Endocrine Abstracts

Introduction: Cushing’s disease is a rare condition that represents the most common cause of endogenous Cushing’s syndrome. Its severity is due to cardiovascular complications, with high morbi-mortality rates. This study aims to evaluate the specific features of metabolic disorders in females having Cushing’s disease and presenting a clinical hyperandrogenism.

Materials and methods: Retrospective and descriptive study, including 12 female patients with Cushing’s disease presenting a clinical hyperandrogenism, recruited in the Endocrinology-Diabetology-Nutrition department of university hospital center Mohammed VI of Oujda between 2016 and 2022. Statistical analysis was performed by SPSS version 21 software.

Results: The mean age was 30.3±11.8 years, with age ranging from 14 to 54 years. The average BMI was 32.7±8.1 kg/m², obesity was observed in 41.6% of our patients. The mean waist circumference was 107.4±13 cm. Dyslipidemia was found in 66.7% of patients: mixed dislipidemia was noted in 58.3% of them, hypercholesterolemia was found in 91.6% and hypoHDLemia was described in 83.3% of cases. In addition 33.3% of our patients were diabetics with a mean HBA1c of 6.5±1.3%, requiring insulin therapy in 50% and metformin in monotherapy in 50% of cases. Twenty-five percent of our patients had an association of diabetes and arteriel hypertension. In total, 58.3% of our patients had a metabolic syndrome.

Discussion-conclusion: In Cushing’s disease, hypercortisolism leads, through a combination of effects on the liver, muscles, adipose tissue and pancreas, to an augmentation of gluconeogenesis and an alteration of insulin sensitivity, causing glucidic metabolism disorders. The therapeutic approach to these patients must be comprehensive, including the control of associated cardiometabolic diseases, in order to reduce morbidity and mortality rates. (1)

Bibliography: 1-Tritos NA, Biller BM. Cushing’s disease. Handb Clin Neurol. 2014;124:221-34. Doi: 10.1016/B978-0-444-59602-4.00015-0. PMID: 25248590.