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Cited by 122Pituitary Gland Disorders and TreatmentsAdrenal and Paraganglionic TumorsAdrenal Hormones and Disorders

Metabolic and cardiovascular outcomes in patients with Cushing’s syndrome of different aetiologies during active disease and 1 year after remission: Cushing’s syndrome and metabolic/cardiovascular outcomes

Giordano, Roberta, Picu, Andreea, Marinazzo, Elisa, D’Angelo, Valentina, Berardelli, Rita, Karamouzis, Ioannis, Forno, Daniela, Zinnà, Domenico +3 more·2011·Clinical Endocrinology
DOI 10.1111/j.1365-2265.2011.04055.x
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Abstract

OBJECTIVE: Cushing's syndrome is associated with several comorbidities responsible for the increased cardiovascular risk, not only during the active phase but also after disease remission. DESIGN: In 29 patients with Cushing's syndrome (14 Cushing's diseases and 15 adrenal adenomas), waist circumference, fasting and 2-h glucose after oral glucose tolerance test (OGTT), lipid profile and blood pressure were evaluated during the active disease and 1 year after remission and compared with those in 29 sex-, age- and BMI-matched controls. RESULTS: During the active disease, waist circumference, 2-h glucose after OGTT, total and LDL cholesterol were higher in patients with Cushing's syndrome than in controls (P < 0·001) but similar in Cushing's disease and adrenal adenomas. The prevalence of impaired glucose tolerance (IGT), diabetes mellitus, dyslipidaemia and hypertension was higher (P < 0·001) in patients with Cushing's syndrome (27%, 24%, 59% and 72%) than in controls (10%, 0%, 21% and 10%), with no significant difference between Cushing's disease and adrenal adenomas. One year following hormonal remission, waist circumference persisted higher than in controls (P < 0·05) in both Cushing's disease and adrenal adenomas. Metabolic and cardiovascular abnormalities were still present in both groups, although with a lower prevalence, as well as with a more marked decrease in adrenal adenomas (P < 0·05 vs active disease for IGT, dyslipidaemia and hypertension). CONCLUSIONS: These results show that chronic hypercortisolism, independently of its aetiology, contributes to metabolic impairment and increased cardiovascular risk, while these abnormalities mostly persist in patients with previous Cushing's disease after hormonal remission. Pituitary hormonal deficiencies, hormonal replacement treatments and/or incomplete cure from Cushing's disease may account for these findings.

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  • Among patients with endogenous Cushing syndrome, 20% to 45% have diabetes and 10% to 30% have defective glucose tolerance, so overall prevalence of glucose metabolism impairment can approach 70%.

    “From % to % of patients with endogenous CS have DM, and % to % have defective glucose tolerance, so the overall prevalence of glucose metabolism impairments can come close to %, as shown in Table  (, , -).”

    From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [186]

  • Diabetes can develop irrespective of the etiology of cortisol excess in endogenous Cushing syndrome.

    “Diabetes can develop irrespective of the etiology of cortisol excess in patients with endogenous CS (, ), and its onset does not seem to correlate with the duration of the latter disease ().”

    From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [186]

  • Controlling hypercortisolism is the first step toward improving glucose metabolism in endogenous Cushing syndrome, but different treatments may affect diabetes outcome regardless of how well cortisol excess is corrected.

    “Controlling hypercortisolism is the first step toward improving glucose metabolism in patients with endogenous CS, but different treatments for hypercortisolism may affect the outcome of diabetes, regardless of how well cortisol excess is corrected (, , , , , , ).”

    From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [186]

  • Other prospective studies reported similar findings in patients with Cushing syndrome before and 1 year after remission achieved by pituitary neurosurgery, pituitary irradiation, or adrenalectomy.

    “Other prospective studies [Faggiano et al.,  (); Giordano et al.,  ()] reported similar findings in patients with CS before and  year after remission was achieved thanks to pituitary neurosurgery, pituitary irradiation, or adrenalectomy.”

    From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [186]

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Authors
Giordano, R., Picu, A., Marinazzo, E., D’Angelo, V., Berardelli, R., Karamouzis, I., Forno, D., Zinnà, D., Maccario, M., Ghigo, E., & Arvat, E.
Affiliations
University of Turin (IT)
Corresponding author
Arvat, Emanuela
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2011-08-05
Volume
75
Issue
3
Pages
354-360
ISSN
0300-0664 (ISSN-L)
DOI
10.1111/j.1365-2265.2011.04055.x
OpenAlex
W1945278090
Cited by
122
References
28
Citations by year
2026: 10 · 2025: 10 · 2024: 9 · 2023: 10 · 2022: 9 · 2021: 10 · 2020: 7 · 2019: 7 · 2018: 10 · 2017: 5 · 2016: 4 · 2015: 7 · 2014: 10 · 2013: 8 · 2012: 6
FWCI
6.30
Type
journal article
Language
en
Open access
closed
Licence
doi.wiley.com/10.1002/tdm_license_1 (tdm, 1488 d)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
Funders
  • Università degli Studi di Torino
  • Regione Piemonte
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
Cushing's syndrome, Cushing's disease, adrenal adenoma, hypercortisolism, cardiovascular risk, metabolic comorbidities, impaired glucose tolerance, diabetes mellitus, dyslipidemia, hypertension, waist circumference, remission, hormone replacement therapy, hypopituitarism
MeSH terms
Adrenal Cortex Neoplasms, Adult, Blood Glucose, Blood Pressure, Cardiovascular Diseases, Fasting, Female, Humans, Hydrocortisone, Hypertension, Lipids, Male, Middle Aged, Remission Induction, Risk Factors, Time Factors, Multivariate Analysis, Linear Models, Adrenocortical Adenoma, Metabolic Syndrome, Pituitary ACTH Hypersecretion, Waist Circumference

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