{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:06:43Z","timestamp":1791313603401,"version":"4.3.1"},"reference-count":36,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T00:00:00Z","timestamp":1599091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius Stiftung","doi-asserted-by":"crossref","award":["2012_A103"],"award-info":[{"award-number":["2012_A103"]}],"id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius Stiftung","doi-asserted-by":"crossref","award":["2015_A228"],"award-info":[{"award-number":["2015_A228"]}],"id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["314061271-TRR 205"],"award-info":[{"award-number":["314061271-TRR 205"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinician Scientist Program RISE"},{"DOI":"10.13039\/501100007952","name":"Eva Luise und Horst K\u00f6hler Stiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007952","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Munich Excellence Training Initiative for Physician Scientists"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Glucocorticoid-induced myopathy is a characteristic symptom of endogenous Cushing\u2019s syndrome (CS). Its long-term outcome is largely unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate long-term muscle function following the remission of endogenous CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Observational longitudinal cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary care hospitals and a specialized outpatient clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>As part of the prospective multicenter German Cushing\u2019s Registry, we assessed muscle strength in patients with overt endogenous CS. We studied the patients at the time of diagnosis (n = 88), after 6 months (n = 69), and thereafter annually, following surgical remission over a period of up to 4 years (1 year: n = 55; 2 years: n = 34; 3 years: n = 29; 4 years: n = 22). Muscle function was evaluated by hand grip strength and by chair rising test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Grip strength was decreased to 83% of normal controls (100%) at the time of diagnosis. It further decreased to 71% after 6 months in remission (P \u2264 0.001) and showed no improvement during further follow-up compared with baseline. Chair rising test performance improved initially (8 seconds at baseline vs 7 seconds after 6 months, P = 0.004) but remained at this reduced level thereafter (7 seconds after 3 years vs 5 seconds in controls, P = 0.038). In multivariate analysis, we identified, as predictors for long-term muscle dysfunction, age, waist-to-hip ratio, and hemoglobin A1c at baseline. Furthermore, muscle strength during follow-up was strongly correlated with quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study shows that CS-associated myopathy does not spontaneously resolve during remission. This calls for action to identify effective interventions to improve muscle dysfunction in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa625","type":"journal-article","created":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T15:32:24Z","timestamp":1599147144000},"page":"e4490-e4498","source":"Crossref","is-referenced-by-count":56,"title":["Persisting Muscle Dysfunction in Cushing\u2019s Syndrome Despite Biochemical Remission"],"prefix":"10.1210","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8821-8968","authenticated-orcid":false,"given":"Frederick","family":"Vogel","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah T","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7260-0748","authenticated-orcid":false,"given":"German","family":"Rubinstein","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Zopp","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"K\u00fcnzel","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finn","family":"Strasding","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Albani","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Riester","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Schmidmaier","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bidlingmaier","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4028-1671","authenticated-orcid":false,"given":"Marcus","family":"Quinkler","sequence":"additional","affiliation":[{"name":"Endocrinology in Charlottenburg, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Deutschbein","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7826-3984","authenticated-orcid":false,"given":"Felix","family":"Beuschlein","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"},{"name":"Klinik f\u00fcr Endokrinologie, Diabetologie und Klinische Ern\u00e4hrung, Universit\u00e4tsSpital Z\u00fcrich, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9817-9875","authenticated-orcid":false,"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Ludwig Maximilians University Munich, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2020,9,3]]},"reference":[{"issue":"5","key":"2021122106312550500_CIT0001","doi-asserted-by":"crossref","first-page":"913","DOI":"10.4103\/2230-8210.117215","article-title":"Glucocorticoid-induced myopathy: pathophysiology, diagnosis, and treatment","volume":"17","author":"Gupta","year":"2013","journal-title":"Indian J Endocrinol Metab."},{"issue":"4","key":"2021122106312550500_CIT0002","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1210\/jc.2002-021518","article-title":"Gender-related differences in the presentation and course of Cushing\u2019s disease","volume":"88","author":"Pecori Giraldi","year":"2003","journal-title":"J Clin Endocrinol Metab."