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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
PubMed

Insights

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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