Subclinical Atherosclerosis in Patients with Cushing Syndrome: Evaluation with Carotid Intima-Media Thickness and Ankle-Brachial Index.
BACKGROUND
Cushing syndrome (CS) has been described as a killing disease due its cardiovascular complications. In fact, chronic cortisol excess leads to a constellation of complications, including hypertension, hyperglycemia, adiposity, and thromboembolism. The main vascular alteration associated with CS is atherosclerosis.


METHODS
Aim of this study was to analyze carotid intima-media thickness (cIMT) and ankle-brachial index (ABI), two surrogate markers of subclinical atherosclerosis in a consecutive series of CS patients, compared to patients with essential hypertension (EH) and health subjects (HS).


RESULTS
Patients with CS showed a significant increase (P<0.05) of cIMT (0.89±0.17 mm) compared to EH (0.81±0.16 mm) and HS (0.75±0.4 mm), with a high prevalence of plaque (23%; P<0.03). Moreover, CS patients showed a mean ABI values (1.07±0.02) significantly lower respect to HS (1.12±0.11; P<0.05), and a higher percentage (20%) of pathological values of ABI (≤0.9; P<0.03).


CONCLUSIONS
In conclusion, we confirmed and extended the data of cIMT in CS, and showed that the ABI represent another surrogate marker of subclinical atherosclerosis in this disease.
Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.
Luigi
L
Petramala
Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.
D'Elia
D
Lorenzo
Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.
Gino
G
Iannucci
Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.
Antonio
A
Concistré
Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.
Laura
L
Zinnamosca
Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy.
Cristiano
C
Marinelli
Section Nuclear Medicine, Department of Radiology, University of Rome "Sapienza", Rome, Italy.
Giuseppe
G
De Vincentis
Department of Surgery, "P. Valdoni", University of Rome "Sapienza", Rome, Italy.
Antonio
A
Ciardi
Department of Surgery, "P. Valdoni", University of Rome "Sapienza", Rome, Italy.
Giorgio
G
De Toma
Department of Internal Medicine and Medical Specialties, University of Rome "Sapienza", Rome, Italy. claudio.letizia@uniroma1.it.
Claudio
C
Letizia
Ankle brachial index; Carotid intima-media thickness; Cushing syndrome; Subclinical atherosclerosis