Recommended Citation
Cecil A, Essien E, Amoako G, Agyekum A. Inflammatory Burden and Multisystem Outcomes in Cushing's Disease: A Five-Year Comparative Cohort Study Stratified by hs-CRP. Poster presentation at: American Association of Clinical Endocrinology Annual Meeting; April 23, 2026; Las Vegas, NV.
Presentation Notes
Poster presentation at: American Association of Clinical Endocrinology Annual Meeting; April 23, 2026; Las Vegas, NV.
Abstract
OBJECTIVE:
Cushing's disease is associated with significant cardiovascular and metabolic morbidity, yet the role of systemic inflammation as a prognostic marker remains incompletely characterized. We investigated whether elevated high-sensitivity C-reactive protein (hs-CRP) identifies a higher-risk phenotype among patients with pituitary-dependent Cushing's disease across multiple organ systems.
METHODS:
Using the TriNetX Global Collaborative Network (155 healthcare organizations), we conducted a propensity-matched comparative cohort analysis of adults with Cushing's disease stratified by hs-CRP levels (≥1.20 mg/L vs. <1.20 mg/L). Following 1:1 propensity score matching for demographics, comorbidities, and medication use, 617 patients per cohort were analyzed. Outcomes included mortality, cardiovascular events (myocardial infarction, heart failure, pulmonary embolism), chronic kidney disease, hypertension, type 2 diabetes, depression, osteoporosis, and cerebrovascular disease over a five-year follow-up period (1-1825 days post-index).
RESULTS:
Patients with elevated hs-CRP demonstrated significantly higher all-cause mortality (20.5% vs. 7.9%; HR 2.86, p<0.001) , increased risks of heart failure (7.9% vs. 4.5%; HR 1.98, p=0.023), and type 2 diabetes (14.5% vs. 6.1%; HR 2.71, 95% CI 1.65-4.45, p<0.001). No significant differences were observed in myocardial infarction (3.3% vs. 2.3%, p=0.303), chronic kidney disease (12.1% vs. 8.3%; p=0.052), hypertension (23.5% vs. 16.9%; p=0.067), pulmonary embolism (3.1% vs. 1.7%, p=0.118), depression (6.3% vs. 5.6%, p=0.606), osteoporosis (7.1% vs. 6.5%, p=0.704), or cerebrovascular disease (8.4% vs. 7.6%, p=0.635).
DISCUSSION/CONCLUSIONS:
In this propensity-matched cohort of patients with Cushing’s disease, elevated hs-CRP was associated with higher all-cause mortality and increased risks of heart failure and incident type 2 diabetes over five years. These findings suggest that systemic inflammation may identify a higher-risk phenotype within this population. No significant differences were observed for several other cardiovascular, renal, skeletal, or neuropsychiatric outcomes, indicating that the prognostic value of hs-CRP may be selective rather than global. Given the observational design and potential for residual confounding, hs-CRP should be interpreted as a risk marker rather than a causal mediator. Prospective studies are warranted to clarify its clinical utility and prognostic role in Cushing’s disease.
Type
Poster
Affiliations
Aurora Healthcare