Persistence of Increased Cardiovascular Risk in Patients with Cushing's Disease after Five Years of Successful Cure

1999 ◽  
Vol 84 (8) ◽  
pp. 2664-2672 ◽  
Author(s):  
A. Colao
Keyword(s):  
Cardiovascular Risk ◽  
Cushing’S Disease ◽  
Cushing's Disease

scholarly journals Persistence of Increased Cardiovascular Risk in Patients with Cushing’s Disease after Five Years of Successful Cure

1999 ◽  
Vol 84 (8) ◽  
pp. 2664-2672 ◽  
Author(s):  
Annamaria Colao ◽  
Rosario Pivonello ◽  
Stefano Spiezia ◽  
Antongiulio Faggiano ◽  
Diego Ferone ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Cushing’S Disease ◽  
Cushing's Disease

scholarly journals Lipid Abnormalities in Patients With Cushing’s Disease and Its Relationship With Impaired Glucose Metabolism

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaolin Sun ◽  
Ming Feng ◽  
Lin Lu ◽  
Zixuan Zhao ◽  
Xinjie Bao ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Glucose Metabolism ◽  
Cushing’S Disease ◽  
Cushing's Disease ◽  
Impaired Glucose Metabolism ◽  
Post Surgery ◽  
Morning Cortisol ◽  
Independent Risk Factors ◽  
Lipid Abnormalities ◽  
The Impact

PurposeDyslipidemia has been frequently reported and associated with increased cardiovascular risk in patients with Cushing’s disease (CD). Few studies are available regarding the relationships between lipid abnormalities and other preoperative metabolic comorbidities in CD, and the data on alterations of the lipid profile after surgery is quite variable. We aimed to investigate the associations between hyperlipidemia and other baseline metabolic and hormonal parameters and the impact of surgical remission on lipid metabolism in patients with CD.MethodsThis retrospective study included 104 patients diagnosed with CD. Baseline hormonal and metabolic parameters were compared between the hyperlipidemia (HLP) group and non-hyperlipidemia (NLP) group, and their relationships with hyperlipidemia at diagnosis were evaluated. Alterations in lipid profiles after surgical remission of CD were evaluated in 65 patients with available follow-up data.ResultsUpon baseline, logistic regression analysis showed that impaired glucose metabolism (IGM) (OR=4.68, 95%CI:1.38–15.91) and morning cortisol levels (per 10 μg/dl change) (OR=1.81, 95%CI:1.11–2.95) are both independent risk factors of preoperative occurrence of hyperlipidemia in patients with CD. The baseline triglyceride (TG) level was positively correlated with systolic blood pressure (SBP) (r=0.297, p=0.003). Lipid abnormalities had improvement but may persist after surgical remission, and the persisted hyperlipidemia is associated with higher baseline total cholesterol (TC) levels (r=0.505, p=0.033).ConclusionsPersistence of post-surgery hyperlipidemia is associated with severe baseline lipid abnormalities. Surgical remission with concomitant control of impaired glucose metabolism at diagnosis may have significant implications for controlling hyperlipidemia and reducing cardiovascular risk in CD.

scholarly journals Cardiovascular risk in patients with Cushing’s disease – an interdisciplinary problem

2021 ◽  
Vol 17 (3) ◽  
pp. 197-202
Author(s):  
Agnieszka Jurek ◽  
◽  
Paweł Krzesiński ◽  
Grzegorz Gielerak ◽  
Beata Uziębło-Życzkowska ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Risk ◽  
Cushing’S Disease ◽  
Treatment Options ◽  
Pituitary Tumour ◽  
Cushing's Disease ◽  
Entire Body ◽  
Systemic Complications ◽  
Cardiovascular Assessment

Cushing’s disease is a chronic endogenous hypercortisolaemia associated with overproduction of adrenocorticotropic hormone by a pituitary adenoma, leading to multiple systemic complications that significantly increase morbidity and mortality, as well as reduce the quality of life as a result of prolonged tissue exposure to excess cortisol. Hypercortisolaemia in Cushing’s disease is associated with significant functional and constitutional disorders of the entire body. The consequences of chronic hypercortisolaemia include haemodynamic disorders associated with excessive vascular contraction and increased blood pressure, obesity, carbohydrate metabolism disorders, dyslipidaemia, and coagulopathies, which may contribute to significant cardiovascular remodelling. Cardiovascular disorders have a particular impact on long-term prognosis and quality of life in Cushing’s disease. If left untreated, Cushing’s disease significantly increases the cardiovascular risk and limits the treatment options for secondary organ complications. Cardiovascular mortality (myocardial infarction, heart failure, stroke) is several times higher in patients with Cushing’s disease than in the general population. Early diagnosis of the corticotropic pituitary tumour, as well as a thorough morphological and functional cardiovascular assessment seem essential in risk stratification. Normalisation of cortisol levels after combined neurosurgical and/or pharmacological treatment reduces mortality and the risk of cardiovascular and respiratory complications. The aim of this study is to present the complexity of clinical problems in patients with Cushing’s disease, who are in a particular need of interdisciplinary care.

