Endocrine Abstracts

Introduction: Cushing’s disease (CD) leads to glucose homeostasis alterations, obesity, unfavorable changes in body composition and cardiovascular complications.

Aim of study: i) Prospective evaluation of the frequency of pre-diabetes and diabetes. ii) Assessment of insulin resistance (IR) indices in CD. iii) Analysis of the influence of family history of type 2 diabetes (T2D) on the anthropometry in CD.

Methods: The study group included 47 patients with CD (37 women and ten men, aged 43.1±14.6). Waist and hip circumferences, BMI, and body fat content were recorded. Glucose and insulin levels during an oral glucose tolerance test (OGTT) were assessed. HOMA-IR, QUICKI, and Matsuda indices were calculated. Patients previously diagnosed with diabetes were examined exclusively for fasting glucose and HbA1c.

Results: Sixteen patients (34%) had diabetes, another 18 (38.3%) had pre-diabetes. Hypertension was confirmed in 37 patients (78.7%). Mean total fat content was 34.52±10.64 kg and trunk fat was 17.49±5.18 kg. Mean BMI was 30.9±6.6 kg/m². Obesity was confirmed in 23 patients (48.9%) and overweight in 17 (36.2%). In patients with hypertension trunk fat was higher than in the normotensive group (18.38±4.87 kg vs 14.25±5.2 kg, P<0.05). Positive family history of T2D was found in 15 patients (32%). It was associated with a greater hip circumference (114.37±17.84 cm vs 102.81±9.6 cm, P<0.05) compared to those without T2D in the family history. Matsuda and QUICKI indices were higher in patients without concomitant glucose homeostasis alterations than in patients with pre-diabetes (4.01±2.04 vs 2.08±0.92, P=0.001 and 0.338±0.034 vs 0.311±0.024, P=0.01 respectively). There was no significant difference with regards to HOMA-IR (2.78±1.44 vs 5.33±4.82, P=0.08).

Conclusions: i) Glucose homeostasis alterations were observed in 70% of patients with CD. ii) We confirmed the association between the presence of arterial hypertension and trunk fat content. iii) The family history of T2D may be associated with a higher risk of obesity in CD. iv) Matsuda index contrary to HOMA-IR may be a more sensitive marker of IR in CD.

Disclosure: This work was supported by the grant of Military Institute of Medicine No. 1/8807(258)/2013.