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Vascular health in patients in remission of Cushing's syndrome is comparable to that in BMI-matched controls.

Wagenmakers, M and Roerink, S and Schreuder, T and Plantinga, TS and Holewijn, S and Thijssen, DHJ and Smit, JW and Rongen, GA and Pereira, AM and Wagenmakers, AJM and Netea-Maier, RT and Hermus, A (2016) Vascular health in patients in remission of Cushing's syndrome is comparable to that in BMI-matched controls. Journal of Clinical Endocrinology and Metabolism. ISSN 1945-7197

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Abstract

CONTEXT: In active Cushing's syndrome (CS), patients suffer from endothelial dysfunction and premature atherosclerosis. However, it is uncertain to what extent vascular health recovers after long-term remission. This is highly relevant as this topic relates to future development of cardiovascular disease. OBJECTIVE: To investigate whether micro- and macrovascular health is impaired after long-term remission of CS, in patients with no or adequately treated co-morbidities. DESIGN AND SETTING: Cross-sectional case-control study in two tertiary referral centers. PATIENTS AND MAIN OUTCOME MEASURES: 63 patients (remission of CS for ≥ 4 years) and 63 healthy, well-matched controls were compared. In group A (58 patients and 58 controls) serum biomarkers associated with endothelial dysfunction, intima media thickness, pulse wave velocity and pulse wave analysis were studied. In group B (14 patients and 14 controls) endothelium-dependent and-independent vasodilatation was studied in conduit arteries (flow mediated dilation of the brachial artery) and forearm skeletal muscle resistance arteries (vasodilator response to intra-arterial acetylcholine, sodium-nitroprusside and N(G)-monomethyl-L-arginine using venous occlusion plethysmography). RESULTS: There were no significant differences between the outcome measures of vascular health of patients and controls in group A and B. CONCLUSION: Vascular health of patients in long-term remission of Cushing's syndrome seems to be comparable to that of healthy gender-, age and BMI matched controls, provided that the patients have no, or adequately controlled co-morbidities. Therefore, the effects of hypercortisolism per se on the vasculature may be reversible. This accentuates the need for stringent treatment of metabolic co-morbidities in these patients.

Item Type: Article
Uncontrolled Keywords: 1103 Clinical Sciences, 1114 Paediatrics And Reproductive Medicine
Subjects: R Medicine > RC Internal medicine
Divisions: Sport & Exercise Sciences
Publisher: Endocrine Society
Related URLs:
Date Deposited: 25 Oct 2016 13:04
Last Modified: 07 Sep 2017 09:00
DOI or Identification number: 10.1210/jc.2016-1674
URI: http://researchonline.ljmu.ac.uk/id/eprint/4691

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