GLP-1 Drugs Improve Metabolic Outcomes in Cushing’s Syndrome Without Hormonal Harm: Study
Researchers have discovered in a new study that among patients with Cushing’s syndrome, treatment with GLP-1 drugs led to significant weight loss and better glycemic control. Importantly, these benefits were achieved without adversely affecting cortisol levels or liver function, according to a small retrospective study. The study was published in the journal Endocrine by Pedro I. and colleagues.
Cushing’s syndrome presents with marked metabolic abnormalities such as obesity, insulin resistance, diabetes mellitus, and dyslipidemia, which are major risk factors for cardiovascular diseases. Based on the results of the study, GLP-1RAs show clear benefits for improving metabolism in a high-risk patient population, potentially serving as a new therapeutic tool for the management of obesity and diabetes in Cushing’s syndrome.
The study design was a retrospective analysis of 20 biochemically confirmed adult patients with Cushing’s syndrome who received GLP-1RAs for at least 3 months. The therapeutic agents used in the study were liraglutide, semaglutide, tirzepatide, and dulaglutide. The study subjects had co-existing metabolic conditions like type 2 diabetes and/or obesity. The study subjects were assessed for various anthropometric, metabolic, hepatic, hormonal, and hemodynamic parameters. The median follow-up of the study subjects was 13 months.
Key findings:
In patients with Cushing's syndrome receiving GLP-1RAs, body weight decreased by 10.3 ± 8.8 kg (p < 0.001) and BMI by 4.2 ± 2.8 kg/m² (p < 0.001).
Fasting glucose levels decreased by 12.1 ± 35.3 mg/dL (p = 0.015), whereas HbA1c levels decreased by 0.5 ± 0.9% (p = 0.011).
Liver function tests showed improvement, with decreases in ALT levels by 3.9 ± 21.4 U/L (p = 0.005) and GGT levels by 25.9 ± 57.3 U/L (p = 0.012).
AST levels decreased slightly by 5.2 ± 9.2 U/L (p = 0.046).
No changes were noted in blood pressure or lipid levels.
Hormonal levels were stable.
Mild gastrointestinal side effects were noted in 26.3%.
The use of GLP-1 receptor agonists showed promising effects in terms of metabolism, including weight loss and improved glycemic control, in Cushing’s syndrome without affecting hormonal balance, thus providing potential use as an adjunctive therapy.
Reference:
Iglesias, P., Nobre, E.L., Hanzu, F. et al. Efficacy and safety of GLP-1 receptor agonists in the treatment of type 2 diabetes and/or obesity in patients with Cushing’s syndrome: a multicenter retrospective study. Endocrine 91, 108 (2026). https://doi.org/10.1007/s12020-026-04587-7
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