Determinants of Muscle Function and Health-Related Quality of Life in Patients with Endogenous Hypercortisolism: A Cross-Sectional Study
Abstract
OBJECTIVE
Prospective data on determinants of muscle strength impairment and quality of life in patients with various subtypes and severity of endogenous hypercortisolism are lacking.
DESIGN
Single-center cross-sectional study, 2019 to 2022.
METHODS
Patients with Cushing syndrome (CS) and mild autonomous cortisol secretion (MACS) were assessed with clinical and biochemical severity score, muscle function (non-dominant hand grip strength, sit-to-stand test), and quality of life(Short Form-36 [SF36] and CushingQoL). Referent subjects were recruited from the local population undergoing abdominal imaging for reasons other than suspected adrenal disorder.
RESULTS
Of 164 patients, 81(49%) had MACS, 14(9%) had adrenal CS, 60(37%) had pituitary CS, and 9(5%) had ectopic CS. Median age was 53 years (IQR: 42-63 years), and 126 (77%) were women. SF36 mental component score was similarly low in patients with MACS vs CS, but physical component score was lower in CS when compared to MACS (mean of 34.0 vs 40.5, P = 0.001). Compared to MACS, patients with CS had lower scores on the standardized CushingQoL (mean of 47.1 v 34.2, P < 0.001). Compared to referent subjects, patients with MACS demonstrated reduced muscle strength, similar to patients with CS (mean Sit to stand Z score of -0.47 vs -0.54, P = 0.822). Clinical severity (r = -0.22, P = 0.004) but not biochemical severity was associated with sit-to-stand test performance.
CONCLUSIONS
Both patients with overt CS and MACS demonstrate…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 164 participants or records.
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