Soluble TNF alpha-receptor 1 as a predictor of coronary calcifications in patients after long-term cure of Cushing's syndrome
Por:
Barahona, MJ, Resmini, E, Vilades, D, Fernandez-Real, JM, Ricart, W, Moreno-Navarrete, JM, Pons-Llado, G, Leta, R, Webb, SM
Publicada:
1 feb 2015
Resumen:
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.
Filiaciones:
Barahona, MJ:
Hosp Univ Mutua Terrassa, Dept Endocrinol, Barcelona 08221, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Raras CIBERER, Unidad 747, Madrid, Spain
Resmini, E:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Raras CIBERER, Unidad 747, Madrid, Spain
Univ Autonoma Barcelona, Hosp St Pau, Dept Endocrinol, E-08193 Barcelona, Spain
Univ Autonoma Barcelona, Hosp St Pau, Dept Med, E-08193 Barcelona, Spain
Vilades, D:
Univ Autonoma Barcelona, Hosp St Pau, Dept Cardiol, E-08193 Barcelona, Spain
Fernandez-Real, JM:
Hosp Josep Trueta, Inst Invest Biomed Girona IDIBGI, Dept Endocrinol, Girona, Spain
Hosp Josep Trueta, CIBER Fisiopatol Obesidad & Nutr CB06 03 010, Girona, Spain
Ricart, W:
Hosp Josep Trueta, Inst Invest Biomed Girona IDIBGI, Dept Endocrinol, Girona, Spain
Hosp Josep Trueta, CIBER Fisiopatol Obesidad & Nutr CB06 03 010, Girona, Spain
Moreno-Navarrete, JM:
Hosp Josep Trueta, Inst Invest Biomed Girona IDIBGI, Dept Endocrinol, Girona, Spain
Hosp Josep Trueta, CIBER Fisiopatol Obesidad & Nutr CB06 03 010, Girona, Spain
Pons-Llado, G:
Univ Autonoma Barcelona, Hosp St Pau, Dept Cardiol, E-08193 Barcelona, Spain
Leta, R:
Univ Autonoma Barcelona, Hosp St Pau, Dept Cardiol, E-08193 Barcelona, Spain
Webb, SM:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Raras CIBERER, Unidad 747, Madrid, Spain
Univ Autonoma Barcelona, Hosp St Pau, Dept Endocrinol, E-08193 Barcelona, Spain
Univ Autonoma Barcelona, Hosp St Pau, Dept Med, E-08193 Barcelona, Spain
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