiometry (DXA) in patients with CS in a prospective and controlled study. We considered 23 patients with CS, whose remission was achieved after surgery in 14 or gained with pharmacological treatment in 9 subjects. Clinical and DXA data (lean and fat mass in total body, trunk, and R1 box) were collected during active hypercortisolism and after sustained remission, defined as the normalization of both late night salivary and 24-h urinary cortisol levels, at least for 6 consecutive months. Healthy subjects, matched with CS for gender, age, and BMI, were considered as controls (n=25). After remission of hypercortisolism, body compositions of patients were similar to matched controls; fat mass in total body (−7.53%), trunk (−3.24%), and R1- box (−12.82%, all p<0.01) were decreased from baseline levels. Dividing patients by type of treatment, fat mass reduction was higher in those that achieved surgical remission of CS (total body −17.26%, trunk −22.73%, and R1 box −21.21%, all p<0.05). Surgical remission of hypercortisolism is characterized by improvement of body composition, particularly fat reduction, easily detectable with DXA during routine clinical practice.

Key words

Cushing’s syndrome - body composition - dual-energy X-ray absorptiometry - remission

* CS and VC should be considered as senior co-authors


 

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