| Food-dependent Cushing's syndrome: possible involvement of leptin in cortisol hypersecretion. | |
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MedLine Citation:
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PMID: 10523036 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Stimulation ofcortisol secretion by food intake has been implicated in the pathogenesis of some cases of ACTH-independent Cushing's syndrome, via an aberrant response of the adrenal glands to gastric inhibitory polypeptide (GIP). We report here a novel case of food-dependent Cushing's syndrome in a patient with bilateral macronodular adrenal hyperplasia. In this patient we were able to confirm a paradoxical stimulation of cortisol secretion by GIP in vivo as well as in vitro on dispersed tumor adrenal cells obtained at surgery. In addition to GIP, in vitro stimulation of these cultured tumor adrenal cells with leptin, the secreted product of the adipocyte, induced cortisol secretion. By comparison, no such stimulation was observed in vitro in adrenal cells obtained from another patient with bilateral macronodular adrenal hyperplasia and Cushing's syndrome that did not depend on food intake, in tumor cells obtained from a solitary cortisol-secreting adrenal adenoma, and in normal human adrenocortical cells. These results demonstrate that as in previously described cases of food-dependent Cushing's syndrome, GIP stimulated cortisol secretion from the adrenals of the patient reported here. Therefore, they indicate that such a paradoxical response probably represents the hallmark of this rare condition. In addition, they suggest that leptin, which normally inhibits stimulated cortisol secretion in humans, participated in cortisol hypersecretion in this case. Further studies in other cases of food-dependent Cushing's syndrome, however, will be necessary to better ascertain the pathophysiological significance of this finding. |
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Authors:
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F P Pralong; F Gomez; L Guillou; F Mosimann; S Franscella; R C Gaillard |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of clinical endocrinology and metabolism Volume: 84 ISSN: 0021-972X ISO Abbreviation: J. Clin. Endocrinol. Metab. Publication Date: 1999 Oct |
Date Detail:
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Created Date: 1999-11-04 Completed Date: 1999-11-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0375362 Medline TA: J Clin Endocrinol Metab Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 3817-22 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Institute of Pathology, University Hospital and Lausanne Medical School, Switzerland. francois.pralong@chuv.hospvd.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Glands
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drug effects,
pathology,
secretion Adrenocorticotropic Hormone / pharmacology Adult Cushing Syndrome / blood, metabolism*, pathology Female Food* Gastric Inhibitory Polypeptide / blood, pharmacology Humans Hydrocortisone / secretion* Hyperplasia Leptin / pharmacology, physiology* Middle Aged |
| Chemical | |
Reg. No./Substance:
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0/Leptin; 50-23-7/Hydrocortisone; 59392-49-3/Gastric Inhibitory Polypeptide; 9002-60-2/Adrenocorticotropic Hormone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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