Abstract
Increased adiposity and direct effects of glucocorticoid excess on muscle, liver, and β-cells are responsible for the high prevalence of impaired glucose tolerance (IGT) and type 2 diabetes in patients with Cushing syndrome (CS) (1,2). In the SEISMIC study, the glucocorticoid receptor antagonist mifepristone improved glucose tolerance and produced weight loss over 24 weeks in CS patients (3). Using oral glucose tolerance test data from SEISMIC, our goal was to assess whole-body insulin sensitivity (Matsuda index), β-cell function (insulinogenic index, homeostasis model assessment-β [HOMA-β]), disposition index (4,5), weight (WT), and waist circumference (WC) over time. Complete data in patients not receiving insulin were available in 19 patients, 8 with diabetes and/or IGT (C-DM) and 11 with hypertension only (C-HT). Within-group comparisons for change over time were analyzed with a mixed-effects repeated measures two-way ANOVA with cohort (C-DM and C-HT), time, and cohort by time interaction as fixed effects; unpaired Student t tests were used to assess differences between groups …
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