title: The estimation of selected endogenous anticoagulation system parameters in patients with subclinical Cushing's syndrome.
abstract: OBJECTIVE
  An increased tendency towards thromboembolic events is observed in patients with Cushing's syndrome. There are much fewer publications available about thromboembolic complications in patients with subclinical Cushing's syndrome (SCS). Therefore, a question arises whether hemostatic disturbances appear in this particular disease phase.
  
  
  OBJECTIVE
  Estimation of protein C (PC), free protein S (FPS), antithrombin (AT) activity, thrombomodulin (TM) concentration and activated PC resistance (APCR) in patients with SCS.
  
  
  METHODS
  We studied 35 patients with SCS. The control group consisted of 33 healthy volunteers. The activity of PC, AT, FPS, APCR and the concentration of TM was estimated in all representatives.
  
  
  RESULTS
  The comparison of the examined coagulation parameters between the patients with SCS and the healthy individuals revealed significantly higher mean PC activity and mean FPS activity in the SCS group. Mean TM concentration was significantly lower in patients with SCS compared with the control group. The differences in APCR and AT activity were not significant. We did not prove any statistically significant correlations between the examined coagulation parameters and hormonal parameters. We did not find any correlation between the concentration of cortisol and basic coagulation parameters such as international normalized ratio, activated partial thromboplastin time or fibrinogen in the group with SCS either.
  
  
  CONCLUSIONS
  The patients with SCS present disturbances in endogenous anticoagulation system defined as PC, FPS activity and TM concentration. This finding suggests an impact of mild autonomic cortisol overproduction on coagulation system.
authors.affiliation: Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Ul. Dębinki 7, Gdańsk, Poland. rensto@gumed.edu.pl
authors.forename: Renata
authors.initials: R
authors.lastname: Swiatkowska-Stodulska
authors.forename: Sonia
authors.initials: S
authors.lastname: Kaniuka-Jakubowska
authors.forename: Piotr
authors.initials: P
authors.lastname: Wisniewski
authors.forename: Anna
authors.initials: A
authors.lastname: Skibowska-Bielinska
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Sworczak
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000097:blood*; D001777:Blood Coagulation / Q000502:physiology*; D003430:Cross-Sectional Studies; D003480:Cushing Syndrome / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011486:Protein C / Q000378:metabolism; D017293:Protein S / Q000378:metabolism; D013923:Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D018180:Thrombomodulin / Q000097:blood
chemical_list: D000925:Anticoagulants; D011486:Protein C; D017293:Protein S; C546931:THBD protein, human; D018180:Thrombomodulin