Long-term metabolic consequences: persistence of visceral obesity and diabetes mellitus after remission from Cushing's syndrome.
Cushing's syndrome (CS) is associated with increased cardiovascular morbidity and mortality, both of which may persist after long-term remission. Our aim was to evaluate the prevalence of type 2 diabetes mellitus, fat distribution and other metabolic characteristics in patients with prior CS compared with matched population-based controls to assess metabolic risk factors.
Comorbidities were retrospectively analyzed in a cohort of 99 patients with CS from a single tertiary care center. Patients were longitudinally evaluated at baseline during active disease and at 7 years after biochemical remission. Data were compared to a control group matched for age and sex (n = 396) from the KORA study in a 1:4 fashion.
Despite long-term improvements, patients with CS in sustained remission still exhibit adverse metabolic outcomes 7 years after remission, including higher relative fat mass (39% vs. 35%, p = 0.0013), a higher waist-to-hip ratio (0.89 vs. 0.82, p < 0.0001), elevated HbA1c (5.5% vs. 5.4%, p = 0.0087), and increased diabetes prevalence (19% vs. 4%, p < 0.0001) compared with controls. These persistent metabolic alterations were strongly associated with inflammatory markers, suggesting inflammation as a potential contributor to the sustained diabetes risk.
Patients with prior CS remain burdened by adverse metabolic profiles that may contribute to their increased long-term cardiovascular risk.
Comorbidities were retrospectively analyzed in a cohort of 99 patients with CS from a single tertiary care center. Patients were longitudinally evaluated at baseline during active disease and at 7 years after biochemical remission. Data were compared to a control group matched for age and sex (n = 396) from the KORA study in a 1:4 fashion.
Despite long-term improvements, patients with CS in sustained remission still exhibit adverse metabolic outcomes 7 years after remission, including higher relative fat mass (39% vs. 35%, p = 0.0013), a higher waist-to-hip ratio (0.89 vs. 0.82, p < 0.0001), elevated HbA1c (5.5% vs. 5.4%, p = 0.0087), and increased diabetes prevalence (19% vs. 4%, p < 0.0001) compared with controls. These persistent metabolic alterations were strongly associated with inflammatory markers, suggesting inflammation as a potential contributor to the sustained diabetes risk.
Patients with prior CS remain burdened by adverse metabolic profiles that may contribute to their increased long-term cardiovascular risk.
Authors
Rubinstein Rubinstein, Fedtke Fedtke, Then Then, Nowak Nowak, Vogel Vogel, Braun Braun, Zopp Zopp, Zimmermann Zimmermann, Peters Peters, Heier Heier, Linkohr Linkohr, Roden Roden, Bidlingmaier Bidlingmaier, Beuschlein Beuschlein, Reincke Reincke, Ritzel Ritzel
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