Epidemiology and blood parameter changes in Cushing's syndrome - a population-based study

Area of Science:

• Endocrinology and Epidemiology
• Clinical Biochemistry
• Oncology

Background:

• Cushing's syndrome (CS) is a complex endocrine disorder with varied etiologies.
• Accurate epidemiological data and differentiation of biochemical markers are crucial for diagnosis and prognosis.
• Distinguishing between benign and malignant causes of CS impacts patient management and outcomes.

Purpose of the Study:

• To present comprehensive epidemiological data for Cushing's syndrome.
• To analyze and differentiate biochemical parameters, including blood count indices and inflammation scores, in CS patients.
• To identify markers that predict the severity and malignancy of CS.

Main Methods:

• Retrospective analysis of clinical records from 35 CS patients (2008-2020).
• Collection and detailed examination of clinical and biochemical data.
• Application of correlation and receiver operator characteristics (ROC) curve analyses to determine predictive thresholds for malignant CS.

Main Results:

• Standardized incidence rates for CS and its subtypes (CD, ectopic CS, adrenal adenoma, ACC) were established.
• Malignant CS cases showed significantly higher cortisol, tumor size, neutrophil-to-lymphocyte ratio (NLR), and systemic immune inflammation index, with lower potassium and lymphocyte-to-monocyte ratio.
• ROC analysis identified specific thresholds for potassium (<3.05), post-ODST cortisol (>841 nmol/L), and NLR (>3.9) with high sensitivity and specificity for predicting malignant CS.

Conclusions:

• Biochemical markers, blood count indices, and inflammatory scores significantly differ between benign and malignant endogenous CS.
• These indices serve as valuable tools for predicting disease severity and patient prognosis.
• The study highlights the utility of routine laboratory parameters in differentiating CS subtypes and guiding clinical decisions.