},{"issue":"1","key":"2021122106312550500_CIT0003","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jbspin.2010.02.025","article-title":"Glucocorticoid-induced myopathy","volume":"78","author":"Pereira","year":"2011","journal-title":"Joint Bone Spine."},{"issue":"5","key":"2021122106312550500_CIT0004","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1007\/BF03347462","article-title":"Steroid myopathy: some unresolved issues","volume":"34","author":"Minetto","year":"2011","journal-title":"J Endocrinol Invest."},{"issue":"7","key":"2021122106312550500_CIT0005","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s40618-018-0979-9","article-title":"Ultrasound-based detection of glucocorticoid-induced impairments of muscle mass and structure in Cushing\u2019s disease","volume":"42","author":"Minetto","year":"2019","journal-title":"J Endocrinol Invest."},{"issue":"1","key":"2021122106312550500_CIT0006","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/S0733-8619(03)00053-7","article-title":"Neuromuscular manifestations of endocrine disorders","volume":"20","author":"Alshekhlee","year":"2002","journal-title":"Neurol Clin."},{"issue":"2","key":"2021122106312550500_CIT0007","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/00008483-199703000-00002","article-title":"Glucocorticoid-induced muscle atrophy. The role of exercise in treatment and prevention","volume":"17","author":"LaPier","year":"1997","journal-title":"J Cardiopulm Rehabil."},{"issue":"1","key":"2021122106312550500_CIT0008","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1038\/nrd4467","article-title":"Muscle wasting in disease: molecular mechanisms and promising therapies","volume":"14","author":"Cohen","year":"2015","journal-title":"Nat Rev Drug Discov."},{"issue":"2","key":"2021122106312550500_CIT0009","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1097\/PHM.0b013e31815869d0","article-title":"Strenuous exercise-induced alterations of muscle fiber cross-sectional area and fiber-type distribution in steroid myopathy rats","volume":"87","author":"Uchikawa","year":"2008","journal-title":"Am J Phys Med Rehabil."},{"issue":"9","key":"2021122106312550500_CIT0010","doi-asserted-by":"crossref","first-page":"E1640","DOI":"10.1210\/jc.2012-1945","article-title":"Long-term cognitive impairments and attentional deficits in patients with Cushing\u2019s disease and cortisol-producing adrenal adenoma in remission","volume":"97","author":"Ragnarsson","year":"2012","journal-title":"J Clin Endocrinol Metab."},{"issue":"11","key":"2021122106312550500_CIT0011","doi-asserted-by":"crossref","first-page":"3950","DOI":"10.1210\/jcem.84.11.6112","article-title":"Impaired cardiac performance in elderly patients with growth hormone deficiency","volume":"84","author":"Colao","year":"1999","journal-title":"J Clin Endocrinol Metab."},{"issue":"3","key":"2021122106312550500_CIT0012","first-page":"1078","article-title":"Loss of body cell mass in Cushing\u2019s syndrome: effect of treatment","volume":"87","author":"Pirlich","year":"2002","journal-title":"J Clin Endocrinol Metab."},{"issue":"5","key":"2021122106312550500_CIT0013","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1210\/jc.2011-3123","article-title":"Body composition and cardiovascular risk markers after remission of Cushing\u2019s disease: a prospective study using whole-body MRI","volume":"97","author":"Geer","year":"2012","journal-title":"J Clin Endocrinol Metab."},{"issue":"6","key":"2021122106312550500_CIT0014","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1530\/EJE-16-0689","article-title":"Persistence of myopathy in Cushing\u2019s syndrome: evaluation of the German Cushing\u2019s Registry","volume":"176","author":"Berr","year":"2017","journal-title":"Eur J Endocrinol."},{"issue":"4","key":"2021122106312550500_CIT0015","doi-asserted-by":"crossref","DOI":"10.1210\/clinem\/dgz286","article-title":"Decreased aerobic exercise capacity after long-term remission from Cushing syndrome: exploration of mechanisms","volume":"105","author":"Roerink","year":"2020","journal-title":"J Clin Endocrinol Metab."},{"key":"2021122106312550500_CIT0016","doi-asserted-by":"crossref","first-page":"766","DOI":"10.3389\/fendo.2019.00766","article-title":"Toward a diagnostic score in Cushing\u2019s syndrome","volume":"10","author":"Braun","year":"2019","journal-title":"Front Endocrinol (Lausanne)."},{"key":"2021122106312550500_CIT0017","article-title":"Supplementary data from: Persisting muscle dysfunction in Cushing\u2019s syndrome despite biochemical remission","author":"Vogel","year":"2020","journal-title":"Figshare."},{"issue":"2","key":"2021122106312550500_CIT0018","first-page":"69","article-title":"Grip and pinch strength: normative data for adults","volume":"66","author":"Mathiowetz","year":"1985","journal-title":"Arch Phys Med Rehabil."},{"issue":"10","key":"2021122106312550500_CIT0019","doi-asserted-by":"crossref","first-page":"705","DOI":"10.5014\/ajot.40.10.705","article-title":"Grip and pinch strength: norms for 6- to 19-year-olds","volume":"40","author":"Mathiowetz","year":"1986","journal-title":"Am J Occup Ther."},{"issue":"2","key":"2021122106312550500_CIT0020","doi-asserted-by":"crossref","first-page":"M85","DOI":"10.1093\/geronj\/49.2.M85","article-title":"A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission","volume":"49","author":"Guralnik","year":"1994","journal-title":"J Gerontol."},{"issue":"5","key":"2021122106312550500_CIT0021","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1530\/EJE-07-0762","article-title":"Evaluation of health-related quality of life in patients with Cushing\u2019s syndrome with a new questionnaire","volume":"158","author":"Webb","year":"2008","journal-title":"Eur J Endocrinol."