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Neuroendocrinology and Pituitary

SUN-019 - Impaired Work Ability and Elevated Disability in Cushing'S Syndrome: Evidence from A Multicenter German Cohort Study

Sunday, June 14, 2026
9:00 AM - 4:00 PM CT
Location: ENDOExpo; Poster Floor
Disclosure(s):
Elisabeth Nowak, MD: Esteve: Advisory Board (), Speaker's honoraria ()


Objective: Evidence on social and occupational consequences of Cushing’s syndrome (CS) is limited. In Germany, disability guidelines classify surgically treated patients as "cured", potentially overlooking lasting functional limitations. We evaluated work ability, as well as social and employment status in patients with newly diagnosed and remitted CS.

Methods: National observational study with two arms: Cohort 1 comprised a monocentric prospective study of patients evaluated for suspected endogenous glucocorticoid excess, and cohort 2 a multicenter cross-sectional study of patients in remission from CS, comparing those with recovered versus persistent adrenal insufficiency. Across both cohorts, participants underwent standardized clinical and biochemical assessments and completed validated questionnaires on socioeconomic status, work ability, and fatigue.

Results: In cohort 1, individuals with active CS (n=28) and excluded CS (n=56) had comparable clinical parameters, education, and employment. However, work ability scores were lower in active CS (median 22.5 vs. 28.5, p=0.008) and correlated inversely with biochemical cortisol excess. In cohort 2 (n=89, 39 with recovered and 50 with persistent adrenal insufficiency), overall employment was 69%. Poor work ability was common (42% with recovered vs. 58% with persistent adrenal insufficiency) and weekly working hours were lower in those with persistent insufficiency (33h vs. 39h, p=0.051). Overall, illness-related absences occurred in 76% during the preceding year, disability was recognized in 47%, and 15% received reduced earning capacity pensions. Fatigue showed a strong negative correlation with work ability (r=-0.73, p< 0.0001).

Conclusion: Despite high education, patients with CS face substantial occupational challenges, particularly in active disease and persistent adrenal insufficiency. As CS predominantly affects young women, a group already facing occupational gender disparities, this population is especially vulnerable. The mismatch between documented functional impairment and current disability assessments reveals a structural gap, underscoring the need for targeted rehabilitation and reintegration to support return to occupational and social participation.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*