Endocrine Abstracts

Background: Quality of life (QoL) has become a useful outcome in recent studies among different specialties. In Cushing’s syndrome, elevated cortisol levels result in a decreased QoL, the cause for this impairment being multifactorial. More studies are necessary to find modifiable factors where doctors could intervene and thus improve QoL.

Objective: To evaluate QoL in a group of Romanian patients with Cushing’s syndrome. Design: We performed a cross-sectional study, administering three standardized questionnaires (EuroQol-5D, CushingQol and a recently developed one, specific for Cushing’s disease, QoL-CD) to 24 patients (mean age 52.46 ±11.39 years) with both Cushing’s disease (n=16) and syndrome (n=8). The questionnaires were administered by telephone in march 2022.

Results: There was no difference between the two aetiologies when evaluating gender, age, body mass index, serum cortisol at diagnosis and remission status. The most affected domain was the one referring to pain/discomfort, where 66.7% patients reported problems. Mobility was the second most affected dimension (41.7%), followed by anxiety/depression and usual activities (each 37.5%). The least impaired domain was self-care. Patients with Cushing’s syndrome reported a significantly higher degree of impairment in almost all of the investigated domains compared to the healthy Romanian population: mobility (41.7 vs 17.22, P=0.0047), pain/discomfort (66.7 vs 26.99, P=0.0001), usual activities (37.5 vs 15.81, P=0.009) and anxiety/depression (37.5 vs 17.22, P=0.0249). Patients with obesity reported lower QoL in the psychosocial subscale (51.16 vs 69.72, P=0.048) of the CushingQol questionnaire, but not in the physical one, compared with those without obesity. The presence of depression (31.25 vs 65.75, P<0.001) and anxiety disorder (27.78 vs 62.50, P=0.012) was associated with lower scores. Other conditions, such as cardiac ischemic disease and dyslipidaemia, were also associated with poor QoL. Remission status did not influence any of these scores. In the QoL-CD questionnaire, patients with diabetes reported impairment in domains concerning mental status (P=0.020) and general health (P=0.043). Depressive disorder was linked with problems in general health and emotional health domains. The overall scores from this questionnaire were negatively correlated with those of the CushingQol questionnaire (rho=-0.874, P<0.001). The same correlation was found when analysing related domains such as emotional health and the psychosocial subscale from the CushingQol (rho=-0.710, P=0.002).

Conclusions: Improving the control of conditions such as obesity, diabetes and psychiatric disorders could result in better QoL for these patients. The use of QoL-CD is feasible and helpful in real clinical setting.