title: Increased Soluble TNF Receptor-1 and Glutathione Peroxidase may Predict Carotid Intima Media Thickness in Females with Cushing Syndrome.
abstract: OBJECTIVE
  Cardiovascular events are the most common cause of mortality in Cushing syndrome (CS). This study aimed to evaluate the impact of novel factors on atherosclerosis in endogenous CS.
  
  
  METHODS
  A total of 22 female patients with CS and 33 normal female controls underwent evaluation of fibrinogen, high-sensitivity C-reactive protein (hsCRP), inflammatory cytokines (interleukin [IL]-6, IL-1β, soluble tumor necrosis factor receptor [sTNFR]-1, and sTNFR2), glutathione peroxidase (GPx; measure of oxidative stress), carotid intima media thickness (CIMT; a measure of atherosclerosis), and percent change in flow-mediated vasodilation (%FMV) of the brachial artery, a measure of endothelial dysfunction. Stepwise multiple linear regressions were done after adjusting for variables in models 1 through 3 to evaluate their role in predicting CIMT and %FMV. Model 1 consisted of age and body mass index (BMI). Model 2 consisted of model 1 plus blood pressure (BP), fasting blood glucose (FBG), and 2-hour postglucose blood glucose (2hPGBG). Model 3 consisted of model 2 plus triglycerides and low- and high-density lipoprotein.
  
  
  RESULTS
  Females with CS had significantly higher BMI, BP, FBG, 2hPGBG, total cholesterol, triglycerides, fibrinogen, IL-6, IL-1β, sTNFR1, and GPx. CIMT and %FMV were significantly higher and lower, respectively, in CS patients. Regression analyses revealed sTNFR1 to be a consistent predictor of CIMT after adjusting for model 1 (β = 0.656; P = .004), model 2 (β = 0.571; P = .047), and model 3 (β = 0.683; P =.026). GPx was a predictor of CIMT after adjusting for model 1 (β = 0.565; P = .033) and model 3 (β = 0.756; P= .038).
  
  
  CONCLUSIONS
  This study highlights increased CIMT and endothelial dysfunction in CS, associated with an altered inflammatory milieu. sTNFR1 and GPx may predict CIMT in females with CS.
authors.affiliation: Department of Endocrinology & Metabolism, Institute of Post-Graduate Medical Education & Research (IPGMER) and Seth Sukhlal Karnani Memorial (SSKM) Hospital, Calcutta, India.
authors.forename: Ks
authors.initials: K
authors.lastname: Shivaprasad
authors.affiliation: Department of Endocrinology & Metabolism, Institute of Post-Graduate Medical Education & Research (IPGMER) and Seth Sukhlal Karnani Memorial (SSKM) Hospital, Calcutta, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Department of Endocrinology & Metabolism, Post-Graduate Institute of Medical Education & Research (PGIMER) & Dr. Ram Manohar Lohia (RML) Hospital, New Delhi, India.
authors.forename: Deep
authors.initials: D
authors.lastname: Dutta
authors.affiliation: Department of Cardiology, IPGMER and SSKM Hospital, Calcutta, India.
authors.forename: Bineet
authors.initials: B
authors.lastname: Sinha
authors.affiliation: Department of Biochemistry, Dr. B.C. Roy Post-Graduate Institute of Basic Medical Education and Research, IPGMER & SSKM Hospital, Calcutta, India.
authors.forename: Samim Ali
authors.initials: SA
authors.lastname: Mondal
authors.affiliation: Department of Medicine, Dr. Rath Govinda (RG) Kar Medical College & Hospital, Calcutta, India.
authors.forename: Indira
authors.initials: I
authors.lastname: Maisnam
authors.affiliation: Department of Endocrinology & Metabolism, Institute of Post-Graduate Medical Education & Research (IPGMER) and Seth Sukhlal Karnani Memorial (SSKM) Hospital, Calcutta, India.
authors.forename: Satinath
authors.initials: S
authors.lastname: Mukhopadhyay
authors.affiliation: Department of Endocrinology & Metabolism, Institute of Post-Graduate Medical Education & Research (IPGMER) and Seth Sukhlal Karnani Memorial (SSKM) Hospital, Calcutta, India.
authors.forename: Subhankar
authors.initials: S
authors.lastname: Chowdhury
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000209:etiology; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D059168:Carotid Intima-Media Thickness; D003480:Cushing Syndrome / Q000097:blood / Q000473:pathology*; D004730:Endothelium, Vascular / Q000502:physiology; D005260:Female; D005979:Glutathione Peroxidase / Q000378:metabolism*; D006801:Humans; D008297:Male; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000032:analysis*; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology
chemical_list: D001786:Blood Glucose; D047888:Receptors, Tumor Necrosis Factor, Type I; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D005979:Glutathione Peroxidase