Excess Morbidity Persists in Patients With Cushings Disease During Long-term Remission: A Swedish Nationwide Study

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Excess Morbidity Persists in Patients With Cushings Disease During Long-term Remission: A Swedish Nationwide Study

Papakokkinou, Eleni (författare): Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

Olsson, Daniel S. (författare): Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

Chantzichristos, Dimitrios (författare): Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Dahlqvist, Per (författare): Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

Segerstedt, Elin (författare): Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

Olsson, Tommy (författare): Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

Petersson, Maria (författare): Department of Molecular Medicine and Surgery, Karolinska Institutet and The Department of Endocrinology, Metabolism and Diabetology, Karolinska University Hospital, Stockholm, Sweden

Berinder, Katarina (författare): Department of Molecular Medicine and Surgery, Karolinska Institutet and The Department of Endocrinology, Metabolism and Diabetology, Karolinska University Hospital, Stockholm, Sweden

Bensing, Sophie (författare): Department of Molecular Medicine and Surgery, Karolinska Institutet and The Department of Endocrinology, Metabolism and Diabetology, Karolinska University Hospital, Stockholm, Sweden

Höybye, Charlotte (författare): Department of Molecular Medicine and Surgery, Karolinska Institutet and The Department of Endocrinology, Metabolism and Diabetology, Karolinska University Hospital, Stockholm, Sweden

Eden-Engström, Britt (författare): Department of Medical Sciences; Endocrinology, Diabetes and Metabolism, Uppsala University Hospital, Uppsala, Sweden

Burman, Pia (författare): Department of Medical Sciences; Endocrinology, Diabetes and Metabolism, Uppsala University Hospital, Uppsala, Sweden

Bonelli, Lorenza (författare): Department of Endocrinology, Skåne University Hospital, University of Lund, Malmö, Sweden

Follin, Cecilia (författare): Department of Endocrinology, Skåne University Hospital, Lund, Sweden

Petranek, David (författare): Department of Endocrinology, Skåne University Hospital, Lund, Sweden

Erfurth, Eva Marie (författare): Department of Endocrinology, Skåne University Hospital, Lund, Sweden

Wahlberg, Jeanette, 1969- (författare): Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Endokrinmedicinska kliniken

Ekman, Bertil, 1958- (författare): Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Endokrinmedicinska kliniken

Åkerman, Anna-Karin (författare): Department of Internal Medicine, School of Health and Medical Sciences, Örebro University, Örebro, Sweden

Schwarcz, Erik (författare): Department of Internal Medicine, School of Health and Medical Sciences, Örebro University, Örebro, Sweden

Bryngelsson, Ing-Liss (författare): Department of Occupational and Environmental Medicine, University Hospital, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

Johannsson, Gudmundur (författare): Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

Ragnarsson, Oskar (författare): Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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ENDOCRINE SOC, 2020
2020
Engelska.
Ingår i: Journal of Clinical Endocrinology and Metabolism. - : ENDOCRINE SOC. - 0021-972X .- 1945-7197. ; 105:8, s. 2616-2624

Relaterad länk:: https://doi.org/10.1...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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Context: Whether multisystem morbidity in Cushings disease (CD) remains elevated during long-term remission is still undetermined. Objective: To investigate comorbidities in patients with CD. Design, Setting, and Patients: A retrospective, nationwide study of patients with CD identified in the Swedish National Patient Register between 1987 and 2013. Individual medical records were reviewed to verify diagnosis and remission status. Main Outcomes: Standardized incidence ratios (SIRs) with 95% confidence intervals (Os) were calculated by using the Swedish general population as reference. Comorbidities were investigated during three different time periods: (i) during the 3 years before diagnosis, (ii) from diagnosis to 1 year after remission, and (iii) during long-term remission. Results: We included 502 patients with confirmed CD, of whom 419 were in remission for a median of 10 (interquartile range 4 to 21) years. SIRs (95% CI) for myocardial infarction (4.4; 1.2 to 11.4), fractures (4.9; 2.7 to 8.3), and deep vein thrombosis (13.8; 3.8 to 35.3) were increased during the 3-year period before diagnosis. From diagnosis until 1 year after remission, SIRs (95% CI were increased for thromboembolism (18.3; 7.9 to 36.0), stroke (4.9; 1.3 to 12.5), and sepsis (13.6; 3.7 to 34.8). SIRs for thromboembolism (4.9; 2.6 to 8.4), stroke (3.1; 1.8 to 4.9), and sepsis (6.0; 3.1 to 10.6) remained increased during long-term remission. Conclusion: Patients with CD have an increased incidence of stroke, thromboembolism, and sepsis even after remission, emphasizing the importance of early identification and management of risk factors for these comorbidities during long-term follow-up.