ECE2023 Poster Presentations Pituitary and Neuroendocrinology (123 abstracts)
Prevalence of steatosis and organ-specific distribution of adipose tissue in patients affected by Cushing’s syndrome
Emanuele Ferrante 1 , Giovanna Oberti 2 , Beatrice Mantovani 3 , Rita Indirli 3 , Arianna Cremaschi 3 , Elisa Sala 1 , Giulia Carosi 3 , Anna Ludovica Fracanzani 2 , Giovanna Mantovani 3 , Rosa Lombardi 2 & Maura Arosio 3
1Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; 2Unit of Internal Medicine and Metabolic Diseases, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; 3Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
Introduction: Endogenous hypercortisolism is associated with cardio-metabolic complications and promotes the deposition of lipids in different tissues, particularly in the liver. However, the prevalence of hepatic steatosis in patients with Cushing’s syndrome (CS) has been little investigated so far and only one previous study reported a prevalence of 20% using computed tomography. The aim of the study is to evaluate the prevalence of hepatic steatosis and the organ-specific distribution of adipose tissue in patients affected by CS.
Methods: We performed a cross-sectional collection of clinical, biochemical and instrumental data (abdominal ultrasound, fibroscan, assessment of epicardial fat, supra-aortic trunks ultrasound and body composition through BIA) of patients diagnosed with CS and followed at our Endocrinology Unit.
Results: Forty-three CS patients were studied (M/F: 8/35; age 53±13 years; 4: active disease, 29: disease remission, 6: disease control, 4: partial remission). The prevalence of hepatic steatosis was 49% (21/43 patients, of which 9 with moderate to severe degree), but only 1 patient showed fibroscan values consistent with significant hepatic fibrosis. The prevalence of carotid atherosclerosis was 58%, while an increase in epicardial fat was found in 37% of patients. CS patients with steatosis, when compared to those without steatosis, had a higher number of previous cardiovascular events (4 vs 0, P=0.045), a higher BMI (27.7±5.4 vs 22.4±3.3, P<0.01), a higher fat mass (34.8±8.4 vs 24.7±6.7, P<0.01), a higher prevalence of metabolic syndrome (57% vs 18%, P<0.05) and hyperuricemia (45% vs 9%, P<0.05). In a multivariate analysis model including age, sex, hyperuricemia and metabolic syndrome, the latter was associated with the development of hepatic steatosis (OR: 4.98, IC 1-25.65). Finally, the CS group with steatosis was compared to a group of 42 subjects with NAFLD, matched for age and sex. Compared to the latter, despite a similar prevalence of metabolic comorbidities, patients with CS showed a lower fat mass (34.8±8.7% vs 40.2±8.8%, P<0.05) and a higher prevalence of carotid atherosclerosis (62% vs 31%, P<0.05).
Conclusions: CS is characterized by a high prevalence of hepatic steatosis, carotid atherosclerosis and increase in epicardial fat. In these patients, metabolic syndrome is associated with the development of hepatic steatosis. At the same degree of steatosis, CS patients have a lower percentage of fat mass but an increased prevalence of carotid atherosclerosis compared to NAFLD patients, suggesting the pathogenetic role of hypercortisolism in the development of these complications.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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