Food-dependent Cushing's syndrome: possible involvement of leptin in cortisol hypersecretion.

Details

Serval ID
serval:BIB_DF3B856627A1
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Food-dependent Cushing's syndrome: possible involvement of leptin in cortisol hypersecretion.
Journal
The Journal of clinical endocrinology and metabolism
Author(s)
Pralong F.P., Gomez F., Guillou L., Mosimann F., Franscella S., Gaillard R.C.
ISSN
0021-972X
Publication state
Published
Issued date
1999
Peer-reviewed
Oui
Volume
84
Number
10
Pages
3817-22
Language
english
Notes
Publication types: Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
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.
Keywords
Adrenal Glands, Adrenocorticotropic Hormone, Adult, Cushing Syndrome, Female, Food, Gastric Inhibitory Polypeptide, Humans, Hydrocortisone, Hyperplasia, Leptin, Middle Aged
Pubmed
Web of science
Create date
25/01/2008 17:26
Last modification date
20/08/2019 17:03
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