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Old 05-07-2011
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Question Cushing's syndrome abnormal fat distribution

Why is there abnormal fat deposition in Cushing's syndrome?
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Old 05-07-2011
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increased cortisol secretion leads to increased fat metabolism which deposits in trunk (trucal obesity) and around the neck and face (moon like facies).
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Old 05-07-2011
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Good question, unfortunately it is not known why fat is broken down in some areas of the body and deposited in others.

Just remember that the two major overall effects of cortisol on metabolism are to: 1. Block glucose uptake into cells, thus increasing blood glucose and 2. Increase breakdown of proteins (especially muscle) into amino acids for gluconeogenesis

The increased breakdown of protein explains the striae (thinning of skin due to protein breakdown), bone loss (breakdown of organic component -- Hydroxyproline), and muscle wasting.
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Old 05-07-2011
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Thanks a lot.

I was just listening to goljan audios. He said that the moon face and truncal obesity is due to protein wasting from the extremities and excess fat deposition in the central adipocytes. And the reason he gave for increased fat deposition central adipocytes was due to their better responsiveness to high levels of insulin as compared to peripheral adipocytes.
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