Cushing's syndrome leads to long-term disruption of the gut microbiota
People with Cushing's syndrome appear to have a significant imbalance in their gut microbiota for several years after their recovery. This dysbiosis could explain why the risk of diabetes and cardiovascular disease persists in such people.
About this article
We know that gut microbiota imbalance has been linked with obesity, insulin resistance, excess triglycerides and cholesterol, all of which are risk factors for diabetes and cardiovascular disease.
If people who have suffered from Cushing's syndrome, a condition caused by a benign tumor of the pituitary gland, have a higher cardiometabolic risk even several years after they have gone into remission, could this also be due to dysbiosis?
Comparing the data with that of healthy women
To answer this question, a team of Spanish researchers recruited 28 women aged under 60 who had suffered from Cushing's syndrome1. All had been in remission for over five years.
They collected their stool to analyze their microbiota and blood samples to measure various cardiovascular risk parameters. They also examined their body fat distribution.
This data was compared with that of a control group of 25 healthy women of the same age and build ( (sidenote: Body Mass Index (BMI) Body Mass Index (BMI) assesses the corpulence of an individual by estimating the body fat mass calculated by a ratio between weight ((kg) and height squared (m2). https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi ) ).
What did the results show?
Clear differences in microbiota
As expected, the women in remission had several more cardiovascular risk factors than the healthy volunteers, namely more abdominal fat, higher levels of glycated hemoglobin, triglycerides and fasting glucose, less 'good' cholesterol (HDL), etc.
In addition, all had acute intestinal dysbiosis. Not only were their microbiota less rich and diverse, but they also had a very different structure.
For example, the Suturella strain, which was absent in the control group, was present in abundance in the women in the Cushing's syndrome group. A number of studies have reported the presence of this bacterium in people suffering from diabetes, obesity, excess insulin, atherosclerosis, etc.
The persistence of metabolic disorders in former Cushing's patients may be linked to dysbiosis
Surprisingly, in former patients, the index measuring bacterial diversity was associated with fibrinogen levels, a protein involved in coagulation, and therefore linked to the risk of vascular accident. In addition, this index was inversely correlated with triglycerides, blood glucose and insulin levels.
This suggests that the persistence of metabolic disorders in former Cushing's patients is very probably linked to dysbiosis.
This is the first time that such a link has been scientifically demonstrated.
The gut microbiota
These results need to be confirmed by larger-scale studies. They do, however, point to the possibility that one day we may be able to intervene in a targeted manner, either through probiotics or fecal microbiota transplant (FMT), to restore the microbiota balance in people suffering from Cushing's syndrome.
As a result, years of healthy life could be gained!
1. Valassi E, Manichanh C, et al. Gut microbial dysbiosis in patients with Cushing's disease in long-term remission. Relationship with cardiometabolic risk. Front Endocrinol (Lausanne). 2023 Jun 5;14:1074757.