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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
"cushing syndrome"
symptom
adrenal incidentaloma
carcinoma of the gallbladder
congenital adrenal hyperplasia
cushing syndrome
This symptom has already been validated