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27-03-2020

The association between physical activity, sleep, and quality of life in patients in bio-chemical remission from Cushing’s syndrome

Auteurs: Susette A. Moyers, Jitske Tiemensma

Gepubliceerd in: Quality of Life Research | Uitgave 8/2020

Abstract

Purpose

Cushing’s syndrome can negatively affect patient’s quality of life (QoL) after treatment and remission. Exposure to increased cortisol over time can result in visceral obesity, which makes this population vulnerable to cardiovascular risk factors associated with visceral obesity. Sleep disturbances are present in patients in remission from Cushing’s syndrome, impacting QoL. Moderate intensity physical activity performed 3 times a week decreases visceral obesity and improves sleep quality, therefore, engaging in physical activity after remission may improve patient’s QoL. The current study aims to explore the association between sleep quality, physical activity, and QoL in patients in remission of Cushing’s syndrome.

Methods

Patients in bio-chemical remission from Cushing’s syndrome (N = 147) were recruited through the Cushing’s Support and Research Foundation. Quality of life was assessed using the Cushing Quality of Life Questionnaire (CushingQoL), sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI), and physical activity levels were assessed with the Godin-Sheppard Leisure-Time Physical Activity Questionnaire (GSLTPAQ).

Results

Sleep quality was significantly associated with both subscales of the CushingQoL (both p < .001), but physical activity was not significantly associated with either subscale. Sleep was not significantly associated with physical activity engagement in this sample.

Conclusion

Results suggest that patients in remission from Cushing’s syndrome experience sleep disturbances that are significantly associated with impaired QoL. Future research should focus on ameliorating the persisting clinical features of Cushing’s syndrome that are associated with impaired QoL after bio-chemical remission to improve QoL and expedite complete functional remission.

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Boscaro, M., Barzon, L., Fallo, F., & Sonino, S. (2001). Cushing’s Syndrome. Lancet,357, 783–791. https://doi.org/10.1016/S0140-6736(00)04172-6.CrossRefPubMed

Valassi, E., Crespo, I., Santos, A., & Webb, S. M. (2012). Clinical consequences of Cushing’s syndrome. Pituitary,15, 319–329. https://doi.org/10.1007/s11102-012-0394-8.CrossRefPubMed

Newell-Price, J., Bertagna, X., Grossman, A. B., & Nieman, L. K. (2006). Cushing’s syndrome. Lancet,367, 1605–1617. https://doi.org/10.1016/S0140-6736(06)68699-6.CrossRefPubMed

van Aken, M. O., Pereira, A. M., Biermasz, N. R., van Thiel, S. W., Hoftijzer, H. C., Smit, J. W. A., et al. (2005). Quality of life in patients after long-term biochemical cure of Cushing’s disease. The Journal of Clinical Endocrinology & Metabolism,90(6), 3279–3286. https://doi.org/10.1210/jc.2004-1375.CrossRef

Lindsay, J. R., Nansel, T., Baid, S., Gumowski, J., & Nieman, L. K. (2006). Long-term impaired quality of life in Cushing’s syndrome despite initial improvement after surgical remission. The Journal of Clinical Endocrinology & Metabolism,91(2), 447–453. https://doi.org/10.1210/jc.2005-1058.CrossRef

Sonino, N., Bonnini, S., Fallo, F., Boscaro, M., & Fava, G. A. (2006). Personality characteristics and quality of life in patients treated for Cushing’s syndrome. Clinical Endocrinology,64(3), 314–318. https://doi.org/10.1111/j.1365-2265.2006.02462.x.CrossRefPubMed

Colao, A., Pivonello, R., Spiezia, S., Faggiano, A., Ferone, D., & Filippella, M. (1999). Persistence of increased cardiovascular risk in patients with Cushing's disease after five years of successful cure. The Journal of Clinical Endocrinology and Metabolism,84, 2664–2672. https://doi.org/10.1210/jcem.84.8.5896.CrossRefPubMed

Forget, H., Lacroix, A., & Cohen, H. (2002). Persistent cognitive impairment following surgical treatment of Cushing’s syndrome. Psychoneuroendocrinology,27, 376–382. https://doi.org/10.1016/S0306-4530(01)00059-2.CrossRef

Czepielewski, M. A., Rollin, G. A., Casagrande, A., & Ferreira, N. P. (2007). Criteria of cure and remission in Cushing’s disease: An update. Arquivos Brasileiros de Endocrinologia & Metabologia,51(8), 1362–1372. https://doi.org/10.1590/S0004-27302007000800023.CrossRef

10.

