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): Gothenburg University,Göteborgs universitet,University of Gothenburg,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,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition

Olsson, Daniel S, 1983 (författare): Gothenburg University,Göteborgs universitet,University of Gothenburg,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,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition

Chantzichristos, Dimitrios, 1976 (författare): Gothenburg University,Göteborgs universitet,University of Gothenburg,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,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition

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Dahlqvist, Per (författare): Umeå University,Umeå universitet,Avdelningen för medicin,Umeå Univ, Dept Publ Hlth & Clin Med, SE-90187 Umeå, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

Segerstedt, Elin (författare): Umeå University,Umeå universitet,Avdelningen för medicin,Umeå Univ, Dept Publ Hlth & Clin Med, SE-90187 Umeå, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

Olsson, Tommy (författare): Umeå University,Umeå universitet,Avdelningen för medicin,Umeå Univ, Dept Publ Hlth & Clin Med, SE-90187 Umeå, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

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

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

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

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

Engström, Britt E (författare): Uppsala universitet,Endokrinologi och mineralmetabolism,Department of Medical Sciences; Endocrinology, Diabetes and Metabolism, Uppsala University Hospital, Uppsala, Sweden

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,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,Lund Univ, Skane Univ Hosp, Dept Endocrinol, SE-20502 Malmö, Sweden.

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

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

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

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

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

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

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

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

Johannsson, Gudmundur, 1960 (författare): Gothenburg University,Göteborgs universitet,University of Gothenburg,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,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition

Ragnarsson, Oskar, 1971 (författare): Gothenburg University,Göteborgs universitet,University of Gothenburg,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,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition

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(creator_code:org_t)

2020-05-21
2020
Engelska.
Ingår i: Journal of Clinical Endocrinology and Metabolism. - Washington : Oxford University Press. - 0021-972X .- 1945-7197. ; 105:8, s. 2616-2624

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Cushing’s disease
cardiovascular
comorbidity
remission
sepsis
thromboembolism
cardiovascular
comorbidity
Cushing’s disease
remission
sepsis
thromboembolism

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