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Endothelial dysfunction in endocrine disease
T A Abdu1, T Elhadd, M Pfeifer
1Dept of Medicine, School of Postgraduate Medicine, Keele University, Staffordshire, ST4 7QB, Keele, UK.
Insights
Endothelial dysfunction is an early cardiovascular disease marker in endocrinopathies. Measuring endothelial function, like flow-mediated dilation (FMD), helps identify at-risk patients and assess treatment effectiveness for cardiovascular disease (CVD).
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Vascular Biology
Background:
- Endocrinopathies such as acromegaly, Cushing's syndrome, and thyroid disorders are linked to increased cardiovascular disease (CVD) risk and mortality.
- Endothelial dysfunction is recognized as an early indicator of CVD, preceding detectable atherosclerotic changes.
- Assessing endothelial function may enable early identification of at-risk individuals and monitor therapeutic interventions for CVD.
Purpose of the Study:
- To review the role of endothelial function assessment in endocrinopathies.
- To highlight the utility of measuring endothelial function for early CVD risk stratification and treatment evaluation.
Main Methods:
- Noninvasive ultrasound measurement of flow-mediated endothelium-dependent dilation (FMD) in large vessels.
- Analysis of serum markers of endothelial dysfunction, including von Willebrand's factor, thrombomodulin, E-selectin, and intercellular adhesion molecule 1.
Main Results:
- Endothelial dysfunction is a common finding in various endocrinopathies associated with CVD.
- Serum markers of endothelial dysfunction correlate inversely with FMD measurements.
- FMD and serum markers show potential for monitoring treatment efficacy in reducing CVD risk.
Conclusions:
- Endothelial function assessment, particularly FMD, is a valuable tool for early CVD risk identification in patients with endocrinopathies.
- Serum biomarkers can complement FMD measurements in evaluating treatment responses and long-term CVD outcomes.
Abstract:
In addition to diabetes mellitus and obesity, acromegaly, Cushing's syndrome, hypopituitarism, hypo- and hyperthyroidism, hyperparathyroidism and polycystic ovary syndrome are associated with either increased mortality from, or increased prevalence of, cardiovascular disease (CVD). Recently, endothelial dysfunction has been identified as an early marker of CVD and has been shown to predict future coronary artery disease, before atherosclerotic changes appear in arteries. Thus, measurement of endothelial function might identify at-risk individuals early and be a useful means of assessing response to treatment aimed at reducing long-term morbidity and/or mortality from CVD. Such studies are being undertaken in hypopituitarism and other endocrinopathies, and are reviewed herein. Endothelial function in large vessels can be measured noninvasively by ultrasound measurement of flow-mediated endothelium-dependent dilation (FMD). Serum markers of endothelial function, such as von Willebrand's factor, thrombomodulin, E-selectin and intercellular adhesion molecule 1, could be increased and be useful for evaluation of treatment, because they correlate inversely with FMD.