DwayneEMTP Posted October 27, 2007 Share Posted October 27, 2007 Hey all, I'm creating a Power Point presentation on Cushing's disease for class and have a question I can't seem to answer on my own. I am clear on how and why the cortisol levels rise, and maintain their high levels. What I can't seem to figure out (after about 7 hours of rubbing both brain cells together) is why the weight gain is localized to the face and trunk? I have formulated a theory, but have a low level of confidence in it, and haven't been able to strengthen or weaken it with info I have found on the net. It goes a little something like this... The higher levels of cortisol have several effects, but a couple of the main ones are to increase vascular sensitivity to catecholamines, and behave as an insulin antagonist...which has to side effect of raising circulating blood glucose levels. I've wondered if perhaps the increased vasoconstriction from the catecholamine sensitivity could cause poorer circulation in the extremities, causing a higher availability of the circulating glucose to the trunk and head/face, increasing fat storage to those areas. The descriptions I've discovered state “weight gain”, though I don't remember them being described a fat storage specifically. It seems as though the poor circulation theory might also work well with the poor skin condition found in these patients, as well as it's retarded ability to heal and sweat. What seems to torpedo the circulation theory is the lack of significant tissue necrosis, and edema, (as in advanced diabetes) that I would expect to see in these chronic patients...Also, I can't imagine, (though I don't know) that the vascular system could maintain such constriction for a length of time necessary to cause these symptoms before becoming exhausted and simply failing. Though the catecholamine sensitivity is sufficient to cause chronic hypertension I believe? So perhaps the vascular system is more macho then I've been led to believe. (The majority of my exposure to vascular stamina stems from our studies of hypovolemic compensation.) It seems as though every theory I invent, immediately has an evil twin... So, there you have it. My best attempt to appear smart, that will probably end up making me look like an ass. I'm just not sure what direction to go in next. Any help I could get would be greatly appreciated! Have a great day all! Thanks for all you do for us here at the City. Dwayne Link to comment Share on other sites More sharing options...
medic_casey Posted November 4, 2007 Share Posted November 4, 2007 Interesting topic. Being extremely curious and never satisfied without an answer, I tried to quickly look it up online...but you're right. They mention the location of the weight gain, but without explanation. So it got me to thinking...what if the weight gain/fat storage is a result of where the majority of our fatty tissue exists in the first place? That whole "like attracts like" theory...look at "beer bellied" folks! They generally have "chicken legs", do they not? Well, good luck with the presentation, and let us know if you find a definitive answer! [/font:676dedf174] Link to comment Share on other sites More sharing options...
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