Endocrine Abstracts

Background: Impaired health related quality of life (QOL) in patients in long-term remission of Cushing’s syndrome (CS) has previously been reported. However, the major determinants of the impaired QOL have not yet been established.

Aim: To investigate QOL of patients in long-term remission of CS treated in our hospital (1969–2007) and to investigate the influence of the etiology of CS, treatment strategy, coexistent hypopituitarism and glucocorticoid deficiency on the QOL.

Patients and methods: Seven validated questionnaires to evaluate QOL were sent to 182 patients in remission of CS. One hundred and twenty-four patients (107 women, age 52.2±12.0 years, 80% Cushing’s disease (CD) and 20% adrenal CS) completed the questionnaires. Mean duration of remission was 13.3±10.4 years (range 2–39). Questionnaire results of the patient group were compared with those of an age and sex matched control group of 105 healthy subjects. Furthermore, the results of different subgroups of patients were compared.

Results: The average QOL scores in the total patient group and each patient subgroup were significantly worse on all scales of all questionnaires compared to healthy controls (P<0.05). The subgroup analysis revealed no difference between the QOL scores in the different patient groups. In particular, there was no significant difference in QOL between patients without any hormonal deficiencies and patients with one or more hormonal deficiencies. No other patient and disease related factors significantly influenced the QOL.

Conclusion: Our patients in long-term remission of CS experience an impaired QOL compared to healthy control subjects, regardless of the etiology of CS, treatment strategy, coexistent hypopituitarism or glucocorticoid deficiency. Based on these results we hypothesize that the previous longstanding exposure to high cortisol levels may have irreversible effects resulting in impaired QOL, although the previous experience of a severe disease may also influence QOL.