The Journal of clinical endocrinology and metabolism · 2026
Deterioration of blood lipids during early postoperative remission of Cushing's syndrome: a longitudinal cohort study.
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Schrenk Moritz, Haenelt Michael, Oettle Matthias, Kroiss Markus, Zopp Stephanie, Braun Leah T, Rubinstein German, Ritzel Katrin, Stüfchen Isabel, Stifel Ulrich, Schilbach Katharina, Bidlingmaier Martin, Teupser Daniel, Beuschlein Felix, Reincke Martin, Vogel Frederick, Nowak Elisabeth
Аннотация
CONTEXT: Cushing's syndrome (CS) is associated with an unfavorable lipid profile. However, data on lipid alterations during early postoperative remission, a particularly cardiovascular vulnerable period, are lacking.
OBJECTIVE: Evaluation of lipid profiles during active CS and the early postoperative period.
PATIENTS AND METHODS: In this single-center cohort study at LMU Hospital, Munich, we analyzed lipid profiles (total cholesterol, LDL, HDL, ApoA1, ApoB, lipoprotein (a), triglycerides, and non-esterified fatty acids) and metabolic markers in 26 patients with endogenous CS before surgery and 1, 3, 6, 12 and 24 months (n = 23) after curative surgery and compared them with 26 age-, BMI-, and sex-matched controls without hypercortisolism at baseline.
RESULTS: Paradoxically, most lipid parameters worsened postoperatively. One month following surgery, HDL (1 month postoperative 38 mg/dL [35-46] vs. active CS 49.5 mg/dL [45-61.3], P < .0001) and ApoA1 concentrations (1-month postoperative 160 mg/dL [147-168] vs. active CS 193 mg/dL [169-211], P < .0001) were significantly lower compared to preoperative levels. Similarly, 1-month following surgery triglycerides concentrations (1-month postoperative 185 mg/dL [154-218] vs. active CS 129 mg/dL [89.3-186] preoperatively, P < .0001) were higher. These changes remained evident until 6 months post-surgery. The triglyceride-glucose index increased during early remission and showed a positive correlation with inflammatory markers CRP and IL-6. Non-esterified fatty acids displayed 3 distinct postoperative trajectories depending on BMI at baseline.
CONCLUSION: During the early remission phase following curative surgery for CS, we observed a further deterioration in lipid parameters. This can affect cardiovascular health and provide the basis for targeted therapy.
OBJECTIVE: Evaluation of lipid profiles during active CS and the early postoperative period.
PATIENTS AND METHODS: In this single-center cohort study at LMU Hospital, Munich, we analyzed lipid profiles (total cholesterol, LDL, HDL, ApoA1, ApoB, lipoprotein (a), triglycerides, and non-esterified fatty acids) and metabolic markers in 26 patients with endogenous CS before surgery and 1, 3, 6, 12 and 24 months (n = 23) after curative surgery and compared them with 26 age-, BMI-, and sex-matched controls without hypercortisolism at baseline.
RESULTS: Paradoxically, most lipid parameters worsened postoperatively. One month following surgery, HDL (1 month postoperative 38 mg/dL [35-46] vs. active CS 49.5 mg/dL [45-61.3], P < .0001) and ApoA1 concentrations (1-month postoperative 160 mg/dL [147-168] vs. active CS 193 mg/dL [169-211], P < .0001) were significantly lower compared to preoperative levels. Similarly, 1-month following surgery triglycerides concentrations (1-month postoperative 185 mg/dL [154-218] vs. active CS 129 mg/dL [89.3-186] preoperatively, P < .0001) were higher. These changes remained evident until 6 months post-surgery. The triglyceride-glucose index increased during early remission and showed a positive correlation with inflammatory markers CRP and IL-6. Non-esterified fatty acids displayed 3 distinct postoperative trajectories depending on BMI at baseline.
CONCLUSION: During the early remission phase following curative surgery for CS, we observed a further deterioration in lipid parameters. This can affect cardiovascular health and provide the basis for targeted therapy.