Endocrine Abstracts

Introduction: Cushing’s disease represents the most frequent etiology of endogenous cushing’s syndrome. It is a severe condition associated to many comorbidities and increased mortality that occurs a long-term management to optimize these patients outcomes. This study aims to describe the phosphocalcium profile and to assess the prevalence of osteporosis in patients with cushing’s disease.

Materiels and Methods: Retrospective and descriptive study, including 17 patients with cushing’s disease hospitalized in the Endocrinology-Diabetology-Nutrition department of university hospital center Mohammed VI of Oujda between 2016 and 2022, we had excluded the cases where a bone densitometry was missing. Statistical analysis was performed by SPSS version 21 software.

Results: The average age was 34.8±10.8 years, with a clear female predominance (70.6%). The average time to consultation after onset of symptomatology in our patients was 3.2±3 years. The mean level of phosphorus in our series was 32.3±4.5 mg/l, 5.8% of our patients had hypophosphatemia. On the other hand, none of our patients had hypocalcemia with a mean value of calcemia at 93.8±3.1 mg/l. The mean vitamin D level in our series was 16.2±7.9 ng/ml, hypovitaminosis D was described in 94.1% of the patients, of which 31.2% had vitamin D deficiency, while 62.9% were vitamin D deficient. Eighteen percent of our patients had osteoporosis, with a predominance of the lumbar spine in all patients. Osteopenia was found in 53% of the patients in our series, with involvement of the lumbar spine in all cases, 30% of whom had involvement of the lumbar spine associated with the femoral neck.

Discussion-Conclusion: Cushing’s disease leads to many complications that heavily impact on life’s quality and survival of affected patients. Cushing osteopathy is one of the most severe ones, in fact, the risk of fracture increases immediately with the onset of the disease, hence the need for rapid management in order to limit these complications and optimize the survival of these patients.

References: 1. Frara S, di Filippo L, Doga M, Loli P, Casanueva FF, Giustina A. Novel approaches to bone comorbidity in Cushing’s disease: an update. Pituitary. 2022 Oct;25(5):754-759. doi: 10.1007/s11102-022-01252-w. Epub 2022 Jul 18. PMID: 35849272.

2. Belkacem, S., & Semrouni, M. (2017). Prévalence de l’ostéoporose dans la maladie de Cushing : à propos de 120 cas. Annales d’Endocrinologie, 78(4), 252–253. https://doi.org/10.1016/j.ando.2017.07.103.