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Long-term metabolic consequences: Persistence of visceral obesity and diabetes mellitus after remission from Cushing's syndrome.
Diabetes Res. Clin. Pract. 239:113436 (2026)
Aims: 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. Methods: 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. Results: 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. Conclusion: Patients with prior CS remain burdened by adverse metabolic profiles that may contribute to their increased long-term cardiovascular risk.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Co-morbidities ; Cushing'sdisease ; Cushing'ssyndrome ; Diabetesmellitus ; Remission; Cardiovascular Risk; Active Disease; Mortality; Outcomes
ISSN (print) / ISBN
0168-8227
e-ISSN
1872-8227
Quellenangaben
Volume: 239,
Article Number: 113436
Publisher
Elsevier
Publishing Place
Elsevier House, Brookvale Plaza, East Park Shannon, Co, Clare, 00000, Ireland
Reviewing status
Peer reviewed
Institute(s)
Institute of Epidemiology (EPI)
Grants
State of Bavaria
Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)
Munich Clinician Scientist Program I (MCSP) of the LMU Muenchen
Clinician Scientist Program RISE (Rare Important Syndromes in Endocrinology)
German Research Foundation (DFG)
European Community
Schmutzler-Stiftung
Ministry of Culture and Science of the State of North Rhine-Westphalia
German Federal Ministry of Health (BMG) to the German Diabetes Center
Federal Ministry for Research (BMBF) to the German Center for Diabetes Research
Helmholtz Zen-trum Muenchen German Research Center for Environmental Health by German Federal Ministry of Education and Research (BMBF)
Else Kroener-Fresenius Stiftung
Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)
Munich Clinician Scientist Program I (MCSP) of the LMU Muenchen
Clinician Scientist Program RISE (Rare Important Syndromes in Endocrinology)
German Research Foundation (DFG)
European Community
Schmutzler-Stiftung
Ministry of Culture and Science of the State of North Rhine-Westphalia
German Federal Ministry of Health (BMG) to the German Diabetes Center
Federal Ministry for Research (BMBF) to the German Center for Diabetes Research
Helmholtz Zen-trum Muenchen German Research Center for Environmental Health by German Federal Ministry of Education and Research (BMBF)
Else Kroener-Fresenius Stiftung