Abstract

In ten adrenalectomized patients with central Cushings syndrome, the hormonal and metabolic regulation during moderate long-term exercise was investigated. Patients and controls accomplished both tests without failure during work and recovery periods. In patients, epinephrine was neither detectable at rest nor after exercise. After exercise, ACTH and norepinephrine were significantly higher in patients than in controls. The exercise-induced insulin decline was less pronounced in patients. Immediately after exercise, cortisol increased only in controls. FFA and glycerol were significantly higher in patients than in controls, and in patients the FFA increase was positively correlated with the ACTH elevation. After exercise and during recovery, the ketone body concentration was lower. The blood glucose decline did not differ between patients and controls, but after work the lactate level was higher in patients. Since there was no evidence of a disturbed glucose homeostasis during work despite impaired hepatic glycogenolysis as a result of the complete absence of epinephrine stimulation, one may conclude that during exercise an enhanced fatty acid liberation and metabolization compensated for the reduced hepatic glucose production in the patients. Verf.-Referat