THE FOOD-DEPENDENT CUSHINGS-SYNDROME - A NEW CAUSE OF CUSHINGS-SYNDROME SUBGROUPS

Diagnosis of Cushing's syndrome is quite difficult in endocrinology. S pontaneous Cushing's syndrome is usually divided into two subgroups, o ne which is dependent on corticotropin (ACTH) and another one which is not. In the first class are Cushing's disease, the etopic corticotrop in syndrome and the rare ectopic corticotropin-releasing hormone (CRH) syndrome; these ACTH-dependent Cushing's syndrome have usually diffus ely enlarged adrenal glands. In the second class are cortisol producin g unilateral adrenocortical adenomas or carcinomas, and the recent Cus hing's syndrome with food dependent periodic hormonogenesis. This food dependent Cushing's syndrome is an ACTH-independent Cushing's syndrom e with multinodular enlargement of both adrenal glands. Pathogenesis i s an aberrant adrenal sensitivity to physiologic secretion of gastric inhibitory peptide (GIP). Ectopic expression of GIP receptors on adren al cells involve pathologic food induced cortisol secretion. Food depe ndent Cushing's syndrome is a new cause of Cushing's syndrome. Food in duced cortisol secretion may have to be explored in the ACTH-independe nt Cushing's syndrome.