Endocrine Abstracts

Introduction: Although the metabolic impact of Cushing’s syndrome and hypercortisolemia are well known, the metabolic impact of ACTH is less established.

Objective: To identify differences in the glucidic, lipid and bone metabolism in ACTH-dependent versus ACTH-independent Cushing’s syndrome.

Methods: Retrospective, cross-sectional study of 99 patients with Cushing’s syndrome (54 with ACTH-dependent Cushing’s syndrome and 45 with ACTH-independent Cushing’s syndrome) admitted to ‘C.I.Parhon’ National Institute of Endocrinology during 1998–2016. Clinical and paraclinical data were analyzed.

Results: Type 2 diabetes was found in 39% and prediabetes was found in 31% of the patients in the ACTH-dependent group; in the ACTH-independent group 31% of the patients had diabetes and 27% had prediabetes. Regarding lipid metabolism, 15% of the patients in the ACTH-dependent group were already on lipid-lowering drugs compared with 29% in the ACTH-independent group; of the remaining patients, who were not on lipid-lowering drugs, 63% had hypercholesterolemia and 46% had hypertriglyceridemia in the ACTH-dependent group, compared with 75% having hypercholesterolemia and 50% having hypertriglyceridemia in the ACTH-independent group. Osteoporosis was found in 31% of the tested patients in the ACTH-dependent group and in 60% of the tested patients in the ACTH-independent group.

Conclusions: Lipid and bone metabolism were more affected in the ACTH-independent group, while glucidic metabolism was more affected in the ACTH-dependent group.