Webb, S. M., Crespo, I., Santos, A., Resmini, E., Aulinas, A., & Valassi, E. (2017). Quality of life tools for the management of pituitary disease. European Journal of Endocrinology,177, R13–26. https://doi.org/10.1530/EJE-17-0041.CrossRefPubMed

11.

Hays, R. D. (2008). Reeve B (2010) Measurement and modeling of health-related quality of life. In K. Heggenhougen & S. Quah (Eds.), International encyclopedia of public health (Vol. 4, pp. 241–252). San Diego: Academic Press.CrossRef

12.

Pivonello, R., Faggiano, A., Lombardi, G., & Colao, A. (2005). The metabolic syndrome and cardiovascular risk in Cushing’s syndrome. Endocrinology and Metabolism Clinics of North America,34(2), 327–339. https://doi.org/10.1016/j.ecl.2005.01.010.CrossRefPubMed

13.

Resmini, E., Minuto, F., Colao, A., & Ferone, D. (2009). Secondary diabetes associated with principal endocrinopathies: The impact of new treatment modalities. Acta Diabetologica,46(2), 85–95. https://doi.org/10.1007/s00592-009-0112-9.CrossRefPubMed

14.

Shipley, J. E., Schteingart, D. E., Tandon, R., & Starkman, M. N. (1992). Sleep architecture and sleep apnea in patients with Cushing’s disease. Sleep,15(6), 514–518. https://doi.org/10.1093/sleep/15.6.514.CrossRefPubMed

15.

Lipsky, R. H., & Marini, A. M. (2007). Brain-derived neurotrophic factor in neuronal survival and behavior-related plasticity. Annals of the New York Academy of Sciences,1122(1), 130–143. https://doi.org/10.1196/annals.1403.009.CrossRefPubMed

16.

Huang, E. J., & Reichardt, L. F. (2001). Neurotrophins: Roles in neuronal development and function. Annual Review of Neuroscience,24(1), 677–736. https://doi.org/10.1146/annurev.neuro.24.1.677.CrossRefPubMedPubMedCentral

17.

Bourdeau, I., Bard, C., Noël, B., Leclerc, I., Cordeau, M. P., Bélair, M., et al. (2002). Loss of brain volume in endogenous Cushing’s syndrome and its reversibility after correction of hypercortisolism. The Journal of Clinical Endocrinology & Metabolism,87(5), 1949–1954. https://doi.org/10.1210/jcem.87.5.8493.CrossRef

18.

Giese, M., Unternährer, E., Hüttig, H., Beck, J., Brand, S., Calabrese, P., et al. (2014). BDNF: An indicator of insomnia? Molecular Psychiatry,19(2), 151–152. https://doi.org/10.1038/mp.2013.10.CrossRefPubMed

19.

Pires, P., Santos, A., Vives-Gilabert, Y., Webb, S. M., Sainz-Ruiz, A., Resmini, E., et al. (2017). White matter involvement on DTI-MRI in Cushing’s syndrome relates to mood disturbances and processing speed: A case-control study. Pituitary,20(3), 340–348. https://doi.org/10.1007/s11102-017-0793-y.CrossRefPubMed

20.

Valassi, E., Crespo, I., Keevil, B. G., Aulinas, A., Urgell, E., Santos, A., et al. (2017). Affective alterations in patients with Cushing’s syndrome in remission are associated with decreased BDNF and cortisone levels. European Journal of Endocrinology,176(2), 221–231. https://doi.org/10.1530/EJE-16-0779.CrossRefPubMed

21.

