Endocrine Abstracts

Objective: To evaluate the frequency of symptoms of Cushing’s disease (CD) at baseline and it dependence on different quantities.

Material and methods: Clinical and laboratory data of 44 patients with CD (40 females and four males, 37.9±10.5 years old), duration of the disease 35.5 (22; 75) months.

Results: Complaints: i) >80% – fatigability, weight gain, apathy, and headache, ii) 40–50% – loss of libido, bruisability, muscle weakness, insomnia, and hair loss, iii) <40% – irritability, striae, back pain, memory loss, impaired wound healing, increased appetite, and acne. 6/15 (34.1%) patients with back pain had spinal fracture. One patient with spinal fracture had no back pain. Regular menstruation – in 5/40 (12.5%) women, 12 (30%) – menstrual irregularities, and 23 (57.5%) – amenorrhea. Clinical examination: arterial hypertension – in 100% (by BPM). More than 70% had facial plethora, overweight/obesity, dorsocervical fat pad, hirsutism (females), and leg edema. BMI at baseline – 33.7 (30.4; 38.4). Normal weight 7%, 16.3% – overweight, 76.7% – obese (34.9% – I grade). Median weight gain 13.0 (10.0; 26.2) kg, correlated with duration of the disease (r²=0.2; P=0.007). Positive correlations were found between: i) midnight serum cortisol level and apathy, muscle weakness, hair loss, and waist to hip ratio (r²=0.35, P=0.005; r²=0.3, P=0.009; r²=0.2, P=0.04; and r²=0.2, P=0.049 respectively), ii) morning serum cortisol level with apathy and impaired wound healing (r²=0.1, P=0.04 and r²=0.2, P=0.006), iii) morning and midnight serum ACTH levels with increased appetite (r²=0.2, P=0.01 and r²=0.3, P=0.01 respectively), iv) midnight serum ACTH with fatigability (r²=0.2, P=0.03), and v) UFC with supraclavicular fat pads (r²=0.15, P=0.04). Back pain and striae correlated with BMI (r²=0.1, P=0.04 and r²=0.17, P=0.006 respectively). Weight gain and acne had a positive correlation with duration of the disease (r²=0.2, P=0.007 and r²=0.14, P=0.001 respectively).

Conclusions: The most frequent symptoms of CD are nonspecific. The strongest correlation observed between symptoms and midnight serum cortisol and ACTH levels.