Determinants of muscle function and health-related quality of life in patients with endogenous hypercortisolism: a cross-sectional study.
Determinants of muscle function and health-related quality of life in patients with endogenous hypercortisolism: a cross-sectional study.
复制标题
内源性皮质醇增多症患者肌肉功能和健康相关生活质量的决定因素：一项横断面研究。
DOI：
10.1093/ejendo/lvad069
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发表时间：
2023
影响因子：
5.8
通讯作者：
Bancos,Irina
中科院分区：
文献类型：
--
作者：
Li,Dingfeng;Zhang,CatherineD;Saini,Jasmine;Singh,Sumitabh;Nathani,Rohit;Thangamuthu,Karthik;Suresh,Malavika;Atkinson,ElizabethJ;Achenbach,SaraJ;VanGompel,Jamie;Young,WilliamF;Bancos,Irina
库欣综合征（CS）和轻度自主性皮质醇分泌（MACS）患者的临床和生化严重程度评分进行评估，肌肉功能（非优势手握力和坐立测试）和生活质量（简表-36 [SF 36]和CushingQoL）。从当地人口进行腹部成像的原因以外的其他可疑adrenal disorder.ResultsOf 164例，81（49%）有MACS，14（9%）有肾上腺CS，60（37%）有垂体CS，和9（5%）异位CS。中位年龄为53岁（四分位距：42-63岁），126例（77%）为女性。MACS患者的SF 36心理健康评分低于CS患者，但CS患者的躯体健康评分低于MACS患者（平均值为34.0 vs 40.5，P = 0.001）。与MACS相比，CS患者的标准化CushingQoL评分较低（平均47.1比34.2，P <0.001）。与参照受试者相比，MACS患者表现出肌肉力量降低，与CS患者相似（平均坐立Z评分为-0.47 vs-0.54，P = 0.822）。临床严重程度（r=-0.22，P = 0.004）而非生化严重程度与坐立测试performance.ConclusionsBoth患者与显性CS和MACS表现出肌肉力量下降和生活质量低。使用的临床严重程度评分与CushingQoL的身体和心理社会成分以及SF 36的身体成分相关。
ObjectiveProspective data on determinants of muscle strength impairment and quality of life in patients with various subtypes and severity of endogenous hypercortisolism are lacking.DesignSingle-center cross-sectional study, 2019 to 2022.MethodsPatients with Cushing syndrome (CS) and mild autonomous cortisol secretion (MACS) were assessed with clinical and biochemical severity scores, muscle function (nondominant hand grip strength and 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.ResultsOf 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 (interquartile range: 42-63 years), and 126 (77%) were women. The 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= .001). Compared to MACS, patients with CS had lower scores on the standardized CushingQoL (mean of 47.1 vs 34.2,P< .001). Compared to referent subjects, patients with MACS demonstrated reduced muscle strength, similar to patients with CS (mean sit to standZ-score of −0.47 vs −0.54,P= .822). Clinical severity (r= −0.22,P= .004) but not biochemical severity was associated with sit-to-stand test performance.ConclusionsBoth patients with overt CS and MACS demonstrate reduced muscle strength and low quality of life. The clinical severity score utilized is associated with both physical and psychosocial components of CushingQoL and with the physical component of SF36.