Martinez-Momblan, M. A., Gomez, C., Santos, A., Porta, N., Esteve, J., Ubeda, I., et al. (2015). A specific nursing educational program in patients with Cushing’s syndrome. Endocrine,53(1), 199–209. https://doi.org/10.1007/s12020-015-0737-0.CrossRefPubMed

22.

van der Klaauw, A. A., Kars, M., Biermasz, N. R., Roelfsema, F., Dekkers, O. M., Corssmit, E. P., et al. (2008). Disease-specific impairments in quality of life during long-term follow up of patients with different pituitary adenomas. Clinical Endocrinology,69, 775–784. https://doi.org/10.1111/j.1365-2265.2008.03288.x.CrossRefPubMed

23.

Biermasz, N. R., Joustra, S. D., Donga, E., Pereira, A. M., van Duinen, N., van Dijk, M., et al. (2011). Patients previously treated for nonfunctioning pituitary macroadenomas have disturbed sleep characteristics, circadian movement rhythm and subjective sleep quality. Journal of Clinical Endocrinology and Metabolism,96, 1524–1532. https://doi.org/10.1111/j.1365-2265.2008.03288.x.CrossRefPubMed

24.

Xiao, Q., Keadle, S. K., Hollenbeck, A. R., & Matthews, C. E. (2014). Sleep duration and total and cause-specific mortality in a large US cohort: Interrelationships with physical activity, sedentary behavior, and body mass index. American Journal of Epidemiology,15, 997–1006. https://doi.org/10.1093/aje/kwu222.CrossRef

25.

Holfeld, B., & Ruthig, J. C. (2014). A longitudinal examination of sleep quality and physical activity in older adults. Journal of Applied Gerontology,33, 791–807. https://doi.org/10.1177/0733464812455097.CrossRefPubMed

26.

Reid, K. J., Baron, K. G., Lu, B., Naylor, E., Wolfe, L., & Zee, P. C. (2010). Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep medicine,11(9), 934–940. https://doi.org/10.1016/j.sleep.2010.04.014.CrossRefPubMedPubMedCentral

27.

Martin, C. K., Church, T. S., Thompson, A. M., Earnest, C. P., & Blair, S. N. (2009). Exercise dose and quality of life. Archives of Internal Medicine,169(3), 269. https://doi.org/10.1001/archinternmed.2008.545.CrossRefPubMedPubMedCentral

28.

Ohkawara, K., Tanaka, S., Miyachi, M., Ishikawa-Takata, K., & Tabata, I. (2007). A dose–response relation between aerobic exercise and visceral fat reduction: Systematic review of clinical trials. International Journal of Obesity,31(12), 1786–1797. https://doi.org/10.1038/sj.ijo.0803683.CrossRefPubMed

29.

Ballor, D. L., & Keesey, R. E. (1991). A meta-analysis of the factors affceting exercise-induced changes in body mass, fat mass, and fat-free mass in males and females. International Journal of Obesity,15, 717–726.PubMed

30.

Wallace, B., & Cumming, R. (2000). Systematic review of randomized trials of the effect of exercise on bone mass in pre- and postmenopausal women. Calcified Tissue International,67, 10–18. https://doi.org/10.1007/s00223001089.CrossRefPubMed

31.

Liu, C., Shiroy, D. M., Jones, L. Y., & Clark, D. O. (2014). Systematic review of functional training on muscle strength, physical functioning, and activities of daily living in older adults. European Review of Aging and Physical Activity,11, 95–106. https://doi.org/10.1007/s11556-014-0144-1.CrossRef

32.

Smith, P. J., Blumenthal, J. A., Hoffman, B. M., Cooper, H., Strauman, T. A., Welsh-Bohmer, K., et al. (2010). Aerobic exercise and neurocognitive performance: A meta-analytic review of randomized controlled trials. Psychosomatic Medicine,72(3), 239–252. https://doi.org/10.1097/PSY.0b013e3181d14633.CrossRefPubMedPubMedCentral

33.

