Endocrine Abstracts

Introduction: Cushing’s syndrome (CS) is associated with central obesity, hypertension, insulin resistance, dyslipidemia, prothrombotic state, manifestations which form a metabolic syndrome. Accelerated vascular senescence, due to metabolic and vascular changes, increases, in CS, the cardiovascular risk and the mortality rates compared to age- and gender-matched population. On the other hand, obesity itself is associated with numerous comorbidities, including hypertension, diabetes mellitus, dyslipidemia and major cardiovascular diseases.

Aim: To evaluate the prevalence of the cardiometabolic complications and the cardiovascular risk in CS compared to obese patients.

Methods: 43 patients, mean age 41.46±6.11 years, 39 (90.6%) females, with endogenous CS (26 with Cushing’s disease and 17 with adrenal Cushing’s) and 50 age- and gender- matched subjects with obesity were retrospectively analyzed.

Results: Mean BMI was significantly higher in obese patients than in patients with CS (39.54±3.99 vs 32.26±7.41 kg/m², P<0.001). Systolic blood pressure (139.05±20.74 vs 130.2±19.61 mmHg, P=0.045), diastolic blood pressure (87.77±13.06 vs 79.59±10.59 mmHg, P=0.002) and blood glucose levels (106.94±28.95 vs 93.38±13.69 mg/dl, P=0.005) were higher in CS patients than in obese patients. The prevalence of hypertension (62.5 vs 34%, P=0.007, χ²=7.25), coronary heart disease (20.5% vs 6%, P=0.039, χ²=4.26), diabetes mellitus (32.6% vs 10%, P=0.03, χ²=8.75) and metabolic syndrome (NCEP ATP III criteria) (64.4% vs 40.8%, P=0.032, χ²=4.58) was higher in CS patients compared to obese patients. The 10 years cardiovascular risk (Framingham risk score) was almost double in CS patients compared to obese subjects (9.02% vs 4.66, P=0.006), the risk being higher in patients with adrenal CS compared to patients with Cushing’s disease (12.47 vs 5.59, P=0.015).

Conclusion: Our study reveals a higher prevalence of cardiometabolic complications and an increased cardiovascular risk in patients with Cushing’s syndrome compared to obese patients, the risk being higher in patients with adrenal CS than in patients with Cushing’s disease.