Table 1.

Course of clinical signs, comorbidities and biochemical variables at time of first diagnosis and at time of recurrence (N = 9) of the prospective Cushing cohort

	First diagnosis	Recurrence	p values
Clinical symptoms (frequency)
Weight gain	100%	56%
Buffalo hump	89%	11%
Moon face	78%	None
Bruises	68%	None
Plethora	67%	None
Muscle weakness	67%	11%
Loss of libido	67%	None
Odema	56%	11%
Thin skin	44%	22%
Hair loss	44%	None
Hirsutism	22%	None
Acne	11%	None
Mean number of symptoms	7.0 ± 3.4	1.1 ± 1.2	p = 0.01
Biochemical screening (median and quartiles)
9 am serum cortisol (µg/dL)  reference interval: 4–24 µg/dL	38 (20–45)	10 (8–11)	p = 0.01
ACTH (pg/mL)  reference interval: 10–50 pg/ml	96 (50–109)	34 (16–47)	p = 0.02
LDDST (µg/dL)  reference interval: <2	18 (15–27)	4 (3–6)	p = 0.01
Late-night salivary cortisol (ng/mL)  reference interval: <1.5 nmol/L	12 (5–22)	4 (2–5)	p = 0.01
UFC (µg/24 h)  reference interval: <85 µg/die	748 (394–1220)	111 (70–253)	p = 0.01
Clinical examination (median and quartiles)
BMI	27 (23–32)	24 (23–28)	p = 0.2
Hip (circumference in cm)	97 (94–101)	100 (98–102)	p = 0.5
Waist (circumference in cm)	110 (86–115)	97 (76–100)	p = 0.04
Upper arm (circumference in cm)	27 (26–30)	27 (26–30)	p = 0.6
Waist-hip-ratio	1.0 (0.97–1.15)	0.96 (0.80–0.97)	p = 0.03
Waist-height-ratio	0.59 (0.51–0.71)	0.51 (0.44–0.61)	p = 0.05
Waist-arm-ratio	3.6 (3.5–4.1)	3.2 (2.9–3.3)	p = 0.03
Blood pressure (systolic in mmHg)	149 (140–168)	129 (123–133)	p = 0.07
Blood pressure (diastolic in mmHg)	99 (87–111)	84 (78–89)	p = 0.06
Comorbidities (frequencies)
Hypertension	100%	33%
Diabetes mellitus	22%	11%
Dyslipidemia	67%	44%
Osteoporosis	44%	22%
Depression	22%	22%
Number of comorbidities	2.7 ± 0.9	1.4 ± 0.9	p = 0.03

Bold numbers indicate significance

UFC urinary free cortisol, LDDST 1-mg low-dose dexamethasone suppression test, TSS transsphenoidal surgery, LNSC late-night salivary cortisol