Impact of Cushing’s syndrome on the gonadotrope axis and testicular functions in men

Georgios Papadakis; Benedicte de Kalbermatten; Alexandre Dormoy; Sylvie Salenave; Séverine Trabado; Oceana Vieira-Pinto; Carine Richa; Peter Kamenický; Philippe Chanson; Luigi Maione; Nelly Pitteloud; Jacques Young

doi:10.1093/humrep/dead187

September 23, 2023Human ReproductionOpen Access

Impact of Cushing’s syndrome on the gonadotrope axis and testicular functions in men

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Key Points

To determine whether Cushing's syndrome alters the gonadotrope axis and testicular function differently depending on the severity of hypercortisolism and its underlying etiology.
Monocentric retrospective case-control study conducted between January 1990 and July 2021 at Bicêtre Hospital (Paris-Saclay, France) evaluating 89 men with Cushing's syndrome (51 Cushing's disease, 29 ectopic ACTH secretion, 9 ACTH-independent) compared to 40 age-matched healthy male controls.
Assessed pituitary gonadotrope function, testicular sex steroids, and peptides across all participants, alongside semen analysis in six men and longitudinal follow-up in 20 men after disease remission (mean follow-up 6.0 ± 4.3 years).
Men with Cushing's syndrome had significantly reduced total testosterone, bioavailable testosterone, and free testosterone compared to controls (P < 0.0001), with hypogonadism present in 83% of ectopic ACTH cases, 61% of Cushing's disease, and 33% of ACTH-independent cases.
Patients with ectopic ACTH secretion had significantly lower FSH (P = 0.002), inhibin B (P < 0.0001), and anti-Müllerian hormone (P = 0.003) than controls, while INSL3 levels were significantly lower in Cushing's disease (P = 0.03).
Following curative treatment, reproductive function assessment at 6.0 ± 4.3 years showed marked increases in total testosterone (P < 0.0001) and LH (P = 0.02), reversing hypogonadotropic hypogonadism in 75% of men and normalizing severe oligozoospermia.

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Implication

Case-control study shows that hypercortisolism causes reversible hypogonadotropic hypogonadism in men with Cushing's syndrome, indicating endocrine suppression linked to disease severity.

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Papadakis et al. (2023) studied this question.

synapsesocial.com/papers/6a994b9eaa63da60ef78de4b https://doi.org/10.1093/humrep/dead187

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Impact of Cushing’s syndrome on the gonadotrope axis and testicular functions in men

Key Points

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Implication

Discussion

Cite This Study

Impact of Cushing’s syndrome on the gonadotrope axis and testicular functions in men

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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