Background: Early carbohydrate metabolism disorders (ECMDs) and diabetes mellitus (DM) are frequently associated with endogenous hypercortisolism (EG). Prevalence of secondary (sDM) in these cases are poorly investigated.
Aim: We aimed to assess the prevalence of ECMDs and DM in patients with EG (pituitary-dependent Cushing disease (CD)) and adrenal-dependent Cushing (AC) and ACTH-ectopic syndrome (ACTHs) depending on gender and age.
Patients and methods: Forty-two patients with hypercortisolism (CD 32 patients, AC 7 patients, ACTHs 3 patients), (five men, 37 women; 42.0 (33.749.2) years, estimated duration of EG 36.0 (2470) month) were observed.
OGTT was done in those not yet diagnosed with DM to reveal asymptomatic DM or ECMDs. Comparisons were made between patients with hypercortisolism and participants from the general adult population (GP) (n=838) and an adult population with multiple type 2 diabetes risk factors (HR group) (n=604), matched for age and BMI.
Results: DM was diagnosed in 26 patients with EG (62%) and in 75 (8.9%) of the general population (P<0.001). The prevalence of ECMDs was comparable in patients with hypercortisolism (17%) and in the GP (15.2%) and in the HR group (23.7%); only 21% of patients with EG were normoglycaemic. The prevalence of newly diagnosed DM was more than two times higher in patients with EG compared with the HR group (38.1 and 16.1% accordingly, P<0.05).
The prevalence of DM in women from EG group was 1.5 times higher, than in men (64.8 and 40%, P<0.05), among their newly diagnosed DM was two times higher than in men (40 and 20%, P<0.05). The prevalence of DM increased with age (from 57% (in those younger than 45 years) to 88% (older than 55 years), (P<0.05).
Conclusion: In patients with hypercortisolism, the prevalence of DM and ECMDs considerably exceeds that of the general population and of a high-risk group.