Anthropometric measures and fasting insulin levels in children before and after cure of Cushing syndrome

Abstract

Background & aims: Children with Cushing syndrome present with growth delay and excess adiposity that tends to be generalized rather than centripetal. There are no prospective studies of this phenotype as it evolves before and after treatment in children. The aims of this study were to evaluate children prior to and one-year after surgical cure compared to controls and to determine fasting insulin levels and their possible association with waist circumference and waist-height ratio, pre- and post-cure of Cushing syndrome.

Methods: 30 children with Cushing syndrome were evaluated prior to and one-year post-treatment and compared to 14 age and body mass index-matched controls.

Results: Only triceps skin fold z- score showed a significant difference between patients with active Cushing syndrome and controls. A positive correlation between fasting insulin levels and waist circumference z- score was found for children with Cushing syndrome; this association persisted one-year following cure.

Conclusions: Unlike adults affected with Cushing syndrome, upper arm muscle area of children with Cushing syndrome did not differ from obese children without Cushing syndrome. The persistence of a positive correlation between waist circumference and fasting insulin despite remission of Cushing syndrome suggests that children with a history of Cushing syndrome may have an increased risk for adverse long-term effects of increased abdominal fat mass.

Trial registration: ClinicalTrials.gov NCT00001452 NCT00001595 NCT00005927.

Conflict of interest statement

Conflict of interest statement

The authors declare no conflict of interest.

Published by Elsevier Ltd.

Figures

Figure 1

z scores of anthropometric measures of body composition for patients with CS pre- and post-surgical treatment, and in controls. There was a significant decrease in body mass index (BMI), triceps skin fold (TSF), subscapular skin fold (SSF), upper arm fat area (UFA), mid-arm circumference (MAC), and upper arm muscle area AMA).