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Cushing's disease is caused by the excessive secretion of adrenocorticotropic hormone (ACTH) from the anterior pituitary, usually due to a pituitary adenoma. This elevated ACTH stimulates the adrenal cortex, particularly the zona fasciculata, to produce excessive amounts of cortisol, a glucocorticoid hormone. Cortisol regulates glucose metabolism, protein catabolism, fat distribution, and immune responses. In Cushing's disease, hypercortisolemia leads to increased gluconeogenesis, resulting in hyperglycemia, insulin resistance, and sometimes diabetes mellitus. Proteolysis in muscles causes muscle weakness, thinning of the skin, and easy bruising, while increased lipolysis _____ _____ _____ ___ _______ ________ ____ ______ _______ _________ _______ ____.
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