Endocrine Abstracts

Objective: Cardiovascular risk factors (CVRF) persist with notable prevalence in patients with Cushing’s disease (CD) after remission: obesity/overweight up to 40%, hypertension (HTA) up to 60%, type 2 diabetes (DM-2) up to 60% and dyslipidemia up to 30% of cases. Persistence of metabolic syndrome in patients with controlled CD seems to be related to the duration of the disease before remission. The aim of this study is to describe the prevalence of CVRF in patients with CD in remission.

Patients and methods: Retrospective descriptive study of patients with CD (1995–2016). Variables analyzed: age, sex, body mass index (BMI), CVRF at diagnosis and after the remission of CD, treatment of CVRF. Statistical analysis (SPSS v.18.0 for Windows): t-student for comparison of means and McNemar for comparison of proportions.

Results: 49 patients with CD. Age 44.43±15.29 years. Women: 89.8%. Transsphenoidal surgery: 87.8%. Remission: 68.7%. Time from onset of clinical to diagnosis: 29.7±30 months. At diagnosis of CD: 36% obesity and 16% overweight, 20% DM-2 [treatment with oral antidiabetics 40%: 20% metformin, 20% sulfonylureas; 60% insulinized (insulin dose 26±16 IU/day)], 68% HTA (54% antihypertensive treatment with more than one drug) and 36% dyslipidemia. After remission of CD: 27% obesity (P=0.8), 25% overweight (P=0.7), 15.3% DM-2 persisted (P=0.9) [oral antidiabetics 100% (75% metformin and 25% metformin and secretagogue)], 46% HTA (P=0.3) and 50% dyslipidemia (P=0.5). BMI at diagnosis 32±8 kg/m², after remission 30±5 kg/m² (P=0.8).

Conclusions: CD is more frequent in the fourth decade of life and is more frequent in women. The prevalence of obesity, DM-2 and HTA is reduced after remission of CD, increasing the prevalence of overweight and dyslipidemia, without statistically significant differences.