Особенности Углеводного Обмена У Пациентов С Синдромом Кушинга
Keywords:
Синдром Кушинга, АКТГ, Кортизол, СД, углеводного обмена, гиперкортицизм, глюкокортикоид, инсулинорезистентность, гипопитуитаризм
Abstract
В статье рассказывается о синдроме Кушинга - гипоталамо-гипофизарном заболевании, клинические проявления которого обусловлены избыточным синтезом глюкокортикоидов надпочечниками под влиянием гиперпродукции адренокортикотропного гормона (АКТГ). Актуальность изучения углеводного обмена у больных с синдромом Кушинга объясняется частым возникновением нарушений обмена глюкозы. Эффективность лечения гипергликемии у таких пациентов может быть снижена из-за сложности достижения ремиссии/излечения основного заболевания, а также из-за применения специфической терапии, способствующей развитию гипергликемии.
References
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11. Cassuto H, Kochan K, Chakravarty K, Cohen H, Blum B, Olswang Y, Hakimi P, Xu C, Massillon D, Hanson RW, Reshef L. Glucocorticoids regulate transcription of the gene for phosphoenolpyruvate carboxykinase in the liver via an extended glucocorticoid regulatory unit. J Biol Chem. 2015;280(40):33873–33884.
12. Castinetti F, Guignat L, Giraud P, Muller M, Kamenicky P, Drui D, Caron P, Luca F, Donadille B, Vantyghem MC, Bihan H, Delemer B, Raverot G, Motte E, Philippon M, Morange I, Conte-Devolx B, Quinquis L, Martinie M, Vezzosi D, Le Bras M, Baudry C, Christin-Maitre S, Goichot B, Chanson P, Young J, Chabre O, Tabarin A, Bertherat J, Brue T. Ketoconazole in Cushing’s disease: is it worth a try? J Clin Endocrinol Metab. 2019;99(5): 1623–1630.
13. Castinetti F, Morange I, Jaquet P, Conte-Devolx B, Brue T. Ketoconazole revisited: a preoperative or postoperative treatment in Cushing’s disease. Eur J Endocrinol. 2018;158(1):91–99.
14. Chu JW, Matthias DF, Belanoff J, Schatzberg A, Hoffman AR, Feldman D. Successful long-term treatment of refractory Cushing’s disease with high-dose mifepristone (RU 486). J Clin Endocrinol Metab. 2017;86(8):3568–3573.
15. Colao A, Boscaro M, Ferone D, Casanueva FF. Managing Cushing’s disease: the state of the art. Endocrine. 2014; 47(1):9–20.
16. Colao A, Petersenn S, Newell-Price J, Findling JW, Gu F, Maldonado M, Schoenherr U, Mills D, Salgado LR, Biller BM; Pasireotide B2305 Study Group. A 12-month phase 3 study of pasireotide in Cushing’s disease. N Engl J Med. 2012;366(10):914–924.
17. Colao A, Pivonello R, Spiezia S, Faggiano A, Ferone D, Filippella M, Marzullo P, Cerbone G, Siciliani M, Lombardi G. Persistence of increased cardiovascular risk in patients with Cushing’s disease after five years of successful cure. J Clin Endocrinol Metab. 2016;84(8): 2664–2672.
18. de Guia RM, Rose AJ, Herzig S. Glucocorticoid hormones and energy homeostasis. Horm Mol Biol Clin Investig. 2014;19(2):117–128.
19. Dirlewanger M, Schneiter PH, Paquot N, Jequier E, Rey V, Tappy L: Effects of glucocorticoids on hepatic sensitivity to insulin and glucagon in man. Clin Nutr 2019;19:29–34.
20. Faggiano A, Pivonello R, Spiezia S, De Martino MC, Filippella M, Di Somma C, Lombardi G, Colao A. Cardiovascular risk factors and common carotid artery caliber and stiffness in patients with Cushing’s disease during active disease and 1 year after disease remission. J Clin Endocrinol Metab. 2013;88(6):2527–2533.
21. Filipsson H, Monson JP, Koltowska-H¨aggstrom M, ¨ Mattsson A, Johannsson G. The impact of glucocorticoid replacement regimens on metabolic outcome and comorbidity in hypopituitary patients. J Clin Endocrinol Metab. 2016;91(10):3954–3961.
22. Gadelha MR, Vieira Neto L. Efficacy of medical treatment in Cushing’s disease: a systematic review. Clin Endocrinol (Oxf). 2014;80(1):1–12.
23. Geer EB, Islam J, Buettner C. Mechanisms of glucocorticoidinduced insulin resistance: focus on adipose tissue function and lipid metabolism. Endocrinol Metab Clin North Am. 2014;43(1):75–102.
24. Gibson CD, Karmally W, McMahon DJ, Wardlaw SL, Korner J. Randomized pilot study of cabergoline, a dopamine receptor agonist: effects on body weight and glucose tolerance in obese adults. Diabetes Obes Metab. 2012;14(4):335–340.
25. Giordano R, Picu A, Marinazzo E, D’Angelo V, Berardelli R, Karamouzis I, Forno D, Zinn`a D, Maccario M, Ghigo E, Arvat E. Metabolic and cardiovascular outcomes in patients with Cushing’s syndrome of different aetiologies during active disease and 1 year after remission. Clin Endocrinol (Oxf). 2011;75(3):354–360
26. Gola M, Bonadonna S, Doga M, Giustina A. Clinical review: Growth hormone and cardiovascular risk factors. J Clin Endocrinol Metab. 2015;90(3):1864–1870/
27. Gungunes A, Sahin M, Demirci T, Ucan B, Cakir E, Arslan MS, Unsal IO, Karbek B, Calıskan M, Ozbek M, Cakal E, Delibasi T. Cushing’s syndrome in type 2 diabetes patients with poor glycemic control. Endocrine. 2014;47(3): 895–900.
28. Henley DE, Lightman SL. Cardio-metabolic consequences of glucocorticoid replacement: relevance of ultradian signalling. Clin Endocrinol (Oxf). 2014;80(5):621–628.
29. Hirsch D, Shimon I, Manisterski Y, et al. Cushing’s syndrome: comparison between Cushing’s disease and adrenal Cushing’s. Endocrine. 2018;62(3):712–720. doi:10.1007/s12020-018-1709-y
30. Jia Y, Viswakarma N, Fu T, Yu S, Rao MS, Borensztajn J, Reddy JK. Conditional ablation of mediator subunit MED1 (MED1/PPARBP) gene in mouse liver attenuates glucocorticoid receptor agonist dexamethasone-induced hepatic steatosis. Gene Expr. 2019;14(5):291–306.
31. Kahn SE: The relative contributions of insulin resistance and beta cell dysfunction to the pathophysiology of type 2 diabetes. Diabetologia 2013;46:3–19.
32. Kershaw EE, Flier JS: Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 2019;89:2548–2556.
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Published
2022-02-02
How to Cite
Холматова, Ю. А., Наримова, Д. м. н. Г. Д., Иссаева , К. м. н. С., Эргашова , Ш., & Насирова, Д. м. н. Х. К. (2022). Особенности Углеводного Обмена У Пациентов С Синдромом Кушинга. Central Asian Journal of Medical and Natural Science, 3(1), 96-108. Retrieved from https://cajmns.centralasianstudies.org/index.php/CAJMNS/article/view/567
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