Metabolic status in children with Cushing’s disease and its relationship with remission

Abstract

Introduction Complications of Cushing disease (CD), like diabetes and lipid disturbances, are the risk factors for higher morbidity and mortality. The study aimed to compare the metabolic status of patients with CD with obese children and assessed the impact of remission on metabolic consequences. Material and methods This retrospective study analyzed 32 patients (aged 5 to 17 years) with CD. We evaluated anthropometric data and laboratory parameters - cholesterol fractions, glucose, and insulin levels in an oral glucose tolerance test (OGTT). Results were obtained at the moment of diagnosis and after transsphenoidal pituitary surgery (TSS), leading to remission. The data were compared with the age-matched and body mass index-matched control groups. Results At diagnosis, 40% of patients had impaired glucose tolerance (IGT), 6.7% diabetes (DM), and 3% impaired fasting glucose (IFG). In the lipids profile, 81% of patients presented elevated total cholesterol (TC), 66.7% low-density lipoprotein (LDL-c), and 64% triglycerides (TG). After TSS, we detected only one child with IGT. Patients had lower glucose levels in 0 minutes ('), 30’, 90’,120’, insulin levels in 0’, 30’, and 90’ of OGTT, and lower TC and LDL-c than before TSS. There were statistically significant differences between the study and the control group in insulin levels at all-time points of the OGTT, fasting glucose levels, and 90' of the test. TC, LDL-c, and TG were statistically higher in the CD group. Conclusions Remission significantly impacts improving metabolic parameters. Patients with CD require a higher insulin level to maintain normoglycemia than patients with obesity.