Leptin secretion in Cushing's syndrome: Preservation of diurnal rhythm and absent response to corticotropin-releasing hormone

Martina Weise, Veronica Abad, Robert Considine, Lynnette Nieman, Kristina I. Rother

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

The normal inverse relationship between leptin and cortisol is lost in chronic hypercortisolism. We studied this apparent dysregulation in patients with Cushing's syndrome to investigate 1) the effect of chronic hypercortisolemia on the circadian rhythm of leptin secretion, 2) the response of leptin after administration of CRH, and 3) the short term effect of curative surgery on leptin. The preoperative morning leptin concentration was 54.2 ± 8.1 ng/mL, and the nighttime value was 68.6 ± 9.8 ng/mL, reflecting a mean rise of 32.8 ± 7.6%, similar to the nocturnal increase observed in normal subjects. By contrast, cortisol's diurnal variation (21.8 ± 1.7 vs. 16.9 ± 1.1 mg/dL) was blunted. In women, but not men, body mass index correlated with leptin (P = 0.001). Preoperative ACTH and cortisol (both P <0.0001), but not leptin levels increased after CRH. Ten days after surgery, basal cortisol values were subnormal (1.1 ± 0.6 mg/dL), but leptin levels remained unchanged and did not increase after CRH. Body mass index and insulin also remained unchanged. Insulin, but not age, urinary free cortisol, or plasma cortisol correlated with leptin (P <0.05). In summary, patients with Cushing's syndrome have moderately elevated leptin levels that maintain an intact circadian rhythm but do not respond to acute or subacute alterations of cortisol.

Original languageEnglish (US)
Pages (from-to)2075-2079
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume84
Issue number6
StatePublished - 1999
Externally publishedYes

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Cushing Syndrome
Corticotropin-Releasing Hormone
Circadian Rhythm
Leptin
Hydrocortisone
Surgery
Body Mass Index
Insulin
Ambulatory Surgical Procedures
Adrenocorticotropic Hormone
Plasmas

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Leptin secretion in Cushing's syndrome : Preservation of diurnal rhythm and absent response to corticotropin-releasing hormone. / Weise, Martina; Abad, Veronica; Considine, Robert; Nieman, Lynnette; Rother, Kristina I.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 84, No. 6, 1999, p. 2075-2079.

Research output: Contribution to journalArticle

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