ARE THERE RELIABLE PREDICTORS FOR THE IMPAIRED QUALITY OF LIFE IN PATIENTS WITH CUSHING'S SYNDROME?

Abstract

Patients with Cushing's syndrome (CS) of any etiology experience a number of physical and psychological symptoms which impact negatively on health-related quality of life (HRQoL). HRQoL was measured using CushingQoL questionnaire. The first part of our study was a cross-sectional analysis of 141 patients with CS over a 10-year period. CushingQoL score was lower in pituitary CS compared to adrenal CS. Remission and older age were associated with better outcome on item 7 (physical appearance anxiety). In a multivariate regression analysis after adjustment for etiology, remission status, age, UFC, duration of hypercortisolism and presence of hypercortisolism-associated comorbidities the female gender was the only negative predictor associated with poorer outcome on each of the three scores. The presence of hypercortisolism-associated comorbidities independently predicted poorer outcome on the psychological and the global subscales.The second part of our research was a prospective study of 27 patients with adrenal adenoma. Achievement of remission independently predicted improvement of the total score of any patient. Studying in details and understanding the mechanisms of the impaired HRQoL in patients with CS is the only way to become aware of the problem and create methods that could help these patients.