Background: Residual morbidity in patients with Cushings syndrome (CS) in remission significantly affects Quality of Life (QoL). While sustained muscle weakness is a frequent complaint in these patients, the impact of muscle dysfunction on their psychophysical wellbeing is currently unknown. Patients & methods: We included 28 female patients [mean(±SD) age, 50±12 years; mean (±SD) BMI, 26.7±3.8] and 26 age- and BMI-matched healthy controls. Mean (±SD) duration of remission was 132±87 months and mean (±SD) delay to diagnosis was 32±23 months. QoL was assessed using both generic (SF36) and disease-specific (CushingQoL) questionnaires. Muscle function was assessed using the following tests: gait speed velocity (GS), timed up and go (TUG), walk 3 meters, 30-second chair stand and hand grip strength measured by a manual dynamometer in both hands.
Results: The mean (±SD) CushingQoL total score was 58±19. GS was associated with both total score and several specific items on CushingQoL, including sleep, pain, mood, self confidence, body appearance, social functioning, and daily activity (P<0.01). GS was also associated with several items of the SF36 (physical functioning, general health, vitality, social functioning, role emotion and mental health) in patients but not in controls; P<0.01. In patients, hand grip strength and performance on 30-second chair stand were associated with physical functioning, role physical and body pain on SF36; P<0.01. Duration of TUG was negatively associated with physical functioning, role physical and body pain on SF36 in patients only. Duration of TUG was also associated with body pain and social functioning of CushingQoL; P<0.01. Longer duration of remission was negatively associated with both 30-second chair stand and physical functioning on SF36 (P<0.05). In a multiple linear regression model, GS velocity predicted the CushingQoL total score, independent of age and length of remission (ß 0.65, P<0.001). Duration of TUG negatively predicted social activities on CushingQoL, regardless of age and length of remission (ß -0.41, P=0.031).
Conclusions: Muscle dysfunction is associated with impaired quality of life in patients with Cushings syndrome in remission.
18 - 21 May 2019
European Society of Endocrinology