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2022, Number 3

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Rev Cuba Endoc 2022; 33 (3)

Quality of life in patients with endogenous hypercortisolism before and after surgery

Cabrera GM, Domínguez AE, Ledón LL, Acosta CA, Turcios TSE, Ramos TJ

Language: Spanish
References: 50
Page:
PDF size: 879.24 Kb.


ABSTRACT

Introduction: Chronic exposure to excess cortisol has a negative impact on quality of life.
Objectives: To determine the quality of life in patients with endogenous hypercortisolism to identify whether there is a relationship between this and clinical and hormonal variables in patients before and after surgery.
Methods: A prospective study of 25 patients with endogenous hypercortisolism was conducted. They were evaluated before and six months after surgical treatment. The CushingQoL, Tuebingen CD-25 and WHOQOL BRIF questionnaires were applied. For statistical significance, the mean, standard deviation and McNemar test were determined. Median quantitative clinical and hormonal variables and quality of life questionnaire scores before and after surgery were compared using Wilcoxon testing.
Results: 64 % had Cushing's disease. The median age was 46 years. The median sum of all domains of Tuebingen CD – 25 before surgery was 49 and then 27 points; of CushingQol was 41.6 and 62.5 after, and WHOQOL BREF before was 72 and after it was 78. Waist circumference and cortisol were positively correlated with BMI (r = 0.834; p = 0.000) and (r = 0.614; p = 0.001), respectively.
Cortisol was negatively correlated with psychological health (r = -0.472, p = 0.017) and social relationships (r = -0.401, p = 0.042). Conclusions: Quality of life was perceived as affected before surgery and improved considerably after surgery. There is a relationship between quality of life and some clinical and hormonal parameters.


REFERENCES

  1. Jingya Z, Meng Z, Xue B, Shengnan C, Cheng P, Lin L, et al. Demographic Characteristics, Etiology, and Comorbidities of Patients with Cushing’s syndrome: A 10-Year Retrospective Study at a Large General Hospital in China. Internat J of Endocrinol. 2019;(6):1-10. DOI: https://doi.org/10.1155/2019/7159696

  2. Ragnarsson O, Olsson DS, Chantzichristos D, Papakokkinou E, Dahlqvist P, Segerstedt E, et al. The incidence of Cushing’s disease: a nationwide Swedish study. Pituitary. 2019;22(2):179-86. DOI: https://doi.org/10.1007/s11102-019-00951-1

  3. Nieman LK. Recent Updates on the Diagnosis and Management of Cushing's Syndrome. Endocrinol Metab. 2018;33(2):139-46. DOI: https://doi.org/10.3803/EnM.2018.33.2.139.

  4. Xu C-X, Jiang H, Zheng R-Z, Sun Y-H, Sun Q-F, Bian L-G. Impaired brain network architecture in Cushing’s disease based on graph theoretical analysis Aging. 2020;12(6):5168-82. DOI: https://doi.org/10.18632/aging.102939.

  5. 5 Loriaux DL. Diagnosis and differential diagnosis of Cushing’s syndrome. N Engl J Med. 2017;376(15):1451-59. DOI: https://doi.org/10.1056/NEJMra1505550376:1451-9

  6. Ragnarsson O. Cushing's syndrome e Disease monitoring: Recurrence, surveillance with biomarkers or imaging studies. Best Pract Res Clin Endocrinol Metab. 2020;34(2). DOI: https://doi.org/10.1016/j.beem.2020.101382

  7. Schernthaner-Reiter M H, Siess C, Gessl A, Scheuba C, Wolfsberger S, Riss Ph, et al. Factors predicting long-term comorbidities in patients with Cushing’s syndrome in remission Endocrine 2019;64(1):157-68. DOI: https://doi.org/10.1007/s12020-018-1819-6

  8. Nieman LK. Recent Updates on the Diagnosis and Management of Cushing's Syndrome. Endocrinol Metab. 2018;33(2):139-46. DOI: https://doi.org/10.3803/EnM.2018.33.2.139

  9. Nishioka H, Yamada Sh. Review Cushing’s Disease. J. Clin. Med. 2019;8(11):1951. https://doi.org/DOI:10.3390/jcm8111951

  10. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403-9. DOI: https://doi.org/10.1016/0277-9536(95)00112-k.

