title: Impaired microvascular reactivity and endothelial function in patients with Cushing's syndrome: influence of arterial hypertension.
abstract: The aim of the study was to evaluate skin microvascular reactivity (MVR) and possible influencing factors (fibrinolysis, oxidative stress, and endothelial function) in patients with Cushing's syndrome. Twenty-nine patients with active Cushing's syndrome (ten of them also examined after a successful operation) and 16 control subjects were studied. Skin MVR was measured by laser Doppler flowmetry during post-occlusive (PORH) and thermal hyperemia (TH). Malondialdehyde and Cu,Zn-superoxide dismutase were used as markers of oxidative stress. Fibrinolysis was estimated by tissue plasminogen activator (tPA) and its inhibitor (PAI-1). N-acetyl-beta-glucosaminidase, E-selectin, P-selectin, and ICAM-1 were used as markers of endothelial function. Oxidative stress and endothelial dysfunction was present in patients with hypercortisolism, however, increased concentration of ICAM-1 was also found in patients after the operation as compared to controls (290.8+/-74.2 vs. 210.9+/-56.3 ng.ml(-1), p<0.05). Maximal perfusion was significantly lower in patients with arterial hypertension during PORH and TH (36.3+/-13.0 vs. 63.3+/-32.4 PU, p<0.01, and 90.4+/-36.6 vs. 159.2+/-95.3 PU, p<0.05, respectively) and similarly the velocity of perfusion increase during PORH and TH was lower (3.2+/-1.5 vs. 5.2+/-3.4 PU.s(-1), p<0.05, and 0.95+/-0.6 vs. 1.8+/-1.1 PU.s(-1), p<0.05, respectively). The most pronounced impairment of microvascular reactivity was present in patients with combination of arterial hypertension and diabetes mellitus.
authors.affiliation: Third Department of Internal Medicine, First Faculty of Medicine, Prague, Czech Republic. mpra@LF1.cuni.cz
authors.forename: M
authors.initials: M
authors.lastname: Prázný
authors.forename: J
authors.initials: J
authors.lastname: Ježková
authors.forename: E
authors.initials: E
authors.lastname: Horová
authors.forename: V
authors.initials: V
authors.lastname: Lazárová
authors.forename: V
authors.initials: V
authors.lastname: Hána
authors.forename: J
authors.initials: J
authors.lastname: Kvasnicka
authors.forename: L
authors.initials: L
authors.lastname: Pecen
authors.forename: J
authors.initials: J
authors.lastname: Marek
authors.forename: J
authors.initials: J
authors.lastname: Skrha
authors.forename: M
authors.initials: M
authors.lastname: Krsek
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers / Q000378:metabolism; D001777:Blood Coagulation / Q000502:physiology; D015992:Body Mass Index; D016022:Case-Control Studies; D003480:Cushing Syndrome / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006940:Hyperemia / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D017078:Laser-Doppler Flowmetry; D008297:Male; D016555:Matched-Pair Analysis; D008833:Microcirculation / Q000503:physiopathology*; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology; D012016:Reference Values; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D018799:Intercellular Adhesion Molecule-1; D006854:Hydrocortisone