Abstract：
It is held that the condition of endogenous chronic hypersecretion of cortisol (Cushing syndrome, CS), causes several comorbidities, including cardiovascular and metabolic disorders, musculoskeletal alterations, as well as cognitive and mood impairment. Therefore, CS has an adverse impact on the quality of life and life expectancy of affected patients. What remains unclear is whether disease remission may induce a normalization of the associated comorbid conditions. In order to retrieve updated information on this issue, we conducted a systematic search using the Pubmed and Embase databases to identify scientific papers published from January 1, 2000, to December 31, 2022. The initial search identified 1907 potentially eligible records. Papers were screened for eligibility and a total of 79 were included and classified by the main topic (cardiometabolic risk, thromboembolic disease, bone impairment, muscle damage, mood disturbances and quality of life, cognitive impairment, and mortality). Although the limited patient numbers in many studies preclude definitive conclusions, most recent evidence supports the persistence of increased morbidity and mortality even after long-term remission. It is conceivable that the degree of normalization of the associated comorbid conditions depends on individual factors and characteristics of the conditions. These findings highlight the need for early recognition and effective management of patients with CS, which should include active treatment of the related comorbid conditions. In addition, it is important to maintain a surveillance strategy in all patients with CS, even many years after disease remission, and to actively pursue specific treatment of comorbid conditions beyond cortisol normalization.
摘要：
认为内源性慢性皮质醇分泌过多(库欣综合征，CS),导致几种合并症，包括心血管和代谢紊乱,肌肉骨骼改变，以及认知和情绪障碍。因此,CS对受影响患者的生活质量和预期寿命有不利影响。尚不清楚的是，疾病缓解是否会导致相关的合并症正常化。为了检索有关此问题的更新信息，我们使用Pubmed和Embase数据库进行了系统检索,以确定2000年1月1日至2022年12月31日发表的科学论文.初始搜索识别了1907个潜在合格的记录。对论文进行了资格筛选，共纳入了79篇论文，并按主要主题（心脏代谢风险，血栓栓塞性疾病,骨损伤,肌肉损伤,情绪障碍和生活质量，认知障碍，和死亡率）。尽管许多研究中患者数量有限，但无法得出明确的结论，最新证据支持即使在长期缓解后,发病率和死亡率仍持续增加.可以想象，相关的合并症的归一化程度取决于个体因素和条件的特征。这些发现强调了早期识别和有效管理CS患者的必要性，其中应包括相关合并症的积极治疗。此外,在所有CS患者中保持监测策略很重要，甚至在疾病缓解多年后，并积极寻求皮质醇正常化以外的合并症的特定治疗。