  11. Montes M. Calidad de vida. Rev Mex Fis Rehab. 2006;18(1):5-6.

  12. Moyers S A, Tiemensma J. The association between physical activity, sleep, and quality of life in patients in bio-chemical remission from Cushing’s syndrome. Quality of Life Research.2020. DOI: https://doi.org/10.1007/s11136-020-02480-y

  13. Santos A, Resmini E, Martínez Momblán MA, Valassi E, Martel L, Webb SM Quality of Life in Patients With Cushing’s Disease. Front. Endocrinol. 2019;10:862. DOI: https://doi.org/10.3389/fendo.2019.00862

  14. Van der Klaauw AA, Kars M, Biermasz NR, Roelfsema F, Dekkers OM, et al. Disease specific impairments in quality of life during long-term follow-up of patients with different pituitary adenomas. Clin Endocrinol. 2008;69(5):775-84. DOI: https://doi.org/10.1111/j.1365-2265.2008.03288.x.69:775-84.

  15. Alcalar N, Ozkan S, Kadioglu P, Celik O, Cagatay P, Kucukyuruk B et al. Evaluation of depression, quality of life and body image in patients with Cushing’s disease. Pituit. 2013;16(3):333-40. DOI: https://doi.org/10.1007/s11102-012-0425-5

  16. Huguet I, Ntali G, Grossman A, Karavitaki N. Cushing’s disease – quality of life, recurrence and long-term morbidity. Eur Endocrinol. 2015;11(1):34-8. DOI: https://doi.org/10.17925/EE.2015.11.01.34

  17. Lindholm J, Juul S, Jorgensen JO, Astrup j, Bjerre p, Feldt-Rasmussen U, et al. Incidence and late prognosis of Cushing’s syndrome: a population-based study. J Clin Endocrinol Metab. 2001;86(1):117-23. DOI: https://doi.org/10.1210/jcem.86.1.7093.

  18. Van Aken MO, Pereira AM, Biermasz NR, Van Thiel SW, Hoftijzer HC, Smit JWA, et al. Quality of life in patients after long-term biochemical cure of Cushing’s disease. J Clin Endocrinol Metab. 2005;90(6):3279-86. DOI: https://doi.org/10.1210/jc.2004-1375

  19. Webb SM, Santos A, Resmini E, Martinez-Momblan MA, Martel L. Valassi E. Quality of Life in Cushing’s disease: A long term issue? Ann. Endocrinol. 2018,79(3):132-37. DOI: https://doi.org/10.1016/j.ando.2018.03.007.

  20. Milian M, Teufel P, Honegger J, Gallwitz B, Schnauder G, Psaras T. The development of the Tuebingen Cushing’s disease quality of life inventory (Tuebingen CD-25), part I: construction and psychometric properties. Clin Endocrinol. 2012;76(6):851-60. DOI: https://doi.org/10.1111/j.1365-2265.2011.04191.x.

  21. Webb SM, Ware JE, Forsythe A, Yang M, Badia X, Nelson LM, et al. Treatment effectiveness of pasireotide on health-related quality of life in patients with Cushing’s disease. Eur J Endocrinol. 2014;171(1):89-98. DOI: https://doi.org/10.1530/EJE-13-1013.

  22. Santos A, Resmini E, Martínez-Momblán MA, Crespo I, Valassi E, Roset M, et al. Psychometric performance of the CushingQoL questionnaire in conditions of real clinical practice. Eur J Endocrinol. 2012;167(3):337-42. DOI: https://doi.org/10.1530/EJE-12-0325

  23. Wagenmakers MA, Netea-Maier RT, Prins JB, Dekkers T, Den Heijer M, Hermus AR. Impaired quality of life in patients in long-term remission of Cushing’s syndrome of both adrenal and pituitary origin: a remaining effect of long-standing hypercortisolism? Eur J Endocrinol. 2012;167(5):687-95. DOI: https://doi.org/10.1530/EJE-12-0308.

