Impaired microvascular reactivity and endothelial function in patients with Cushing's syndrome: influence of arterial hypertension.
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.
Prázný
M
M
Third Department of Internal Medicine, First Faculty of Medicine, Prague, Czech Republic. mpra@LF1.cuni.cz
Ježková
J
J
Horová
E
E
Lazárová
V
V
Hána
V
V
Kvasnicka
J
J
Pecen
L
L
Marek
J
J
Skrha
J
J
Krsek
M
M
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
D015415:Biomarkers; D018799:Intercellular Adhesion Molecule-1; D006854:Hydrocortisone