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Cited by 182Pituitary Gland Disorders and TreatmentsAdrenal and Paraganglionic TumorsNeuroendocrine Tumor Research Advances

Mortality and morbidity in Cushing's syndrome in New Zealand

Bolland, Mark J., Holdaway, Ian M., Berkeley, Juliet E., Lim, Sarina, Dransfield, Will J., Conaglen, John V., Croxson, Michael S., Gamble, Greg D. +2 more·2011·Clinical Endocrinology
DOI 10.1111/j.1365-2265.2011.04124.x
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Abstract

OBJECTIVE: Untreated Cushing's syndrome (CS) is associated with significant morbidity and mortality. However, recent operative series suggest low morbidity and mortality for CS, whereas population-based surveys report elevated mortality rates. We investigated the mortality and morbidity of CS in New Zealand. DESIGN: A nationwide retrospective survey of patients with CS between 1960 and 2005 managed at the four main endocrinology services. PATIENTS: A total of 253 patients with CS were identified, excluding adrenal carcinoma and malignant ectopic CS. MEASUREMENTS; The primary outcome was the standardized mortality ratio (SMR), comparing the observed number of deaths with the expected number for the population matched for age, sex and duration of follow-up. Secondary outcomes were the change in prevalence of co-morbidities at presentation and at final follow-up. RESULTS: The approximate prevalence and incidence of CS was 79/million and 1·8/million/y. The mean age at presentation was 39 year, and median duration of follow-up was 6·4 year (range 0-46). Overall, 89% achieved biochemical cure at last follow-up, with >90% achieving biochemical cure for CS from adrenal adenoma and pituitary causes. Thirty-six patients died during follow-up compared with 8·8 expected deaths (SMR 4·1, 95%CI 2·9-5·6). While hypertension, sexual dysfunction, myopathy and mild psychiatric illness were significantly reduced after treatment, hypertension, diabetes mellitus, moderate or major psychiatric illness, and osteoporosis were common at final follow-up. CONCLUSION: CS is associated with both high mortality and a high prevalence of co-morbidities, even when biochemical cure rates are between 80% and 90%.

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  • Patients with CS who achieve remission following curative treatment remain at a slightly increased risk of morbidity and mortality compared to patients without CS.

    “Patients with CS who achieve remission following curative treatment remain at a slightly increased risk of morbidity and mortality compared to patients without CS (27, 28, 113-116).”

    From Measuring cortisol in Cushing syndrome: diagnosis, monitoring, and cortisol circadian rhythm improvement. (2026) · cites this paper as [114]

  • Persistent disruption in cortisol circadian rhythm during remission may play a role in the long-term complications associated with prior glucocorticoid excess.

    “This persistent disruption in cortisol circadian rhythm during remission may play a role in the long-term complications associated with prior glucocorticoid excess (28, 113, 114, 116).”

    From Measuring cortisol in Cushing syndrome: diagnosis, monitoring, and cortisol circadian rhythm improvement. (2026) · cites this paper as [114]

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Authors
Bolland, M. J., Holdaway, I. M., Berkeley, J. E., Lim, S., Dransfield, W. J., Conaglen, J. V., Croxson, M. S., Gamble, G. D., Hunt, P. J., & Toomath, R. J.
Affiliations
  • University of Auckland (NZ)
  • Greenlane Clinical Centre (NZ)
  • Christchurch Hospital (NZ)
  • Waikato Hospital (NZ)
  • Wellington Hospital (NZ)
Corresponding author
Bolland, Mark J.
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2011-09-07
Volume
75
Issue
4
Pages
436-442
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.2011.04124.x
OpenAlex
W1526232299
Cited by
182
References
17
Citations by year
2026: 4 · 2025: 13 · 2024: 13 · 2023: 14 · 2022: 21 · 2021: 14 · 2020: 15 · 2019: 15 · 2018: 16 · 2017: 6 · 2016: 8 · 2015: 14 · 2014: 9 · 2013: 9 · 2012: 11
FWCI
7.57
Type
journal article
Language
en
Update notices
correction (2020-06-10)
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
Keywords
Cushing's syndrome, mortality, morbidity, standardized mortality ratio, biochemical cure, adrenal adenoma, pituitary Cushing's disease, comorbidities, hypertension, diabetes mellitus, osteoporosis, mental illness, myopathy, prevalence, New Zealand
MeSH terms
Adolescent, Adult, Aged, Child, Child, Preschool, Cushing Syndrome, Female, Humans, Male, Middle Aged, New Zealand, Retrospective Studies, Young Adult

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