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Elevated plasma endothelin as an additional cardiovascular risk factor in patients with Cushing's syndrome

G Kirilov1, A Tomova, L Dakovska

  • 1Clinical Center of Endocrinology, Medical University, Sofia, Bulgaria. kirilov@uheg.medicalnet-bg.org

European Journal of Endocrinology
|December 4, 2003
PubMed

Insights

Endothelin-1 (ET-1) levels are significantly elevated in patients with Cushing's syndrome, suggesting its activation in this adrenal disorder. These elevated ET-1 levels may contribute to the development of atherosclerosis in affected individuals.

Area of Science:

  • Endocrinology
  • Cardiovascular Research
  • Adrenal Disorders

Background:

  • Endothelin (ET) plays a presumed pathophysiological role in various adrenal disorders.
  • Previous research suggests ET involvement in primary hyperaldosteronism, pheochromocytoma, and adrenocortical insufficiency.

Purpose of the Study:

  • To investigate circulating endothelin-1 (ET-1) levels in patients diagnosed with endogenous Cushing's syndrome.
  • To determine the relationship between ET-1 levels and clinical parameters in Cushing's syndrome.

Main Methods:

  • Plasma ET-1 levels were quantified using a highly sensitive radioimmunoassay (RIA).
  • The study included thirteen treatment-naïve patients with Cushing's syndrome (8 female, 5 male; mean age 44.2 years).
  • Patient cohorts included Cushing's disease (n=10) and adrenal adenomas (n=3), compared with age-matched healthy controls (n=13).

Main Results:

  • Plasma ET-1 levels were threefold higher in Cushing's syndrome patients compared to healthy controls (1.59 vs. 0.46 pmol/l, P<0.001).
  • No significant difference in ET-1 levels was observed between adrenal adenoma and Cushing's disease subgroups.
  • Elevated ET-1 levels (2.34 pmol/l) were noted in three patients who died from cardiovascular complications.
  • A positive correlation was found between total cholesterol and ET-1 levels (r=+0.73, P<0.02).
  • No correlation was found between ET-1 and blood pressure, plasma cortisol, or urinary cortisol excretion.

Conclusions:

  • The endothelin system is demonstrably activated in Cushing's syndrome.
  • Elevated plasma ET-1 levels are implicated in the accelerated pathogenesis of atherosclerosis in Cushing's syndrome.
  • Further research is warranted to elucidate the precise mechanisms and therapeutic implications.
Abstract

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