  24. Cabrera M, Domínguez E, Acosta A, Turcios SE, Bartolome JL, Ledon L, et al. Calidad de vida en pacientes operados de hipercortisolismo endógeno. Rev Cuban de Endocrinol. 2019 [acceso 22/03/23];30(2):e166. Disponible en: http://www.revendocrinologia.sld.cu/index.php/endocrinologia/article/view/166

  25. García J. Apuntes sobre la calidad de vida: su carácter socioeconómico y su relación con la salud. Rev Cub Invest Biomed. 2005;24(1):72-6.

  26. Valassi E, Santos A, Yaneva M, To ´th M, Strasburger CJ, Chanson P, et al. The European Registry on Cushing’s syndrome: 2-year experience. Baseline demographic and clinical characteristics. Eur J Endocrinol. 2011;165(3):383-92. DOI: https://doi.org/10.1530/EJE-11-0272.

  27. Pivonello R, De Martino C, De Leo M, Simeoli C, Colao A. Cushing’s disease: The burden of illness. Endocrine. 2017;56(1):10-18. DOI: https://doi.org/10.1007/s12020-016-0984-8

  28. Mehta GU, Ding D, Patibandla MR, Kano H, Sisterson N, Su YH, et al. Stereotactic Radiosurgery for Cushing Disease: Results of an International, Multicenter Study. J Clin Endocrinol Metab. 2017;102(11):4284-91. DOI: https://doi.org/10.1210/jc.2017-01385.

  29. Milian M, Kreitschmann-Andermahr I, Siegel S, Kleist B, Führer-Sakel D, Honegger J, et al. Validation of the Tuebingen CD-25 inventory as a measure of postoperative health-related quality of life in patients treated for Cushing’s disease. Neuroendocrinol. 2015;102(1-2):60-7. DOI: https://doi.org/10.1159/000431022.

  30. Sawant N, Sharma A, Shah N. Life events and quality of life in patients of Cushing’s disease. Ann Indian Psychiatry. 2019;3:28-31. DOI: https://doi.org/10.4103/aip.aip_49_18

  31. Milian M, Honegger J, Teufel P, Wolf A, Psaras T. Tuebingen CD-25 is a sensitive tool to investigate health-related quality of life in Cushing’s disease patients in the course of the disease. Neuroendocrinology. 2013;98(3):188-99. DOI: https://doi.org/10.1159/000355622

  32. Psaras T, Milian M, Hattermann V, Will BE, Tatagiba M, Honegger J. Predictive factors for neurocognitive function and Quality of Life after surgical treatment for Cushing’s disease and acromegaly. J Endocrinol Invest. 2011;34(7):e168-77. DOI: https://doi.org/10.3275/7333

  33. Van der Pas R, de Bruin C, Pereira AM, Romijn JA, Netea-Maier RT, Hermus AR, et al. Cortisol diurnal rhythm and quality of life after successful medical treatment of Cushing’s disease. Pituitary.2013;16(4):536-44. DOI: https://doi.org/10.1007/s11102-012-0452-2.

  34. Nader S, Burkhardt T, Vettorazzi E, Milian M, Aberle J, Petersenn S, et al. Health-related quality of life in patients after treatment of Cushing’s disease. Exp Clin Endocrinol Diabetes. 2016;124(03):187-91. DOI: https://doi.org/10.1055/s-0035-1569340 64

  35. Carluccio A, Sundaram NK, Chablani S, Amrock LG, Lambert JK, Post KD, et al. Predictors of quality of life in 102 patients with treated Cushing’s disease. Clin. Endocrinol. 2015;82:404-11. DOI: https://doi.org/10.1111/cen.12521 63

  36. Lindsay JR, Nansel T, Baid S, Gumowski J, Nieman LK. Long-term impaired quality of life in Cushing’s syndrome despite initial improvement after surgical remission. J Clin Endocrinol Metab. 2006;91(2):447-53. DOI: https://doi.org/ 10.1210/jc.2005-1058

  37. Tiemensma J, Kaptein AA, Pereira AM, Smit JW, Romijn JA, Biermasz NR Negative illness perceptions are associated with impaired quality of life in patients after long-term remission of Cushing’s syndrome. Eur J Endocrinol. 2011;165:527-35.

