Abstract
Background Glucose metabolism is frequently impaired in patients with Cushing's syndrome (CS) due to chronic exposure to excess glucocorticoids. Inflammation plays an essential role in the pathophysiology of diabetes mellitus (DM). The present study aimed to investigate the potential associations of inflammatory blood cell parameters, including white blood cell (WBC) count, neutrophil count, neutrophilic granulocyte percentage (NEUT%), lymphocyte count (LYM), and lymphocyte proportion (LYM%), with diabetes mellitus in Cushing's syndrome patients. Materials and Methods The cross-sectional study was conducted in Zhongshan Hospital of Fudan University, China. A total of 150 patients with Cushing's syndrome were retrospectively screened from 2017 to 2019. The demographic data, clinical data, and blood samples (lipids, adrenal, glucose, and inflammatory blood cell parameters) were recorded. Statistical analyses were carried out by using the SPSS software package, version 13.0. Results In this study, the prevalence of diabetes mellitus was 38.7% in patients with Cushing's syndrome. Patients with DM had higher WBC, neutrophil, NEUT% levels than patients without DM (p < 0.05). As the NEUT% increased, a stepwise increase in glucose and glycated hemoglobin (HbA1c) level was observed. In addition, in the multivariate logistic regression, NEUT% was a significant independent risk factor for DM, regardless of gender, age, body mass index (BMI), and triglyceride and 12 midnight cortisol (12 MN cortisol) level (OR = 2.542, 95% CI 1.337–4.835, p < 0.001). Conclusions In conclusion, elevated NEUT% level was linked to diabetes in patients with Cushing's syndrome. The neutrophilic granulocyte percentage may be referred to as a new predictor for diabetes in Cushing's syndrome patients.
Highlights
Cushing’s syndrome (CS) is a set of clinical symptoms caused by long-term exposure to excessive glucocorticoids (GCs) [1]
Diabetes mellitus is a joint complication of chronic exposure to glucocorticoids, and it can contribute to increased morbidity and mortality in CS patients [7]
We found diabetes mellitus (DM) patients had higher white blood cell (WBC) count level (7.8 ± 2.7 vs 6.7 ± 2.2) (p 0.008), neutrophil count (5.86 ± 2.6 vs 4.6 ± 2.1) (p < 0.001), and NEUT% (73.6 ± 11.1 vs 65.2 ± 11.1) (p < 0.001), as well as lower LYM% level (18.8 ± 9.7 vs 25.6 ± 9.5) (p < 0.001), whereas there was no significant difference in the lymphocyte count (Table 1). e mean NEUT% of DM patients was 73.6 ± 11.1, whereas that of non-DM patients was 65.2 ± 11.1 (p < 0.001) (Figure 1(a))
Summary
Cushing’s syndrome (CS) is a set of clinical symptoms caused by long-term exposure to excessive glucocorticoids (GCs) [1]. It was first described in 1912, with diverse clinical features and laboratory examination findings [2], such as obesity, hypertension, diabetes, hyperlipidemia, hirsutism, osteoporosis, and hypokalemia [3, 4]. Glucose metabolism is frequently impaired in patients with Cushing’s syndrome (CS) due to chronic exposure to excess glucocorticoids. E present study aimed to investigate the potential associations of inflammatory blood cell parameters, including white blood cell (WBC) count, neutrophil count, neutrophilic granulocyte percentage (NEUT%), lymphocyte count (LYM), and lymphocyte proportion (LYM %), with diabetes mellitus in Cushing’s syndrome patients. Elevated NEUT% level was linked to diabetes in patients with Cushing’s syndrome. Elevated NEUT% level was linked to diabetes in patients with Cushing’s syndrome. e neutrophilic granulocyte percentage may be referred to as a new predictor for diabetes in Cushing’s syndrome patients
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