ECE2016 Oral Communications Cardiovascular endocrinology (5 abstracts)
Muscle strength in Cushing’s syndrome: cross-sectional evaluation of the German Cushing’s registry
Christina M Berr 1 , Marcus Quinkler 2 , Mareike Stieg 3 , Timo Deutschbein 4 , Andrea Osswald 1 , Ralf Schmidmaier 1 , Nicole Reisch 1 , Katrin Ritzel 1 , Rainer Blaser 5 , Martin Fassnacht 4 , Günter Stalla 3 , Felix Beuschlein 1 & Martin Reincke 1
1Medizinische Klinik und Poliklinik IV, München, Germany; 2Endokrinologie in Charlottenburg, Berlin, Germany; 3Max Planck Institute of Psychiatry, München, Germany; 4Department of Medicine I University of Wurzburg, Würzburg, Germany; 5Institut für Medizinische Statistik und Epidemiologie, München, Germany.
Background: Endogenous Cushing’s syndrome (CS) is rare with an estimated yearly incidence of 1–3 patients/million. CS describes a group of diseases that have in common an excess secretion of glucocorticoids which results in a characteristic clinical phenotype. Severe courses of Cushing’s syndrome are characterized by a break-down of protein catabolism translating into clinical consequences including muscle weakness. While remission of CS is achievable by surgical removal of the ACTH- or cortisol-producing tumour, the effect of biochemical cure on muscular function is yet unclear.
Objective: The aim was to analyze parameters of muscular function in Cushing’s syndrome.
Methods: We performed a cross-sectional, prospective study (as part of the German Cushing’s registry) analysing 289 consecutive patients in 4 centres of the Cushing’s registry. Patients with CS were studied during the active phase of the disease (ACS) or being in remission after successful treatment (CSiR, remission time 2 to 53 years). Rule-out CS patients were used as controls (RO). The following parameters were analysed: hand grip strength using a hand grip dynamometer and the chair rising test as measure of proximal muscular function. Hand grip was standardized to age and gender.
Results: We included 47 patients with ACS (64% female), 149 CSiR (82% female) and 93 RO (72% female). The age and gender corrected normally distributed hand grip strength was significantly lower in ACS compared to the RO group (dominant hand P=0.002, non-dominant hand P=0.003). Similarly, lower limb muscular function was impaired in ACS (P=0.001). The CSiR group showed age and gender corrected reduced hand grip strength (94% for non-dominant hand, P=0.007; 92% for dominant hand P<0.001 compared to normal reference values). 20% of CSiR performed a chair rising test of ≥12 seconds, a threshold associated with adverse outcome in geriatric patients, independent of time elapsed since successful treatment (P=0.89).
Conclusion: Cushing’s syndrome affects muscle strength in the acute phase, but functional impairment remains also severely impaired in one fifths of patients in the long-term.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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