scholarly journals Mortality of Patients with Cushing’s Disease

2020 ◽  
Author(s):  
Georgia Ntali ◽  
Osamah Hakami ◽  
Milanka Wattegama ◽  
Shahzada Ahmed ◽  
Niki Karavitaki
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Pituitary Adenoma ◽  
Early Diagnosis ◽  
Cushing’S Disease ◽  
Rare Condition ◽  
Therapeutic Interventions ◽  
Cushing's Disease ◽  
Close Monitoring

AbstractCushing’s disease is a rare condition of cortisol excess attributed to a pituitary adenoma with an annual incidence of 1.2–2.4 cases per million population. It is associated with several co-morbidities leading to increased mortality predominantly due to cardiovascular disease. Despite the advances in its diagnosis and management, survival can be compromised even after apparent successful treatment. Minimizing the duration and extent of exposure to hypercortisolaemia by early diagnosis and rapid, effective therapeutic interventions, as well as close monitoring and aggressive control of cardiovascular risk factors are vital for improving outcomes of the patients.

scholarly journals Comorbidity and cardiovascular risk factors in adult GH deficiency following treatment for Cushing's disease or non-functioning pituitary adenomas during childhood

2012 ◽  
Vol 166 (4) ◽  
pp. 593-600 ◽  
Author(s):  
Oskar Ragnarsson ◽  
Charlotte Höybye ◽  
Peter J Jönsson ◽  
Ulla Feldt-Rasmussen ◽  
Gudmundur Johannsson ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Cushing’S Disease ◽  
Gh Deficiency ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Pituitary Tumour ◽  
Cushing's Disease ◽  
Pituitary Hormone ◽  
Gh Treatment

ObjectiveCushing's disease (CD) and non-functioning pituitary adenoma (NFPA) are rare in paediatric patients. The aim of this study was to describe long-term consequences in adults with GH deficiency (GHD) treated for CD or NFPA during childhood.Design, patients and methodsThis was a retrospective analysis of data from KIMS (Pfizer International Metabolic Database). Background characteristics, anthropometry and comorbidity were studied in 47 patients diagnosed with childhood-onset (CO)-CD and 62 patients with CO-NFPA. Data from 100 ACTH-sufficient patients with CO-idiopathic hypopituitarism (CO-Idio) were used for comparison. Cardiovascular risk profile was analysed at baseline and at 1 year on GH treatment in a subgroup of patients (17 CO-CD, 24 CO-NFPA and 55 CO-Idio) not receiving GH treatment at study entry.ResultsThe median age at diagnosis of pituitary tumour was 14.0 years (range 10–17) in patients with CO-CD and 13.7 years (range 8–17) in CO-NFPA. In addition to GHD, 41% of patients with CO-CD had three or four other pituitary hormone deficiencies compared with 78% of patients with CO-NFPA (P<0.001). Eighty-nine per cent of patients with CO-CD had height SDS lower than 0 compared with 61% of patients with CO-NFPA (P=0.002). Hypertension was more common in CO-CD compared with CO-Idio (23 vs 9%,P=0.018). At 1 year on GH treatment, total- and low-density lipoprotein-cholesterol decreased significantly in CO-CD but not in CO-NFPA.ConclusionAdult patients with GHD following treatment for paediatric CD and NFPA have long-term adverse consequences. Despite more severe hypopituitarism in CO-NFPA, patients with CO-CD have more frequently compromised final stature.

scholarly journals Glomerular filtration rate in patients with Cushing’s disease: a matched case–control study

2005 ◽  
Vol 153 (6) ◽  
pp. 819-829 ◽  
Author(s):  
P Haentjens ◽  
L De Meirleir ◽  
R Abs ◽  
J Verhelst ◽  
K Poppe ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Cushing’S Disease ◽  
Filtration Rate ◽  
Case Control Study ◽  
Case Control ◽  
Cushing's Disease ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Background: Patients with Cushing’s disease have a high prevalence of atherosclerosis and maintain an increased cardiovascular risk even after cure of the disease. However, the impact of Cushing’s disease on renal function remains to be quantified. Objectives: To evaluate glomerular filtration rate (GFR) and to identify predictors of GFR in patients with Cushing’s disease. Design and methods: We conducted a matched case–control study: 18 patients with active or cured Cushing’s disease were compared with healthy population controls matched for age and sex. The main outcome measures were GFR and micro-albuminuria. Results: Patients with Cushing’s disease had a lower GFR, as measured by 24-h creatinine clearance (79 versus 95 ml/min per 1.73 m2, P = 0.005) and estimated by the MDRD2 formula (75 versus 88 ml/min per 1.73 m2, P = 0.008). Multiple regression analyses indicated that disease duration was the strongest predictor for a worse GFR. The prevalence of micro-albuminuria was low (5.5% in both groups). Conclusions: Patients with Cushing’s disease have a decreased GFR. Even if they are cured, close follow-up with strict control of cardiovascular risk factors and monitoring of GFR seems mandatory. Furthermore, the dosage of certain drugs should be adapted to the individual GFR.

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