title: CONDITIONING FACTORS FOR HIGH CARDIOVASCULAR RISK IN PATIENTS WITH CUSHING SYNDROME.
abstract: OBJECTIVE
  To characterize the alterations in carbohydrate and lipoprotein metabolism, to evaluate markers of lipoprotein functionality, and to identify the presence of novel atherogenic risk factors in patients with Cushing syndrome (CS) in comparison with sex- and age-matched controls.
  
  
  METHODS
  In an open, cross-sectional study, 32 nontreated patients with active CS were consecutively recruited from the Endocrinology Service at "José de San Martín" Clinical Hospital, University of Buenos Aires, Argentina, between April 11, 2010 and December 11, 2012. The patients were compared with sex- and age-matched controls.
  
  
  RESULTS
  Versus controls, patients with CS presented with excess weight, central obesity, and hypercortisolism. They also exhibited an insulin-resistant state, with high resistin levels (median [interquartile range], 16 [10 to 22] ng/mL versus 6 [5 to 9] ng/mL; P<.0001), a more atherogenic lipoprotein profile, high oxidized low-density lipoprotein levels (oxLDL; mean ± SD, 100 ± 31 U/L versus 75 ± 32 U/L; P<.05) and high sensitive C-reactive protein levels (median [interquartile range], 1.2 [0.6 to 3.1] mg/L versus 0.6 [0.3 to 1.1] mg/L; P<.05), and increased leukocyte count (mean ± SD, 9.5 ± 2.6 × 10(3) cells/μL versus 6.5 ± 1.4 × 10(3) cells/μL; P<.0001). Multivariate analyses showed that the increase in waist circumference was associated with both the diagnosis of CS and the degree of insulin resistance. Resistin concentration was related to a greater extent to the diagnosis of CS than to homeostasis model assessment-insulin resistance. Triglyceride and oxLDL levels were only significantly associated with the diagnosis of CS.
  
  
  CONCLUSIONS
  Hypercortisolism is related to the increase observed in triglycerides and oxLDL levels, and, in combination with insulin resistance, acts to increase waist circumference and amplify the inflammatory process, key factors for the development of cardiovascular disease.
authors: Laura
authors: L
authors: Boero
authors: Marcos
authors: M
authors: Manavela
authors: Eliana
authors: E
authors: Botta
authors: Maria Susana
authors: MS
authors: Mallea-Gil
authors: Débora
authors: D
authors: Katz
authors: Tomás
authors: T
authors: Meroño
authors: Walter
authors: W
authors: Tetzlaff
authors: Maximiliano
authors: M
authors: Martin
authors: Leonardo
authors: L
authors: Gómez Rosso
authors: Karina
authors: K
authors: Danilowicz
authors: Fernando
authors: F
authors: Brites
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood*; D003430:Cross-Sectional Studies; D003480:Cushing Syndrome / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055105:Waist Circumference