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Journal of Endocrinological Investigation

Erschienen in:

30.08.2023 | Original Article

Cardiovascular evaluation and endothelial dysfunction in Cushing syndrome following remission: a prospective study

verfasst von: A. Hacioglu, S. T. Firat, A. S. Caglar, Z. Karaca, N. Kalay, S. Taheri, F. Tanriverdi, A. Selcuklu, K. Unluhizarci, F. Kelestimur

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 3/2024

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Abstract

Purpose

Cushing syndrome (CS) is a well-known risk factor for cardiovascular morbidities. We aimed to evaluate endothelial and cardiovascular functions, endothelial mediators and pro-inflammatory cytokines in patients with CS before and after remission.

Methods

Adult patients with newly diagnosed endogenous CS were included. Metabolic [body mass index (BMI), glucose, and lipid values] and cardiovascular evaluation studies [24-h ambulatory blood pressure monitoring, carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), and echocardiography] were performed, and endothelial mediators [asymmetric dimethyl arginine (ADMA) and endothelin-1 (ET-1)] and pro-inflammatory cytokines [interleukin-1β (IL-1β) and tumor necrosis factor-alpha (TNF-α)] were measured. Control group was matched in terms of age, gender, and BMIs.

Results

Twenty-five patients, mean age 40.60 ± 14.04 years, completed the study. Compared to controls (n = 20) mean arterial pressure (MAP) and CIMT were higher (p < 0.005 and p = 0.012, respectively), and FMD (p < 0.001) and mitral E/A ratio (p = 0.007) lower in the patients during active disease. Baseline serum ADMA, ET-1, and IL-1β were similar between the groups, while TNF-α was lower in the patients (p = 0.030). All patients were in complete remission 1 year following surgery. BMI, LDL cholesterol, serum total cholesterol, fasting plasma glucose, MAPs, and CIMT significantly decreased (p < 0.005), while there was no improvement in FMD (p = 0.11) following remission. There was no significant change in ADMA, IL-1β, and TNF-α levels, but ET-1 increased (p = 0.011).

Conclusions

Remission in CS improves some cardiovascular parameters. ADMA and ET-1 are not reliable markers for endothelial dysfunction in CS. Metabolic improvements may not directly reflect on serum concentrations of TNF-α and IL-1β following remission of CS.

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Titel: Cardiovascular evaluation and endothelial dysfunction in Cushing syndrome following remission: a prospective study
verfasst von: A. Hacioglu
S. T. Firat
A. S. Caglar
Z. Karaca
N. Kalay
S. Taheri
F. Tanriverdi
A. Selcuklu
K. Unluhizarci
F. Kelestimur
Publikationsdatum: 30.08.2023
Verlag: Springer International Publishing
Erschienen in: Journal of Endocrinological Investigation / Ausgabe 3/2024
Elektronische ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-023-02183-4

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Cardiovascular evaluation and endothelial dysfunction in Cushing syndrome following remission: a prospective study