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Pituitary

, Volume 18, Issue 1, pp 135–141 | Cite as

Soluble TNFα-receptor 1 as a predictor of coronary calcifications in patients after long-term cure of Cushing’s syndrome

  • María-José Barahona
  • Eugenia Resmini
  • David Viladés
  • José-Manuel Fernández-Real
  • Wifredo Ricart
  • José-María Moreno-Navarrete
  • Guillem Pons-Lladó
  • Rubén Leta
  • Susan M. Webb
Article

Abstract

Purpose

Increased cardiovascular (CV) risk persists in Cushing’s syndrome (CS), despite remission of hypercortisolism. The aim of this study was to evaluate prevalence of coronary artery disease in CS patients and its correlation with classical CV risk factors and inflammatory markers.

Methods

Cardiac multidetector computed tomography (MDCT) was performed in 41 patients (7 men, 31 of pituitary origin, 29 cured, mean age: 48.6 ± 13 years), using 64-slice Toshiba Aquilion systems. Coronary atherosclerotic plaques were detected and coronary calcifications quantified by the Agatston score (AS). Clinical and biochemical parameters were correlated with the AS to identify possible surrogate markers of coronary disease. Normal values for clinical and biochemical parameters were obtained from a gender- and age-matched normal reference population (n = 82).

Results

CS patients with calcifications (AS > 0) (N = 13, 32 %) had higher levels of sTNF-R1, homocysteine, triglycerides, blood pressure and body mass index than patients without calcifications (AS = 0) and those of normal reference population. Both groups of CS patients (AS > 0 and AS = 0) had elevated trunk fat mass and IL-6 compared to reference values. Patients with AS > 0 had less adiponectin and higher insulin, HOMA and fibrinogen than those found in normal reference population. sTNF-R1 correlated positively with AS and remained significant after adjusting for confounding factors. The same result was observed when we considered only cured CS patients.

Conclusion

In our cohort of CS patients sTNF-R1 was a predictor of coronary calcifications. Since MDCT is an expensive technique not readily available in daily clinical practice, increased sTNF-R1 could be a marker of CV risk even in cured CS.

Keywords

Cushing’s syndrome Atherosclerosis Adipokines Coronary calcifications 

Notes

Acknowledgments

Supported by a Grant from the Spanish Health Ministry, Fondo de Investigación Sanitaria 05/0448. The Centro de Investigación Biomédica en Red de Enfermedades Raras is an initiative of the Instituto de Salud Carlos III.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • María-José Barahona
    • 1
    • 3
  • Eugenia Resmini
    • 2
    • 3
  • David Viladés
    • 4
  • José-Manuel Fernández-Real
    • 5
  • Wifredo Ricart
    • 5
  • José-María Moreno-Navarrete
    • 5
  • Guillem Pons-Lladó
    • 4
  • Rubén Leta
    • 4
  • Susan M. Webb
    • 2
    • 3
  1. 1.Department of EndocrinologyHospital Universitari Mútua de TerrassaTerrassaSpain
  2. 2.Departments of Endocrinology and MedicineHospital Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
  3. 3.Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747)Instituto de Salud Carlos IIIMadridSpain
  4. 4.Cardiology DepartmentHospital Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
  5. 5.Endocrinology DepartmentInstitut d’Investigació Biomèdica de Girona (IDIBGI) and CIBER Fisiopatologia de la Obesidad y Nutrición CB06/03/010, Hospital Josep TruetaGironaSpain

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