Mondin, Alessandro and Ceccato, Filippo and Barbot, Mattia (2025) European survey on metabolic and cardiovascular risk in Cushing syndrome - Supplementary data. [Data Collection]
Collection description
Background: Cushing's syndrome (CS) is associated with increased metabolic and cardiovascular (CV) risk factors and morbidities. Evidence-based guidelines for the management of these issues in active or remitted CS are not available, so best practice is derived from guidelines developed for the general population. We aimed to evaluate the awareness and practice variation for CV comorbidities of CS across reference Centres (RCs) of the European Reference Network on Rare Endocrine Conditions (Endo-ERN). Methods: A dedicated online survey was distributed from June 2022 to December 2022 to Endo-ERN RCs with recognized expertise in adrenal and/or pituitary diseases. Results: 19 centres provided complete responses to the survey, accounting for an estimated pool of around one thousand chronically cared CS patients across Europe. Most ERN experts consider patients with CS at high CV risk irrespectively of remission status. Preoperative cortisol-lowering treatment was a common practice, especially for severe cases, and deemed effective in reducing CV risk by many. Most comorbidities were regularly evaluated at diagnosis and during follow-up, although a lack of provocative testing to diagnose diabetes (used only in 26% of RCs) was evidenced. A strict glycaemic control was encouraged although the glycaemic target differed. On the contrary, a less stringent approach to dyslipidaemia and overweight emerged. Preferred initial compounds for patients presenting comorbidities were angiotensin converting enzyme inhibitors, metformin and statins; lifestyle changes were preferred over drugs to control weight excess after cure. Screening for asymptomatic vascular disease was performed routinely and regularly repeated during follow-up by only half of the centres. Important heterogeneity in some responses emerged, especially regarding the effect of remission or medical treatment on comorbidities and CV risk. Discussion: Our survey highlights the awareness of ERN experts on management of metabolic and CV risk factors or disease in CS. Most of them use the current European guidelines and apply strategies for high CV risk patients, although not all these recommendations were fully applied. Since several CV risk factors seem to persist after disease remission, they should be adequately and promptly addressed. Population-specific studies are required to identify the optimal management of CV and metabolic comorbidities of CS patients.
| DOI: |  10.25430/researchdata.cab.unipd.it.00001504 |
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| Keywords: | Cushing’s syndrome, ACTH, cortisol, cardiovascular risk, arterial hypertension, diabetes, obesity, vascular disease. | ||||||||||||
| Subjects: | Life Sciences > Physiology, Pathophysiology and Endocrinology: Organ physiology, pathophysiology, endocrinology, metabolism, ageing, tumorigenesis, cardiovascular diseases, metabolic syndromes > Metabolism, biological basis of metabolism related disorders | ||||||||||||
| Department: | Departments > Dipartimento di Medicina (DIMED) | ||||||||||||
| Depositing User: | Alessandro Mondin | ||||||||||||
| Date Deposited: | 28 Feb 2025 13:19 | ||||||||||||
| Last Modified: | 28 Feb 2025 13:19 | ||||||||||||
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| Type of data: | Text | ||||||||||||
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| Resource language: | English | ||||||||||||
| Metadata language: | English | ||||||||||||
| Publisher: | Research Data Unipd | ||||||||||||
| Date: | 28 February 2025 | ||||||||||||
| Copyright holders: | The Author | ||||||||||||
| URI: | https://researchdata.cab.unipd.it/id/eprint/1504 |
orcid.org/0000-0002-6046-5198
