Hormonal and metabolic rhythms in Cushing's syndrome.

摘要: Hormone and metabolite profiles were investigated over a 12-hr period in six patients with Cushing's syndrome, ten age- sex-matched normal controls, moderately obese subjects matched for weight the patient group. Mean diurnal plasma cortisol levels 563 +/- 74 nmole/liter patients, 275 22 controls 241 32 subjects, total loss of changes syndrome. Fasting blood glucose concentration was similar all groups although mild hyperglycemia occurred after meals compared (mean glucose: 6.31 0.39 mmole/liter; 5.32 0.14 mmole/liter, p < 0.01; 5.41 0.18 0.05) despite marked hyperinsulinemia serum insulin: 57.3 18.2 mU/liter; 19.7 2.5 mU/liter, 0.02; 18.1 4.0 0.05). Concentrations gluconeogenic precursors lactate, pyruvate, alanine raised particularly postprandially. Plasma nonesterified fatty acids (NEFA), glycerol, ketone body concentrations comparable three variation circulating NEFA lost Serum triglyceride (TG) grossly elevated TG: 3.51 1.23 0.89 0.19 0.93 0.23 correlated positively insulin levels. glucagon syndrome glucagon: 23.2 3.7 pmole/liter; 12.3 1.5 pmole/liter 12.2 +/0 2.0 pmole/liter, 0.02) but not alanine, suggesting that some stimulatory factor other than responsible. The metabolic effects chronic glucocorticoid excess thus may be explained on basis obesity alone. Compensatory limits disturbance carbohydrate lipid metabolism important production hypertriglyceridemia observed.