Blood lipids worsen after surgery for Cushing's syndrome

Lipid parameters tend to get worse during the early remission phase following curative surgery for Cushing’s syndrome (CS), reveals a study.

“This can affect cardiovascular health and provide the basis for targeted therapy,” the authors said.

Most lipid parameters deteriorated following surgery in CS patients. At 1 month postoperatively, high-density lipoprotein (38 vs 49.5 mg/dL; p<0.0001) and apolipoprotein A1 concentrations (160 vs 193 mg/dL; p<0.0001) were markedly lower than preoperative levels.

Furthermore, triglyceride concentrations were higher (185 vs 129 mg/dL; p<0.0001) at 1 month after surgery. These changes persisted until 6 months following the procedure.

The triglyceride-glucose index showed an increase during early remission and was positively associated with inflammatory markers C-reactive protein and interleukin-6. Nonesterified fatty acids exhibited three distinct trajectories after surgery, depending on BMI at baseline.

This single-centre cohort study analysed lipid profiles and metabolic markers in 26 patients with endogenous CS prior to surgery and at 1, 3, 6, 12, and 24 months (n=23) after curative surgery. The authors compared these parameters with 26 age-, BMI-, and sex-stratified controls with no hypercortisolism at baseline.

“CS is associated with an unfavourable lipid profile,” the authors said. “However, data on lipid alterations during early postoperative remission, a particularly cardiovascular vulnerable period, are lacking.”