Endocrine Abstracts

Introduction: Cushing’s syndrome (CS) is a rare endocrine disorder caused by chronic exposure to excess gluco - corticoids. Despite surgical remission, cardiometabolic comorbidities frequently persist. Identifying clinical and biological predictors of weight loss and metabolic improvement after remission may help personalize follow-up.

Methods: This retrospective longitudinal study included 85 adult patients with CS in remission for at least one year after surgery. Anthropometric and cardiometabolic comorbidities (type 2 diabetes [T2D], hypertension, dyslipidaemia) were assessed before the onset of symptoms, at diagnosis, and at 12, 24 and 60 months post-remission. Outcomes and potential predictors of weight loss and cardiometabolic improvement were analysed using statistical comparisons and logistic regression models.

Results: At diagnosis, 44% of patients had obesity, 33% had T2D, 67% had hypertension and 82% had dyslipidemia. One year after remission, mean body weight was significantly decreased (-8,5%, P < 0,001), as did the prevalence of hypertension (-21%, P < 0,001) and T2D (-13%, P < 0,001), while the frequency of dyslipidemia remained unchanged. Greater weight gain before diagnosis was correlated with greater weight loss after remission (r = 0,41, P = 0,003). However, no disease characteristics (aetiology, duration or severity of hypercorticism) and no clinical or biological factors independently predicted weight loss or metabolic comorbidity remission.

Conclusion: Remission of CS leads to a significant but partial and highly variable improvement in overweight and cardiometabolic comorbidities. Factors explaining this unpredictable outcome remain however elusive. Nevertheless, our findings highlight the persistent impact of previous chronic hypercortisolism on the metabolic status and the importance of personalized and long-term care in this population. References 1. Pivonello R et al. Complications of Cushing’s syndrome: state of the art. The Lancet Diabetes & Endocrinology, 4(7), 611-629 (2016). 2. Giordano R et al. Metabolic and cardiovascular outcomes in patients with Cushing’s syndrome of different aetiologies during active disease and 1 year after remission. Clinical Endocrinology, 75(3), 354-360 (2011). 3. Schernthaner-Reiter MH et al. Factors predicting long-term comorbidities in patients with Cushing’s syndrome in remission. Endocrine, 64(1), 157-168 (2019).

Keywords: Cushing’s syndrome, weight loss, metabolic comorbidities, predictive factors