Cushing's syndrome in the elderly: data from the European Registry on Cushing's syndrome

• Type: Article in International Scientific Journal
• Date: 2023

Authors

Amodru, V (Author) Other; Ferriere, A (Author) Other; Tabarin, A (Author) Other; Castinetti, F (Author) Other; Tsagarakis, S (Author) Other; Toth, M (Author) Other; Feelders, RA (Author) Other; Webb, SM (Author) Other; Reincke, M (Author) Other; Netea-Maier, R (Author) Other; Kastelan, D (Author) Other; Elenkova, A (Author) Other; Maiter, D (Author) Other; Ragnarsson, O (Author) Other; Santos, A (Author) Other; Valassi, E (Author) Other; Amaral, C (Author) Other; Ambrogio, A (Author) Other; Aranda, G (Author) Other; Arosio, M (Author) Other; Balomenaki, M (Author) Other; Berr-Kirmair, C (Author) Other; Bertherat, J (Author) Other; Bolanowski, M (Author) Other; Bollerslev, J (Author) Other; Cardoso, H (Author) Other; Carvalho, Davide (Author) FMUP; Cavagnini, F (Author) Other; Ceccato, P (Author) Other; Chabre, O (Author) Other; Chanson, P (Author) Other; Christ, E (Author) Other; Demtröder Zentrum fur Endokrinologie, F (Author) Other; Denes, J (Author) Other; Deutschbein, T (Author) Other; Dimopoulou, C (Author) Other; Dreval, A (Author) Other; Droste, M (Author) Other; Duarte, JS (Author) Other; Dusek, T (Author) Other; Ertürk, E (Author) Other; Evang, JA (Author) Other; Fajardo, C (Author) Other; Fazel, J (Author) Other; Feelders, RA (Author) Other; Fica, S (Author) Other; García-Centeno, R (Author) Other; Ghigo, E (Author) Other; Goth, M (Author) Other; Godlewska, M (Author) Other; Greenman, Y (Author) Other; Halperin, I (Author) Other; Hanzu, FA (Author) Other; Hermus, A (Author) Other; Johannsson, G (Author) Other; Hubina, E (Author) Other; Januszewska, A (Author) Other; Kamenicky, P (Author) Other; Kasperlik-Zaluska, A (Author) Other; Kirchner, J (Author) Other; Kastelan, D (Author) Other; Komerdus, I (Author) Other; Kraljevic, I (Author) Other; Krsek, M (Author) Other; Kruszynska, A (Author) Other; Lamas, C (Author) Other; Lambrescu, I (Author) Other; Lang, S (Author) Other; Luger, A (Author) Other; Maiter, D (Author) Other; Marpole, N (Author) Other; Martin, S (Author) Other; Martinie, M (Author) Other; Martins Oliveira, MJ (Author) Other; Moros, O (Author) Other; Netea-Maier, R (Author) Other; Newell-Price, J (Author) Other; Orbetzova, M (Author) Other; Paiva, I (Author) Other; Pecori Giraldi, F (Author) Other; Percovich, JC (Author) Other; Pereira, AM (Author) Other; Pfeifer, M (Author) Other; Pickel, J (Author) Other; Pirags, V (Author) Other; Ragnarsson, O (Author) Other; Reghina, AD (Author) Other; Reincke, M (Author) Other; Riesgo, P (Author) Other; Roberts, M (Author) Other; Roerink, S (Author) Other; Roig, O (Author) Other; Rowan, C (Author) Other; Rudenko, P (Author) Other; Salvador, J (Author) Other; Santos, A (Author) Other; Scaroni, C (Author) Other; Sigurjonsdottir, HA (Author) Other; Skoric Polovina, T (Author) Other; Smith, R (Author) Other; Stachowska, B (Author) Other; Stalla, G (Author) Other; Strasburger, C (Author) Other; Tabarin, A (Author) Other; Terzolo, M (Author) Other; T¿ke, J (Author) Other; Tóth, M (Author) Other; Touraine, P (Author) Other; Trainer, PJ (Author) Other; Tsagarakis, S (Author) Other; Valassi, E (Author) Other; Vila, G (Author) Other; Vinay, S (Author) Other; Wagenmakers, M (Author) Other; Werner, S (Author) Other; Young, J (Author) Other; Zdunowski, P (Author) Other; Zopf, K (Author) Other; Zopp, S (Author) Other; Zosin, I (Author) Other

Journal

Title: European Journal of Endocrinology

Vol. 188

Pages: 395-406

ISSN: 0804-4643

Publisher: BioScientifica Ltd.

Other information

Authenticus ID: P-00Z-23K

DOI: 10.1093/ejendo/lvad008

Abstract (EN): <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objective</jats:title> <jats:p>To evaluate whether age-related differences exist in clinical characteristics, diagnostic approach, and management strategies in patients with Cushing's syndrome (CS) included in the European Registry on Cushing's Syndrome (ERCUSYN).</jats:p> </jats:sec> <jats:sec> <jats:title>Design</jats:title> <jats:p>Cohort study.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We analyzed 1791 patients with CS, of whom 1234 (69%) had pituitary-dependent CS (PIT-CS), 450 (25%) adrenal-dependent CS (ADR-CS), and 107 (6%) had an ectopic source (ECT-CS). According to the WHO criteria, 1616 patients (90.2%) were classified as younger (<65 years old) and 175 (9.8%) as older (¿65 years old).</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Older patients were more frequently males and had a lower Body Mass Index (BMI) and waist circumference when compared with the younger. Older patients also had a lower prevalence of skin alterations, depression, hair loss, hirsutism, and reduced libido, but a higher prevalence of muscle weakness, diabetes, hypertension, cardiovascular disease, venous thromboembolism, and bone fractures than younger patients, regardless of sex (P < .01 for all comparisons). Measurement of urinary free cortisol supported the diagnosis of CS less frequently in older patients when compared with the younger (P < .05). An extrasellar macroadenoma (macrocorticotropinoma with extrasellar extension) was more common in older PIT-CS patients than in the younger (P < .01). Older PIT-CS patients more frequently received cortisol-lowering medications and radiotherapy as a first-line treatment, whereas surgery was the preferred approach in the younger (P < .01 for all comparisons). When transsphenoidal surgery was performed, the remission rate was lower in the elderly when compared with their younger counterpart (P < .05).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Older CS patients lack several typical symptoms of hypercortisolism, present with more comorbidities regardless of sex, and are more often conservatively treated.</jats:p> </jats:sec>

Language: English

Type (Professor's evaluation): Scientific