title: Soluble TNFα-receptor 1 as a predictor of coronary calcifications in patients after long-term cure of Cushing's syndrome.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Endocrinology, Hospital Universitari Mútua de Terrassa, Pl Dr Robert 5, 08221, Terrassa, Barcelona, Spain, 33962mbc@comb.cat.
authors.forename: María-José
authors.initials: MJ
authors.lastname: Barahona
authors.forename: Eugenia
authors.initials: E
authors.lastname: Resmini
authors.forename: David
authors.initials: D
authors.lastname: Viladés
authors.forename: José-Manuel
authors.initials: JM
authors.lastname: Fernández-Real
authors.forename: Wifredo
authors.initials: W
authors.lastname: Ricart
authors.forename: José-María
authors.initials: JM
authors.lastname: Moreno-Navarrete
authors.forename: Guillem
authors.initials: G
authors.lastname: Pons-Lladó
authors.forename: Rubén
authors.initials: R
authors.lastname: Leta
authors.forename: Susan M
authors.initials: SM
authors.lastname: Webb
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D002114:Calcinosis / Q000097:blood / Q000378:metabolism*; D016022:Case-Control Studies; D003331:Coronary Vessels / Q000473:pathology*; D003480:Cushing Syndrome / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery / Q000628:therapy; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000378:metabolism*; D014280:Triglycerides / Q000097:blood
chemical_list: D018124:Receptors, Tumor Necrosis Factor; D014280:Triglycerides; D006710:Homocysteine
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