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Hyperhomocysteinemia in patients with Cushing's syndrome

Massimo Terzolo1, Barbara Allasino, Sandra Bosio

  • 1Dipartimento di Scienze Cliniche e Biologiche, Medicina Interna I, Università di Torino, 10100 Torino, Italy. terzolo@usa.net

The Journal of Clinical Endocrinology and Metabolism
|August 5, 2004
PubMed

Insights

Active Cushing's syndrome elevates serum homocysteine levels and lowers folate. Remission restores homocysteine to normal, suggesting hypercortisolism drives this metabolic change and potential cardiovascular risk.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Clinical Biochemistry

Background:

  • Cushing's syndrome is characterized by hypercortisolism, leading to various metabolic disturbances.
  • Hyperhomocysteinemia is a known risk factor for cardiovascular disease.
  • The role of homocysteine metabolism in Cushing's syndrome is not fully understood.

Purpose of the Study:

  • To investigate serum homocysteine concentrations and methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism in patients with Cushing's syndrome.
  • To compare homocysteine levels in active disease, remission, and healthy controls.
  • To explore the association between homocysteine, cortisol, and folate levels.

Main Methods:

  • Serum homocysteine and folate levels were measured.
  • MTHFR C677T gene polymorphism was analyzed.
  • Patients included 41 with active Cushing's syndrome and 16 in remission.
  • 105 healthy blood donors served as controls.

Main Results:

  • Patients with active Cushing's syndrome exhibited significantly higher homocysteine and lower folate levels compared to controls and those in remission.
  • Homocysteine levels were positively correlated with midnight serum cortisol and negatively with serum folate.
  • No significant difference in MTHFR genotype distribution was observed between groups.

Conclusions:

  • Active hypercortisolism is associated with hyperhomocysteinemia and reduced serum folate.
  • Homocysteine levels normalize upon remission of Cushing's syndrome.
  • Hyperhomocysteinemia may contribute to the prothrombotic state and cardiovascular risk in Cushing's syndrome.

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