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Not All Glucocorticoid-Induced Obesity is the Same: Differences in Adiposity Among Various Diagnostic Groups of Cushing Syndrome.
[cushing syndrome]
The
cAMP
signaling
pathway
is
implicated
in
bilateral
adrenocortical
hyperplasias
(
BAHs
)
,
which
are
often
associated
with
ACTH-independent
Cushing
syndrome
(
CS
)
.
Although
CS
is
invariably
associated
with
obesity
and
is
frequently
associated
with
PKA
signaling
defects
,
we
recently
reported
that
its
different
forms
appear
to
also
present
with
variable
weight
gain
and
adiposity
.
The
present
study
was
aimed
at
characterizing
further
the
phenotypic
and
molecular
differences
in
periadrenal
adipose
tissue
(
PAT
)
among
patients
with
subtypes
of
CS
,
by
anthropometric
/
biochemical
analyses
and
quantification
of
PKA
expression
and
activity
in
BAHs
in
comparison
to
a
non-
CS
group
with
aldosterone
producing
adenomas
(
APAs
)
.
Glucocorticoid
levels
,
serum
parameters
,
and
BMI
were
analyzed
among
a
larger
patient
cohort
including
those
with
different
forms
of
CS
,
APAs
,
and
Cushing
disease
.
Abdominal
CT
scans
were
available
for
a
small
subset
of
patients
examined
for
fat
distribution
.
PAT
collected
during
adrenalectomy
was
assayed
for
PKA
activity
,
cAMP
,
and
PKA
expression
.
BMI
and
BMI
z-score
were
lower
in
adults
with
PPNAD
with
PRKAR
1
A
mutations
and
in
pediatric
patients
with
PPNAD
with
and
without
PRKAR
1
A
mutations
,
respectively
.
Patients
with
PPNAD
had
higher
cAMP
levels
in
PAT
and
different
fat
distribution
.
Thus
,
PKA
activity
in
PAT
differed
between
CS
diagnostic
groups
.
Increased
cAMP
and
PKA
activity
may
have
contributed
to
phenotypic
differences
among
subtypes
of
CS
.
In
agreement
with
the
known
roles
of
cAMP
signaling
in
the
regulation
of
adiposity
,
patients
with
PPNAD
were
less
obese
than
other
patients
with
CS
.
Diseases
Validation
Diseases presenting
"obesity"
symptom
acute rheumatic fever
adrenal incidentaloma
aniridia
aromatase deficiency
carcinoma of the gallbladder
cohen syndrome
congenital adrenal hyperplasia
cushing syndrome
cystinuria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
heparin-induced thrombocytopenia
kabuki syndrome
monosomy 21
phenylketonuria
primary hyperoxaluria type 1
sneddon syndrome
werner syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated