Factors predicting long-term comorbidities in patients with Cushing’s syndrome in remission View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-11-22

AUTHORS

Marie Helene Schernthaner-Reiter, Christina Siess, Alois Gessl, Christian Scheuba, Stefan Wolfsberger, Philipp Riss, Engelbert Knosp, Anton Luger, Greisa Vila

ABSTRACT

PurposeIn Cushing’s syndrome, comorbidities often persist after remission of glucocorticoid excess. Here, we aim to identify factors predicting long-term comorbidities in patients with Cushing’s syndrome in remission.MethodsIn a retrospective cross-sectional study, 118 patients with Cushing’s syndrome in remission (52 pituitary, 58 adrenal, 8 ectopic) were followed for a median of 7.9 years (range 2–38) after the last surgery. Associations between baseline anthropometric, metabolic, hormonal parameters at diagnosis, and comorbidities (obesity, diabetes, hyperlipidemia, hypertension, osteoporosis, depression) at last follow-up, were tested by uni- and multivariate regression analysis.ResultsIn patients with manifest comorbidities at diagnosis, remission of Cushing’s syndrome resolved diabetes in 56% of cases, hypertension in 36% of cases, hyperlipidaemia in 23%, and depression in 52% of cases. In a multivariate regression analysis, age, fasting glucose, BMI, and the number of comorbidities at diagnosis were positive predictors of the number of long-term comorbidities, while baseline 24-h urinary free cortisol (UFC) negatively correlated with the persistence of long-term comorbidities. The negative relationship between baseline UFC and long-term comorbidities was also found when pituitary and adrenal Cushing’s cases were analyzed separately. Baseline UFC was negatively related to the time of exposure to excess glucocorticoids.ConclusionsLong-term comorbidities after remission of Cushing’s syndrome depend not only on the presence of classic cardiovascular risk factors (age, hyperglycemia, BMI), but also on the extent of glucocorticoid excess. Lower baseline UFC is associated with a higher number of long-term comorbidities, possibly due to the longer exposure to excess glucocorticoids in milder Cushing’s syndrome. More... »

PAGES

157-168

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12020-018-1819-6

DOI

http://dx.doi.org/10.1007/s12020-018-1819-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1110133109

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30467627


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