},{"issue":"6","key":"2021122106312550500_CIT0022","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection","volume":"30","author":"Ware","year":"1992","journal-title":"Med Care."},{"issue":"11","key":"2021122106312550500_CIT0023","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1007\/s00103-004-0933-1","article-title":"Methodological views on the SF-36 summary scores based on the adult German population","volume":"47","author":"Ellert","year":"2004","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz."},{"issue":"5-6","key":"2021122106312550500_CIT0024","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s00103-013-1700-y","article-title":"Health related quality of life in adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)","volume":"56","author":"Ellert","year":"2013","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz."},{"key":"2021122106312550500_CIT0025","doi-asserted-by":"crossref","first-page":"173653","DOI":"10.1155\/2015\/173653","article-title":"Mental fatigue and executive dysfunction in patients with Cushing\u2019s syndrome in remission","volume":"2015","author":"Papakokkinou","year":"2015","journal-title":"Behav Neurol."},{"issue":"2","key":"2021122106312550500_CIT0026","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1530\/eje.1.01953","article-title":"Steroid withdrawal syndrome after successful treatment of Cushing\u2019s syndrome: a reminder","volume":"153","author":"Bhattacharyya","year":"2005","journal-title":"Eur J Endocrinol."},{"issue":"6","key":"2021122106312550500_CIT0027","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1210\/jcem.81.6.8964868","article-title":"Acute glucocorticoid deficiency is associated with plasma elevations of interleukin-6: does the latter participate in the symptomatology of the steroid withdrawal syndrome and adrenal insufficiency?","volume":"81","author":"Papanicolaou","year":"1996","journal-title":"J Clin Endocrinol Metab."},{"issue":"8","key":"2021122106312550500_CIT0028","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1111\/dme.12991","article-title":"Dynapenic obesity and the risk of incident Type 2 diabetes: the English Longitudinal Study of Ageing","volume":"33","author":"Cuthbertson","year":"2016","journal-title":"Diabet Med."},{"issue":"1","key":"2021122106312550500_CIT0029","first-page":"131","article-title":"Suppressed spontaneous and stimulated growth hormone secretion in patients with Cushing\u2019s disease before and after surgical cure","volume":"78","author":"Magiakou","year":"1994","journal-title":"J Clin Endocrinol Metab."},{"issue":"1-3","key":"2021122106312550500_CIT0030","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jsbmb.2009.05.014","article-title":"Glucocorticoid-induced apoptosis and cellular mechanisms of myopathy","volume":"117","author":"Dirks-Naylor","year":"2009","journal-title":"J Steroid Biochem Mol Biol."},{"issue":"2","key":"2021122106312550500_CIT0031","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/cen.13512","article-title":"Impact of hypercortisolism on skeletal muscle mass and adipose tissue mass in patients with adrenal adenomas","volume":"88","author":"Delivanis","year":"2018","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"1","key":"2021122106312550500_CIT0032","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/s12020-018-1598-0","article-title":"Alteration in skeletal muscle mass in women with subclinical hypercortisolism","volume":"61","author":"Kim","year":"2018","journal-title":"Endocrine."},{"issue":"2","key":"2021122106312550500_CIT0033","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/cen.13902","article-title":"Changes of computed tomography-based body composition after adrenalectomy in patients with endogenous hypercortisolism","volume":"90","author":"Hong","year":"2019","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"1-2","key":"2021122106312550500_CIT0034","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.clinbiochem.2006.09.002","article-title":"Study of skeletal muscle glycogenolysis and glycolysis in chronic steroid myopathy, non-steroid histochemical type-2 fiber atrophy, and denervation","volume":"40","author":"Danon","year":"2007","journal-title":"Clin Biochem."},{"issue":"3","key":"2021122106312550500_CIT0035","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1007\/s12020-017-1370-x","article-title":"Cushing\u2019s syndrome: a model for sarcopenic obesity","volume":"57","author":"Drey","year":"2017","journal-title":"Endocrine."},{"issue":"1","key":"2021122106312550500_CIT0036","doi-asserted-by":"crossref","DOI":"10.1210\/clinem\/dgz052","article-title":"Glucocorticoid receptor polymorphisms influence muscle strength in Cushing\u2019s syndrome","volume":"105","author":"Muller","year":"2020","journal-title":"J Clin Endocrinol Metab."}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaa625\/33712190\/dgaa625.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/105\/12\/e4490\/41829524\/dgaa625.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/105\/12\/e4490\/41829524\/dgaa625.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T01:32:20Z","timestamp":1640050340000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/105\/12\/e4490\/5901134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,3]]},"references-count":36,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,9,3]]},"published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaa625","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,9,3]]}}}