Endocrine Abstracts

There is considerable evidence that mortality is increased in patients with Cushing’s syndrome of pituitary origin. This is thought to be caused by long-term exposure to supraphysiological cortisol levels inducing harmful effects, such as hypercoagulability, insulin resistance, hypertension, bone loss, and immunosuppression. It is assumed that some cortisol-related effects persist after treatment and the important question is whether this translates in an increased mortality in patients cured after initial therapy. Several epidemiological studies have provided data regarding this question, although individual studies are often underpowered to answer the question definitively. Quantitative summary of different studies suggests an increased mortality in Cushing’s disease, even despite cure. As mortality however is clearly higher in patients not cured, the indication for treatment is not questioned by this finding. It mainly underlines that curing a disease like Cushing does not reverse long-term negative metabolic effects completely.