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ASYMMETRIC DIMETHYLARGININE LEVELS AND ATHEROSCLEROSIS MARKERS IN CUSHING SYNDROME
Insights
Cushing syndrome (CS) patients had lower asymmetric dimethylarginine (ADMA) levels and higher lipids, but similar cardiovascular disease risk markers (hsCRP, Lp-PLA2, homocysteine, ABI, CIMT) compared to controls. Further research on ADMA in CS is warranted.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Biochemistry
Background:
- Cushing syndrome (CS) is linked to atherosclerosis risk factors like diabetes, dyslipidemia, hypertension, and obesity.
- Cardiovascular disease (CVD) is a major cause of mortality and morbidity in CS patients.
- Investigating specific CVD risk markers in CS is crucial for understanding disease pathophysiology.
Purpose of the Study:
- To evaluate key cardiovascular disease (CVD) risk markers in patients with Cushing syndrome (CS).
- Markers assessed include asymmetric dimethylarginine (ADMA), lipoprotein-associated phospholipase A2 (Lp-PLA2), high-sensitive C-reactive protein (hsCRP), homocysteine, lipid profiles, ankle-brachial index (ABI), and carotid intima-media thickness (CIMT).
Main Methods:
- A case-control study involving 27 patients with CS and 27 matched controls.
- Controls were matched for age, sex, body mass index (BMI), and comorbid diseases.
- Measurements included plasma levels of ADMA, hsCRP, Lp-PLA2, homocysteine, lipids, apolipoproteins, and physical measurements of ABI and CIMT.
Main Results:
- Plasma ADMA levels were significantly lower in the CS group (P = .013).
- Patients with CS exhibited higher levels of total cholesterol, LDL, triglycerides, HDL, apolipoprotein A1, and apolipoprotein B compared to controls (P<.05).
- No significant differences were observed in hsCRP, Lp-PLA2, homocysteine, CIMT, or ABI between the groups (P>.05).
Conclusions:
- Asymmetric dimethylarginine (ADMA) levels are lower in Cushing syndrome (CS), a finding requiring further investigation.
- Cardiovascular disease risk markers including hsCRP, Lp-PLA2, homocysteine, CIMT, and ABI did not show significant differences between CS patients and matched controls.
- These specific markers did not independently indicate increased CVD risk in CS, suggesting risk is influenced by comorbidities.
Objective:
As a consequence of hypercortisolism, Cushing syndrome (CS) is frequently observed with other diseases that are associated with atherosclerosis, including diabetes mellitus, dyslipidemia, hypertension, and obesity. Cardiovascular disease (CVD) is the primary cause of mortality and morbidity in CS. We investigate CVD risk markers such as asymmetric dimethylarginine (ADMA), lipoprotein-associated phospholipase A2 (Lp-PLA2), highsensitive C-reactive protein (hsCRP), homocysteine, lipid levels, ankle-brachial index (ABI), and carotid intimamedia thickness (CIMT) in CS.
Methods:
Our study included 27 patients with CS and 27 age-, sex-, body mass index (BMI)-, and comorbid disease-matched control subjects.
Results:
Plasma ADMA levels were significantly lower in the CS group than the control group (P = .013). Total cholesterol, low-density lipoprotein, triglycerides, high-density lipoprotein, and apolipoprotein A1 and apolipoprotein B levels were higher in patients with CS than the control group (P<.05). We did not find any statistically significant differences in levels of hsCRP, Lp-PLA2, or homocysteine or CIMT and ABI measurements between the CS group and comorbidity-matched control group (P>.05).
Conclusion:
We found that ADMA levels were lower in CS, the finding that should be further investigated. Levels of hsCRP, Lp-PLA2, and homocysteine levels and CIMT and ABI measurements were similar between the CS group and comorbidity-matched control group. None of these markers was prominent to show an increased risk of CVD in CS, independent of the comorbidities of CS.
Abbreviations:
ABI = ankle-brachial index Apo = apolipoprotein ADMA = asymmetric dimethylarginine BMI = body mass index CVD = cardiovascular disease CIMT = carotid intima-media thickness CS = Cushing syndrome DM = diabetes mellitus DDAH = dimethylarginine dimethylaminohydrolase ELISA = enzyme-linked immunosorbent assay HDL = high-density lipoprotein hsCRP = high-sensitive C-reactive protein HOMA-IR = homeostatic model assessment of insulin resistance HT = hypertension LDL = low-density lipoprotein Lp-PLA2 = lipoprotein-associated phospholipase A2 Lp-a = lipoprotein a NO = nitric oxide.
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