Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität, München, Germany.
Department of Neurosurgery, University of Tuebingen, Tübingen, Germany.
Endocrine. 2021 Sep;73(3):674-681. doi: 10.1007/s12020-021-02707-z. Epub 2021 Apr 5.
Cushing's syndrome (CS) can lead to structural changes in the brain and cognitive impairment, but chemosensory function has not been investigated yet. The aim was to analyze sense of smell and taste in patients with CS and explore the effect of therapy.
The study cohort comprised 20 patients with florid CS treated between 2018 and 2020 in the outpatient clinic of the LMU Munich. We compared these 20 patients with CS to 40 healthy subjects matched for age, sex, and smoking status. Patients' sense of smell and taste was examined at diagnosis and 3 months after successful therapeutic surgery leading to clinical and biochemical remission. Odor threshold, discrimination, and identification were measured with "Sniffin' Sticks", taste was measured with "Taste Strips". Perceived sense of smell and taste was retrieved via a questionnaire.
Patients with florid CS had significantly reduced smell (total smell score 30.3 vs. 34.4, p < 0.0005) and taste scores (9.5 vs. 12.0, p < 0.0005) compared to controls and significantly more frequently hyposmia (55 vs. 2.5%, p < 0.0005), hypogeusia (40 vs. 0%, p < 0.0005), and self-reported chemosensory impairment (60 vs. 0%, p < 0.0005). Three months after successful surgery, CS patients showed significant improvement of odor threshold (8.1 vs. 7.0, p < 0.0005), odor discrimination (12.0 vs. 11.0, p = 0.003), total smell score (33.4 vs. 30.3, p < 0.0005), and taste (11.5 vs. 9.5, p = 0.003).
Chemosensory dysfunction is a novel and clinically relevant feature of CS.
库欣综合征（CS）可导致大脑结构改变和认知障碍，但嗅觉和味觉功能尚未得到研究。本研究旨在分析 CS 患者的嗅觉和味觉，并探讨治疗的效果。
研究队列包括 2018 年至 2020 年在慕尼黑大学门诊就诊的 20 例表现明显的 CS 患者。我们将这 20 例 CS 患者与 40 例年龄、性别和吸烟状况相匹配的健康对照进行比较。在诊断时和成功的治疗性手术导致临床和生化缓解后 3 个月，我们对患者的嗅觉和味觉进行了检查。嗅觉阈值、辨别和识别采用“Sniffin' Sticks”进行测量，味觉采用“Taste Strips”进行测量。通过问卷获取对嗅觉和味觉的感知。
与对照组相比，表现明显的 CS 患者的嗅觉（总嗅觉评分 30.3 对 34.4，p<0.0005）和味觉评分（9.5 对 12.0，p<0.0005）明显降低，且更频繁地出现嗅觉减退（55 对 2.5%，p<0.0005）、味觉减退（40 对 0%，p<0.0005）和自我报告的嗅觉和味觉障碍（60 对 0%，p<0.0005）。手术成功后 3 个月，CS 患者的嗅觉阈值（8.1 对 7.0，p<0.0005）、嗅觉辨别（12.0 对 11.0，p=0.003）、总嗅觉评分（33.4 对 30.3，p<0.0005）和味觉（11.5 对 9.5，p=0.003）均显著改善。
嗅觉和味觉功能障碍是 CS 的一个新的且具有临床相关性的特征。
