Endokrin remisyon sonrası Cushing sendromlu hastaların uzun dönem izlem sonuçları

Year 2024, Volume: 49 Issue: 4, 1006 - 1013, 30.12.2024

Gamze Akkuş , Ülcaz Perihan Aksoydan , Fulya Odabaş , Nur Sinem Şengöz Coşkun , Bekir Tamer Tetiker , Murat Sert

https://doi.org/10.17826/cumj.1501540

Abstract

Amaç: Bu çalışma, Cushing Sendromlu hastaların aktif dönem ve uzun süreli remisyon sonrası metabolik parametrelerini ve kemik yoğunluğu ölçümlerini değerlendirmeyi ve uzun süreli takip sonuçlarını sunmayı amaçlamıştır.
Gereç ve Yöntem: Cushing Sendromu tanısı almış ve takipte endokrin remisyona ulaşan 20 hastanın plazma glukoz, lipid değerleri, kan basıncı ölçümü, ve kemik mineral dansitesi değerlendirilip kayıt edildi.
Bulgular: Çalışmaya dahil edilen tüm hastalar kadın hasta olup ortalama yaşları 35±9.5 (aralık 25-45) olarak değerlendirildi. 60 aylık ortalama takip süresi boyunca kilo değişimi (87.6±21.2 vs 71.1±18.8) ve bel çevresi değişimi (98.02±11.5) anlamlı olarak saptandı. Endokrin remisyon öncesi ve sonrası total kolesterol ve trigliserid değerleri benzer iken, LDL kolesterol (143.6±35.8 vs 127.7±37.06) anlamlı olarak azalmıştı. Takip süresi boyunca hastaların %63.6’sı antihipertansif tedavi kesildi. Kemik mineral yoğunluğu ölçümü ise bazal ölçümlere göre anlamlı olarak artmıştı.
Sonuç: Bu çalışmada Cushing Sendromu nedeni ile takip edilen hastaların takipte metabolic parametrelerinin ve kemik yoğunluğunun iyileştiğini saptadık. Ancak bu parametrelerin değişmesinde yaş, cinsiyet ve hiperkortizolizm süresinin etkili olduğu ve komorbiditelerin iyileşmesinde major rolü olduğu kanatindeyiz.

Keywords

Cushing sendromu, hipertansiyon, osteoporoz, hiperkortizolemi, 24 saatlik idrar kortizolü

Long-term outcomes of the patients with Cushing syndrome after endocrine remission

Abstract

Purpose: The study aimed to evaluate metabolic parameters and bone density measurements during the active phase and after long-term remission, as well as to present long-term follow-up results of patients with Cushing Syndrome.
Materials and Methods: In 20 patients with Cushing Syndrome, weight, waist circumference, fasting plasma glucose, lipid parameters, blood pressure and bone mineral density were evaluated during the active disease and after endocrine remission.
Results: All patients were female, premenopausal with mean age of 35±9.5 (range 27-45). During the long-term follow-up (median 60 months), weight (87.6±21.2 vs 71.1±18.8) and waist circumference (98.02±11.5,) were decreased significantly compared to baseline measurements. While total cholesterol and triglyceride values were similar between before and after remission, LDL cholesterol (143.6±35.8 vs 127.7±37.06) was decreased significantly in all patients. During the hormonal remission, 63.6% of patients’ antihypertensive medication was discontinued. Bone mineral density in lumbar spine was increased compared to the baseline values of all patients.
Conclusion: Metabolic parameters and bone status were improved during the long-term follow-up time in patients with Cushing syndrome. Age, gender and duration of hypercortisolism or following time can influence the recovery of these comorbidities.

Keywords

hypercortisolemia, type 2 diabetes mellitus, hypertension, cushing syndrome

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