庫欣綜合症（CS）是心血管疾病的眾所周知的危險因素。本研究旨在評估CS患者在緩解前後的內皮和心血管功能、內皮介質和前炎症細胞激素。納入新診斷的成人內源性CS患者。進行代謝學（身體質量指數（BMI）、葡萄糖和脂質值）和心血管評估（24小時動態血壓監測、頸動脈內膜中層厚度（CIMT）、流介導擴張（FMD）和超聲心動圖）研究，並測量內皮介質（非對稱二甲基精氨酸（ADMA）和endothelin-1（ET-1））和前炎細胞因子（白細胞介素-1β（IL-1β）和腫瘤壞死因子-α（TNF-α））。對照組與年齡、性別和BMI相匹配。共有25名患者，平均年齡40.60±14.04歲，完成研究。與對照組（n=20）相比，患者在活動性疾病期間平均動脈壓（MAP）和CIMT較高（P<0.005和P=0.012），FMD（P<0.001）和二尖瓣E/A比值（P=0.007）較低。基線血清ADMA、ET-1和IL-1β在兩組之間相似，而TNF-α在患者中較低（P=0.030）。所有患者在手術後一年完全緩解。BMI、低密度脂蛋白膽固醇、血清總膽固醇、空腹血漿葡萄糖、MAP和CIMT均明顯降低（P<0.005），而FMD無改善（P=0.11）。緩解後ADMA、IL-1β和TNF-α水平無顯著變化，但ET-1增加（P=0.011）。CS的緩解對一些心血管參數有改善作用。ADMA和ET-1在CS的內皮功能障礙中並不可靠。代謝改善可能不會直接反映在CS緩解後的TNF-α和IL-1β血清濃度中。© 2023. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).

Cushing syndrome (CS) is a well-known risk factor for cardiovascular morbidities. We aimed to evaluate endothelial and cardiovascular functions, endothelial mediators and pro-inflammatory cytokines in patients with CS before and after remission.Adult patients with newly diagnosed endogenous CS were included. Metabolic [body mass index (BMI), glucose, and lipid values] and cardiovascular evaluation studies [24-h ambulatory blood pressure monitoring, carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), and echocardiography] were performed, and endothelial mediators [asymmetric dimethyl arginine (ADMA) and endothelin-1 (ET-1)] and pro-inflammatory cytokines [interleukin-1β (IL-1β) and tumor necrosis factor-alpha (TNF-α)] were measured. Control group was matched in terms of age, gender, and BMIs.Twenty-five patients, mean age 40.60 ± 14.04 years, completed the study. Compared to controls (n = 20) mean arterial pressure (MAP) and CIMT were higher (p < 0.005 and p = 0.012, respectively), and FMD (p < 0.001) and mitral E/A ratio (p = 0.007) lower in the patients during active disease. Baseline serum ADMA, ET-1, and IL-1β were similar between the groups, while TNF-α was lower in the patients (p = 0.030). All patients were in complete remission 1 year following surgery. BMI, LDL cholesterol, serum total cholesterol, fasting plasma glucose, MAPs, and CIMT significantly decreased (p < 0.005), while there was no improvement in FMD (p = 0.11) following remission. There was no significant change in ADMA, IL-1β, and TNF-α levels, but ET-1 increased (p = 0.011).Remission in CS improves some cardiovascular parameters. ADMA and ET-1 are not reliable markers for endothelial dysfunction in CS. Metabolic improvements may not directly reflect on serum concentrations of TNF-α and IL-1β following remission of CS.© 2023. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).