Endocrine Abstracts

Background: The Cushing’s disease (CD) is associated with comorbidities that have a significant impact on patients’ quality of life. However, it is not known the true impact of the disease remission on these comorbidities.

Objectives: To assess the evolution of comorbidities associated with CD, after its remission.

Methods: It was done an observational, analytical and retrospective study of patients with CD in remission, followed in our department. Clinical data concerning the time of diagnosis (active disease) and 1 year after surgery/radiotherapy (remission) were collected.

Results: Of the eighteen included patients, 77.8% were female and the age at diagnosis was 39.6±15.1 years. Seventeen patients (94.4%) were in remission after surgery and one (5.6%) required adjuvant radiotherapy.

At diagnosis, 12 patients had hypertension, three had type 2 diabetes (T2DM), six dyslipidemia and seven were on psychotropic drugs. After 1 year of remission, there was a significant reversal of hypertension (66.7 vs 22.2%, P=0.008). There was a decrease, although not significant, in the number of patients on psychotropic drugs (38.9 vs 16.7%, P=0.219). It was not observed differences in T2DM and dyslipidemia. Eleven patients (61.1%) underwent initial dual-energy X-ray absorptiometry, two had osteoporosis and four osteopenia. At revaluation, patients with osteoporosis normalized T score, and in patients with osteopenia one had recovered.

The CD remission was associated with a significant decrease in the patients’ weight (75.4±13.3 vs 67.3±10.2 kg, P<0.001) and BMI (29.0±4.7 vs 25.8±3.3 kg/m², P=0.001). In this analysis, it was excluded a pediatric patient (31.3 vs 29.1 kg/m²). Despite that, four patients (22.2%) remained obese and six (33.3%) overweight.

Conclusion: After 1 year of CD remission, there were significant improvements in hypertension and obesity/overweight. Other comorbidities had also improved, although without statistical significance. Thus, it is crucial to highlight the requirement of maintain surveillance and reassessment of these long-term changes.