The effect of hypercortisolism treatment on dyslipidemia in Cushing syndrome: systematic review and meta-analysis
Authors' conclusion
Our study demonstrates a significant improvement in serum lipid levels after treatment of CS. Because the cardiovascular complications of hypercortisolism depend on several factors, further studies are needed to determine whether this directly translates into an adequate reduction in the risk of major cardiovascular events.
Study context
- Population
- Patients with Cushing syndrome (CS) treated for hypercortisolism; 29 observational or interventional studies (51.7% of good quality)29 studies
- Comparison
- After vs before CS treatment
- Outcome
- Serum lipid levels: TC, LDL-C, HDL-C and TG
Methodological detailsbefore-after analysis, subgroup analysis, Literature search of PubMed, Scopus and EMBASE
- Before-after analysis
- Subgroup analysis
- Literature search of PubMed, Scopus and EMBASE
Pooled result
As reported in the abstract
Serum lipids after vs before CS treatment
After treatment vs Before treatmentEstimate (95% CI)P value
Decrease in TC
MD (TC) −26.49(−29.95 to −23.04)
P < 0.00001Decrease in LDL-C
MD (LDL-C) −18.44(−21.30 to −15.57)
P < 0.00001Decrease in TG
MD (TG) −17.77(−22.70 to −12.84)
P < 0.00001No significant change in HDL-C
MD (HDL-C) −2.34(−6.96 to 2.28)
P = 0.32Further pooled results
Total cholesterol (TC) decrease by subgroup
- Greater decrease in TC with adrenal hypercortisolism, with steroidogenesis inhibitors, and with treatment duration ≥12 months
Glucose, BMI, waist circumference, insulin resistance index
- CS treatment significantly decreased blood glucose, BMI, waist circumference and insulin resistance index
Original publication
The effect of hypercortisolism treatment on dyslipidemia in Cushing syndrome: systematic review and meta-analysis. J Clin Endocrinol Metab. Published 23 December 2025. doi:10.
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