Symptoms worsen with increasing cortisol levels in Cushing’s disease
Even mild increases in cortisol can lead to other health problems, study says
People with Cushing’s disease may have higher levels of cortisol and more severe symptoms than those with other forms of Cushing’s, according to a recent study in Turkey.
“The severity of disease symptoms worsens with increasing cortisol levels,” researchers wrote.
The study, “Metabolic, hormonal profiles and comorbidities in pituitary Cushing’s syndrome, adrenal Cushing’s syndrome and mild autonomous cortisol secretion: a comparative study,” was published in Postgraduate Medicine.
Cushing’s syndrome is characterized by elevated levels of the hormone cortisol in the body, which is also referred to as hypercortisolism. Cushing’s disease, one of its most common forms, is caused by tumors in the brain’s pituitary gland that lead to the excessive production of adrenocorticotropic hormone (ACTH), a signaling molecule that stimulates the adrenal glands to produce cortisol. Cushing’s may also be caused by tumors in the adrenal glands that lead to the overproduction of cortisol in an ACTH-independent manner.
Hypercortisolism can lead to diabetes, high blood pressure
Symptoms associated with hypercortisolism include changes in fat distribution throughout the body, high levels of fatty molecules in the bloodstream, diabetes, and high blood pressure.
In the study, researchers at a clinic in Turkey looked at metabolic and hormonal disparities, as well as the incidence of coexisting conditions, in patients with different forms of Cushing’s.
They specifically analyzed data from 26 people living with Cushing’s disease, 21 with adrenal Cushing’s, and 29 with mild autonomous cortisol secretion (MACS), a condition in which cortisol levels are higher than normal, but not sufficiently high to cause overt Cushing’s symptoms.
No differences were seen between the three groups of patients in age, sex, height, or body mass index, which is a measure of body fat based on weight and height. Similarly, no significant differences were observed in terms of coexisting conditions.
However, participants with pituitary tumors had higher 24-hour urinary cortisol levels compared with the other groups. This may indicate “that high-amplitude adrenocorticotropic hormone stimulation may lead to increased cortisol secretion in [Cushing’s disease] patients,” the researchers wrote.
They also found people with Cushing’s disease and those with adrenal Cushing’s had higher levels of cortisol in their blood than those with MACS, as well as higher levels of the liver enzyme alanine aminotransferase, some fatty molecules (triglycerides and VLDL cholesterol), and insulin.
Despite having a lower degree of hypercortisolism, MACS patients had coexisting conditions that were similar to those of patients with symptomatic Cushing’s. This suggests “that even mild cortisol secretion abnormalities are sufficient to establish the presence of comorbidities,” according to the researchers.
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