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

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

Papakokkinou, Eleni (författare): University of Gothenburg,Sahlgrenska University Hospital,Univ Gothenburg, Inst Med, Dept Internal Med & Clin Nutr, Sahlgrenska Acad, SE-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, SE-41345 Gothenburg, Sweden.

Olsson, Daniel S. (författare): University of Gothenburg,Sahlgrenska University Hospital,Univ Gothenburg, Inst Med, Dept Internal Med & Clin Nutr, Sahlgrenska Acad, SE-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, SE-41345 Gothenburg, Sweden.

Chantzichristos, Dimitrios (författare): University of Gothenburg,Sahlgrenska University Hospital,Univ Gothenburg, Inst Med, Dept Internal Med & Clin Nutr, Sahlgrenska Acad, SE-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, SE-41345 Gothenburg, Sweden.

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Dahlqvist, Per (författare): Umeå universitet,Umeå University,Institutionen för folkhälsa och klinisk medicin,Umeå Univ, Dept Publ Hlth & Clin Med, SE-90187 Umeå, Sweden.

Segerstedt, Elin (författare): Umeå universitet,Umeå University,Institutionen för folkhälsa och klinisk medicin,Umeå Univ, Dept Publ Hlth & Clin Med, SE-90187 Umeå, Sweden.

Olsson, Tommy (författare): Umeå universitet,Umeå University,Institutionen för folkhälsa och klinisk medicin,Umeå Univ, Dept Publ Hlth & Clin Med, SE-90187 Umeå, Sweden.

Petersson, Maria (författare): Karolinska Institutet,Karolinska University Hospital,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, SE-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol Metab & Diabetol, SE-17176 Stockholm, Sweden.

Berinder, Katarina (författare): Karolinska Institutet,Karolinska University Hospital,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, SE-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol Metab & Diabetol, SE-17176 Stockholm, Sweden.

Bensing, Sophie (författare): Karolinska Institutet,Karolinska University Hospital,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, SE-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol Metab & Diabetol, SE-17176 Stockholm, Sweden.

Höybye, Charlotte (författare): Karolinska Institutet,Karolinska University Hospital

Edén-Engström, Britt (författare): Uppsala University Hospital

Burman, Pia (författare): Lund University,Lunds universitet,Genomik, diabetes och endokrinologi,Forskargrupper vid Lunds universitet,Genomics, Diabetes and Endocrinology,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Endocrinol, SE-20502 Malmö, Sweden.

Bonelli, Lorenza (författare): Skåne University Hospital,Lund University,Lund Univ, Skane Univ Hosp, Dept Endocrinol, SE-20502 Malmö, Sweden.

Follin, Cecilia (författare): Skåne University Hospital,Skåne Univ Hosp, Dept Endocrinol, SE-22242 Lund, Sweden.

Petranek, David (författare): Skåne University Hospital,Skåne Univ Hosp, Dept Endocrinol, SE-22242 Lund, Sweden.

Erfurth, Eva Marie (författare): Skåne University Hospital,Skåne Univ Hosp, Dept Endocrinol, SE-22242 Lund, Sweden.

Wahlberg, Jeanette (författare): Linköping University,Linköping Univ, Dept Endocrinol, SE-58183 Linköping, Sweden.;Linköping Univ, Dept Med & Hlth Sci, SE-58183 Linköping, Sweden.

Ekman, Bertil (författare): Linköping University,Linköping Univ, Dept Endocrinol, SE-58183 Linköping, Sweden.;Linköping Univ, Dept Med & Hlth Sci, SE-58183 Linköping, Sweden.

Åkerman, Anna Karin (författare): Örebro University

Schwarcz, Erik (författare): Örebro University,Örebro Univ, Sch Hlth & Med Sci, Dept Internal Med, SE-70281 Örebro, Sweden.

Bryngelsson, Ing Liss (författare): Örebro University,Örebro University Hospital

Johannsson, Gudmundur (författare): University of Gothenburg,Sahlgrenska University Hospital,Univ Gothenburg, Inst Med, Dept Internal Med & Clin Nutr, Sahlgrenska Acad, SE-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, SE-41345 Gothenburg, Sweden.

Ragnarsson, Oskar (författare): University of Gothenburg,Sahlgrenska University Hospital,Univ Gothenburg, Inst Med, Dept Internal Med & Clin Nutr, Sahlgrenska Acad, SE-41345 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Endocrinol, SE-41345 Gothenburg, Sweden.

Bryngelsson, Ing-Liss (författare): Örebro Univ, Univ Hosp, Fac Med & Hlth, Dept Occupat & Environm Med, SE-70182 Örebro, Sweden.

Eden-Engstrom, Britt (författare)

Akerman, Anna-Karin (författare): Örebro Univ, Sch Hlth & Med Sci, Dept Internal Med, SE-70281 Örebro, Sweden.

Hoybye, Charlotte (författare): Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, SE-17176 Stockholm, Sweden.;Karolinska Univ Hosp, Dept Endocrinol Metab & Diabetol, SE-17176 Stockholm, Sweden.

Engström, Britt E (författare): Uppsala universitet,Endokrinologi och mineralmetabolism

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Washington : Oxford University Press, 2020
2020
Engelska.
Ingår i: The Journal of clinical endocrinology and metabolism. - Washington : Oxford University Press. - 1945-7197 .- 0021-972X. ; 105:8

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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CONTEXT: Whether multisystem morbidity in Cushing's 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 (CIs) 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.