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Endothelial dysfunction aassociated with hypercortisolism is reversible in Cushing's syndrome
Itaru Akaza1, Takanobu Yoshimoto, Kyoichiro Tsuchiya
1Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
Endocrine Journal
|December 22, 2009
Summary
Endothelial dysfunction, a precursor to atherosclerosis, is common in Cushing's syndrome (CS). This study shows that hypercortisolemia in CS patients causes endothelial dysfunction, which improves after treatment, reducing cardiovascular risk.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Vascular Biology
Background:
- Cushing's syndrome (CS) involves chronic excess glucocorticoids, increasing cardiovascular morbidity and mortality.
- Endothelial dysfunction is an early marker of atherosclerosis.
Purpose of the Study:
- To investigate the association between endothelial dysfunction and CS.
- To determine if endothelial dysfunction in CS is reversible after treatment.
Main Methods:
- Vascular endothelial function assessed using ultrasound measurement of flow-mediated vasodilation (FMD).
- Studied 21 CS patients and 12 age/gender-matched controls.
- 12 CS patients were re-evaluated after treatment.
Main Results:
- CS patients exhibited significantly lower %FMD compared to controls (5.8% vs 8.1%).
- %FMD negatively correlated with cortisol levels (morning serum and 24-h urinary free cortisol).
- Treatment significantly decreased cortisol levels and increased %FMD, with improvements inversely correlated to cortisol reduction.
Conclusions:
- Endothelial dysfunction in CS is linked to hypercortisolemia.
- Endothelial dysfunction in CS is reversible following treatment.
- Cortisol excess may play a role in endothelial dysfunction and subsequent cardiovascular complications.
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