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Cardiovascular Risk Factors and Common Carotid Artery Caliber and Stiffness in Patients with Cushing’s Disease during Active Disease and 1 Year after Disease Remission
Abstract
Cardiovascular accidents represent the most important cause of death in patients with Cushing's syndrome. This prospective study aims at evaluating carotid arteries by echo-Doppler ultrasonography and clinical and metabolic markers of atherosclerosis in 25 patients with Cushing's disease (CD) before and after 1 yr of remission. Thirty-two sex- and age-matched subjects (control-1) and 32 body mass index-matched subjects (control-2) served as controls. At diagnosis, CD patients had higher body mass index, waist to hip ratio (WHR), total, low-density lipoprotein-cholesterol and total/high-density lipoprotein (HDL) ratio, glucose and insulin, as well as lower HDL-cholesterol than control-1; they had higher WHR and total/HDL ratio and lower HDL-cholesterol than control-2. They also had higher intima-media thickness (IMT), and lower systolic lumen diameter and distensibility coefficient (DC) than either control group. Atherosclerotic plaques were detected in 31.2% of patients, 0 control-1, and 6.2% of control-2 subjects. One year after remission, WHR, LDL-cholesterol, and IMT significantly decreased, whereas systolic lumen diameter and DC significantly increased. However, all of the above parameters were still abnormal compared with control-1, but not control-2. A significant correlation was found between WHR, glucose and insulin levels, and right and left carotid IMT. WHR was the best predictor of left IMT and left DC in active, but not in cured, patients. The duration of hypercortisolism was the best predictor of right DC in active but not in cured patients. In conclusion, patients with CD have severe atherosclerotic damage. The persistence of a metabolic syndrome, vascular damage, and atherosclerotic plaques after cortisol level normalization makes these subjects still at high cardiovascular risk despite disease remission.
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“From % to % of patients with endogenous CS have DM, and % to % have defective glucose tolerance, so the overall prevalence of glucose metabolism impairments can come close to %, as shown in Table (, , -).”
From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [183]
In the citing paper
“Controlling hypercortisolism is the first step toward improving glucose metabolism in patients with endogenous CS, but different treatments for hypercortisolism may affect the outcome of diabetes, regardless of how well cortisol excess is corrected (, , , , , , ).”
From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [183]
In the citing paper
“Other prospective studies [Faggiano et al., (); Giordano et al., ()] reported similar findings in patients with CS before and year after remission was achieved thanks to pituitary neurosurgery, pituitary irradiation, or adrenalectomy.”
From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [183]
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Self-citation
Metadata
- Authors
- Faggiano, A., Pivonello, R., Spiezia, S., De Martino, M. C., Filippella, M., Di Somma, C., Lombardi, G., & Colao, A.
- Affiliations
- Federico II University Hospital (IT)
- Corresponding author
- Colao, Annamaria
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2003-06
- Volume
- 88
- Issue
- 6
- Pages
- 2527-2533
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2107774273
- Cited by
- 358
- References
- 30
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 17 · 2023: 19 · 2022: 17 · 2021: 13 · 2020: 14 · 2019: 13 · 2018: 7 · 2017: 19 · 2016: 19 · 2015: 18 · 2014: 22 · 2013: 24 · 2012: 20
- FWCI
- 6.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- Cushing's disease, carotid artery stiffness, carotid intima-media thickness, atherosclerosis, cardiovascular risk factors, remission, waist-to-hip ratio, metabolic syndrome, carotid distensibility, atherosclerotic plaque, HDL cholesterol, insulin resistance
- MeSH terms
- Adult, Arteriosclerosis, Cardiovascular Diseases, Cushing Syndrome, Elasticity, Female, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Remission Induction, Risk Factors, Time Factors, Ultrasonography, Carotid Artery, Common
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