Dunn, A. L., Trivedi, M. H., & ONeal, H. A. (2001). Physical activity dose-response effects on outcomes of depression and anxiety. Medicine & Science in Sports & Exercise,33(6Suppl), S587–S597. https://doi.org/10.1097/00005768-200106001-00027.CrossRef

34.

Rao, G. H. (2018). Prevention or reversal of cardiometabolic diseases. Journal of Clinical and Preventive Cardiology,7(1), 22. https://doi.org/10.4103/JCPC.JCPC_41_17.CrossRef

35.

Zoladz, J. A., Pilc, A., Majerczak, J., Grandys, M., Zapart-Bukowska, J., & Duda, K. (2008). Endurance training increases plasma brain-derived neurotrophic factor concentration in young healthy men. Journal of Physiology and Pharmacology,59(7), 119–132.PubMed

36.

Seifert, T., Brassard, P., Wissenberg, M., Rasmussen, P., Nordby, P., Stallknecht, B., et al. (2010). Endurance training enhances BDNF release from the human brain. AJP: Regulatory, Integrative and Comparative Physiology,298(2), R372–R377. https://doi.org/10.1152/ajpregu.00525.2009.CrossRef

37.

Erickson, K. I., Miller, D. L., & Roecklein, K. A. (2012). The aging hippocampus: Interactions between exercise, depression, and BDNF. The Neuroscientist: A Review Journal Bringing Neurobiology, Neurology and Psychiatry,18(1), 82–97. https://doi.org/10.1177/1073858410397054.CrossRef

38.

Donnelly, J. E., Blair, S. N., Jakicic, J. M., Manore, M. M., Rankin, J. W., & Smith, B. K. (2009). Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Medicine & Science in Sports & Exercise,41(2), 459–471. https://doi.org/10.1249/mss.0b013e3181949333.CrossRef

39.

Webb, S. M., Badia, X., Barahona, M. J., Colao, A., Strasburger, C. J., Tabarin, A., et al. (2008). Evaluation of health-related quality of life in patients with Cushing’s syndrome with a new questionnaire. European Journal of Endocrinology,158(5), 623–630. https://doi.org/10.1530/EJE-07-0762.CrossRefPubMed

40.

Tiemensma, J., Depaoli, S., & Felt, J. M. (2016). Using subscales when scoring the Cushing’s quality of life questionnaire. European Journal of Endocrinology,174(1), 33–40. https://doi.org/10.1530/EJE-15-0640.CrossRefPubMed

41.

Santos, A., Resmini, E., Martínez-Momblán, M. A., Crespo, I., Valassi, E., Roset, M., et al. (2012). Psychometric performance of the CushingQoL questionnaire in conditions of real clinical practice. European Journal of Endocrinology,167(3), 337–342. https://doi.org/10.1530/eje-12-0325.CrossRefPubMed

42.

Godin, G. (2011). The Godin-Shephard Leisure Time Physical Activity Questionnaire. The Health & Fitness Journal of Canada,4(1), 18–22. https://doi.org/10.14288/hfjc.v4i1.82.CrossRef

43.

Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., et al. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults. Medicine & Science in Sports & Exercise,43(7), 1334–1359. https://doi.org/10.1249/MSS.0b013e318213fefb.CrossRef

44.

Amireault, S., Godin, G., Lacombe, J., & Sabiston, C. M. (2015). Validation of the Godin-Shephard Leisure-Time Physical Activity Questionnaire classification coding system using accelerometer assessment among breast cancer survivors. Journal of Cancer Survivorship,9(3), 532–540. https://doi.org/10.1007/s11764-015-0430-6.CrossRefPubMed

45.

Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research,28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4.CrossRefPubMed

46.

Backhaus, J., Junghanns, K., Broocks, A., Riemann, D., & Hohagen, F. (2002). Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. Journal of Psychosomatic Research,53(3), 737–740. https://doi.org/10.1016/S0022-3999(02)00330-6.CrossRefPubMed

47.