  38. Andela, CD, Scharloo M, Pereira AM., Kaptein, A.A.; Biermasz, N.R. Quality of life (QoL) impairments in patients with a pituitary adenoma: A systematic review of QoL studies. Pituitary. 2015;(5):752-76. DOI: https://doi.org/10.1007/s11102-015-0636-7

  39. Valassi E, Feelders R, Maiter D, Chanson P, Yaneva M, Reincke M, et al. Worse Health-Related Quality of Life at long-term follow-up in patients with Cushing’s disease than patients with cortisol producing adenoma. Data from the ERCUSYN. Clin Endocrinol. 2018;(6):787-98. DOI: https://doi.org/10.1111/cen.13600

  40. Newell-Price, J. Cushing disease. In The Pituitary. 4th ed. Academic Press: Cambridge MA, USA, 2017. P. 515-71

  41. Feelders RA, Pulgar SJ, Kempel A, Pereira AM. The burden of Cushing’s disease: Clinical and health-related quality of life aspects. Eur. J. Endocrinol. 2012;167(3):311-26. DOI: https://doi.org/10.1530/EJE-11-1095

  42. Lamos E.M, Munir KM. Cushing disease: Highlighting the importance of early diagnosis for both de novo and recurrent disease in light of evolving treatmentpatterns. EndocrPr. 2014;20(9):945-55. DOI: https://doi.org/10.4158/EP14068.RA9

  43. Sharma ST, Nieman LK, Feelders RA. Comorbidities in Cushing’s disease. Pituitary. 2015;18(2):188-94. DOI: https://doi.org/10.1007/s11102-015-0645-6

  44. Dorn LD, Cerrone P. Cognitive function in patients with Cushing syndrome: a longitudinal perspective. Clin Nurs Res. 2000;9(4):420-40. DOI: https://doi.org/10.1177/10547730022158672.

  45. Forget H, Lacroix A, Cohen H. Persistent cognitive impairment following surgical treatment of Cushing’s syndrome. Psychoneuroendocrinology. 2002;27(3):367-83. DOI: https://doi.org/10.1016/s0306-4530(01)00059-2

  46. Ragnarsson O, Berlund P, Eder DN, Johannsson G. Long-term cognitive impairments and attentional deficits in patients with Cushing’s disease and cortisol-producing adrenal adenoma in remission. J Clin Endocrinol Metab. 2012;97:E1640-8. DOI: https://doi.org/10.1210/jc.2012-1945

  47. Feelders RA, Pulgar SJ, Kempel A, Pereira AM. The burden of Cushing’s disease: Clinical and health-related quality of life aspects. Eur. J. Endocrinol. 2012;167:311-26 DOI: https://doi.org/10.1530/EJE-11-1095

  48. Sahakitrungruang T, Srichomthong C, Pornkunwilai S, Amornfa J, Shuangshoti S, Kulawonganunchai S, et al. Germline and somatic DICER1 mutations in a pituitary blastoma causing infantile-onset Cushing’s disease. J. Clin. Endocrinol. Metab. 2014;99(8):E1487-92. DOI: https://doi.org/10.1210/jc.2014-1016.

  49. Pivonello R, De Leo M, Cozzolino A, Colao A. The Treatment of Cushing’s Disease. Rev Endocr. 2015;36(4):385-86. DOI: https://doi.org/10.1210/er.2013-1048

  50. Hawn MT, Cook D, Deveney C, Sheppard BC. Quality of life after laparoscopic bilateral adrenalectomy for Cushing’s disease. Surgery. 2002;132(6):1064-8. DOI: https://doi.org/10.1067/msy.2002.128482.




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