To describe the differences in macrophage infiltration and mRNA expression of adipocytokines in subcutaneous, omental and perirenal fat tissue in Cushing's syndrome compared to healthy controls.
ID
Source
Brief title
Condition
- Hypothalamus and pituitary gland disorders
- Metabolism disorders NEC
- Vascular disorders NEC
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
- a) amount of macrophage infiltration in fat tissue
- b) mRNA expression of adipokines
- c) mRNA expression of proinflammatory cytokines
cytokines and adipokines that can be measured in blood of patients suffering
from Cushing's syndrome and controls.
Secondary outcome
none
Background summary
Cushing's syndrome consists of many symptoms caused by prolonged increased
exposure to glucocorticoids. Cushing's syndrome is iatrogenic mostly, caused by
prescribed glucocortidoids. However the endogenous form is rare with an
incidence of 2-3/1.000.000 new cases a year. Endogenous hypercortisolism is
caused by increased ACTH secretion by the pituitary or an ectopic source or by
autonomous cortisol hypersecretion by the adrenals. The most common cause (70%)
is an ACTH producing pituitary tumor (Cushing's disease).
Fat tissue is nowadays considered to be an important endocrine organ, because
of its ability to secrete metabolically active proteins calles adipokines (i.e.
leptin, aciponectin and resistin) and proinflammatory cytokines. The
consistency of fat tissue changes in obesity; the volume of the adipocyte
increases, macrophages infiltrate the fat tissue, the balance between pro- and
antiinflammatory adipokines changes and the secretion of cytokines increases.
This causes chronic inflammation which most likely plays an important role in
the etiology of glucose intollerance, hypertension, dyslipedemia and
endothelial dysfunction. This complex is also known as the "metabolic
syndrome".
In Cushing's syndrome all features of metabolic syndrome are present. The
mortality risk in Cushing's syndrome is increased and is mostly determined by
increased incidence of cardiovascular complications. It is plausible that in
Cushing's syndrome the same changes in fat tissue happen as in obese patients.
Possibly the chronic state of inflammation is caused or increased by increased
cortisol levels. To our knowledge this has never been studied in fat tissue of
patients with Cushing's syndrome.
Study objective
To describe the differences in macrophage infiltration and mRNA expression of
adipocytokines in subcutaneous, omental and perirenal fat tissue in Cushing's
syndrome compared to healthy controls.
Study design
Cross-sectional study design
Study burden and risks
Given the very minimal amount of fat that we want to harvest, we expect no
additional burden and risk for the patient.
Eerste Oude Heselaan 118
Nijmegen 6541PC
NL
Eerste Oude Heselaan 118
Nijmegen 6541PC
NL
Listed location countries
Age
Inclusion criteria
- patients with active Cushing's syndrome during adrenalectomy, confirmed by increased 24h urine cortisol excretions and a positive dexamethasone supression test.
- over 18 years old.
- informed consent
Exclusion criteria
none
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL41940.091.12 |