Buysse, D. J., Reynolds, C. F., Monk, T. H., Hoch, C. C., Yeager, A. L., & Kupfer, D. J. (1991). Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep,14(4), 331–338. https://doi.org/10.1093/sleep/14.4.331.CrossRefPubMed

48.

Irwin, M. L., Ainsworth, B. E., & Conway, J. M. (2001). Estimation of energy expenditure from physical activity measures: Determinants of accuracy. Obesity Research,9(9), 517–525. https://doi.org/10.1038/oby.2001.68.CrossRefPubMed

49.

Prince, S. A., Adamo, K. B., Hamel, M. E., Hardt, J., Gorber, S. C., & Tremblay, M. (2008). A comparison of direct versus self-report measures for assessing physical activity in adults: A systematic review. International journal of behavioral nutrition and physical activity,5(1), 56. https://doi.org/10.1186/1479-5868-5-56.CrossRef

50.

Wagenmakers, M. M., Netea-Maier, R. T., Prins, J., Dekkers, T., Den Heijer, M., & Hermus, A. M. (2012). Impaired quality of life in patients in long-term remission of Cushing’s syndrome of both adrenal and pituitary origin: A remaining effect of long-standing hypercortisolism? European Journal of Endocrinology,167(5), 687–695. https://doi.org/10.1530/EJE-12-0308.CrossRefPubMed

51.

Valassi, E., Santos, A., Yaneva, M., Tóth, M., Strasburger, C., Chanson, P., et al. (2011). The European Registry on Cushing’s syndrome: 2-year experience Baseline demographic and clinical characteristics. European Journal of Endocrinology,165(3), 383–392. https://doi.org/10.1530/EJE-11-0272.CrossRefPubMed

52.

United States Center for Disease Control. (2005). Morbidity and mortality weekly report: MMWR. Morbidity and mortality weekly report (Vol. 54). U.S. Dept. of Health, Education, and Welfare, Public Health Service, Center for Disease Control. Retrieved November 11, 2017 from https://www.cdc.gov/mmwr/index.html.

53.

Jabonwska-Lietz, B., Wrzosek, M., Wodarczyk, M., & Nowicka, G. (2017). New indexes of body fat distribution, visceral adiposity index, body adiposity index, waist-to-height ratio, and metabolic disturbances in the obese. Kardiologia Polska,759110, 1185–1191. https://doi.org/10.5603/KP.a2017.0149.CrossRef

54.

Sallis, J. F., & Saelens, B. E. (2005). Assessment of physical activity by self-report: Status, limitations, and future directions. Research Quarterly for Exercise and Sport,71(sup2), 1–14. https://doi.org/10.1080/02701367.2000.11082780.CrossRef

55.

Adams, S. A., Matthews, C. E., Ebbeling, C. B., Moore, C. G., Cunningham, J. E., Fulton, J., et al. (2005). The effect of social desirability and social approval on self-reports of physical activity. American Journal of Epidemiology,161(4), 389–398. https://doi.org/10.1093/aje/kwi054.CrossRefPubMed

56.

Barreto, P., Ferrandez, A., & Saliba-Serre, B. (2013). Are older adults who volunteer to participate in an exercise study fitter and healthier than non-volunteers? The participation bias of the study population. Journal of Physical Activity and Health,10(3), 359–367. https://doi.org/10.1123/jpah.10.3.359.CrossRef

57.

D'Angelo, V., Beccuti, G., Berardelli, R., Karamouzis, I., Zichi, C., Giordano, R., et al. (2015). Cushing’s syndrome is associated with sleep alterations detected by wrist actigraphy. Pituitary,18(6), 893–897. https://doi.org/10.1007/s11102-015-0667-0.CrossRefPubMed

Titel: The association between physical activity, sleep, and quality of life in patients in bio-chemical remission from Cushing’s syndrome
Auteurs: Susette A. Moyers
Jitske Tiemensma
Publicatiedatum: 27-03-2020
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 8/2020
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-020-02480-y

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