Markers of atherosclerosis in patients with Cushing's syndrome: a meta-analysis of literature studies
Background: Several studies reported an increased cardiovascular (CV) risk in Cushing's syndrome (CS). We performed a meta-analysis on the impact of CS on major markers of atherosclerosis. Methods: Studies on intima-media thickness (IMT), carotid plaques prevalence, and flow-mediated dilation (...
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| Veröffentlicht in: | Annals of medicine (Helsinki) 2017-04, Vol.49 (3), p.206-216 |
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| creator | Lupoli, Roberta Ambrosino, Pasquale Tortora, Anna Barba, Livia Lupoli, Gelsy Arianna Di Minno, Matteo Nicola Dario |
| description | Background: Several studies reported an increased cardiovascular (CV) risk in Cushing's syndrome (CS). We performed a meta-analysis on the impact of CS on major markers of atherosclerosis.
Methods: Studies on intima-media thickness (IMT), carotid plaques prevalence, and flow-mediated dilation (FMD) in CS patients and controls were searched in the PubMed, Web of Science, Scopus, and EMBASE. Differences between cases and controls were expressed as mean difference (MD) with 95% confidence intervals (95%CI) for continuous variables, and as Odds Ratio (OR) with 95%CI for dichotomous variables.
Results: Fourteen studies (332 CS, 462 controls) were included. Compared with controls, CS patients showed higher IMT (MD: 0.20 mm; 95% CI: 0.12, 0.28; p |
| doi_str_mv | 10.1080/07853890.2016.1252055 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1835509072</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1835509072</sourcerecordid><originalsourceid>FETCH-LOGICAL-c366t-76252f8ae081921306a468db1f785794a50034c08a40ece65ccc0b96b3caedd13</originalsourceid><addsrcrecordid>eNp9kE1v1DAQhi0EapfSnwDyjV6yjOO143CiWpWCVMQFztasM2EN-Vg8jqr99yTaLcdeZi7PO6P3EeKtgrUCBx-gcka7GtYlKLtWpSnBmBdipbQ1RQkWXorVwhQLdCleM_8GgLJScCEuy6qyunJqJegbpj-UWI6txLynNHLolhlZxkEeMEcaMsvHmPdyO_E-Dr_es-Tj0KSxp48SZU8ZCxywOy6h-U4XMyXMUyLJeWoi8RvxqsWO6fq8r8TPz3c_tl-Kh-_3X7e3D0XQ1uaisnON1iGBU3WpNFjcWNfsVDsXqeoNGgC9CeBwAxTImhAC7Gq70wGpaZS-Ejenu4c0_p2Is-8jB-o6HGic2CunjYEaqnJGzQkNc1lO1PpDij2mo1fgF8P-ybBfDPuz4Tn37vxi2vXU_E89KZ2BTycgDu2YenwcU9f4jMduTG3CIUT2-vkf_wBr7It7</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1835509072</pqid></control><display><type>article</type><title>Markers of atherosclerosis in patients with Cushing's syndrome: a meta-analysis of literature studies</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Lupoli, Roberta ; Ambrosino, Pasquale ; Tortora, Anna ; Barba, Livia ; Lupoli, Gelsy Arianna ; Di Minno, Matteo Nicola Dario</creator><creatorcontrib>Lupoli, Roberta ; Ambrosino, Pasquale ; Tortora, Anna ; Barba, Livia ; Lupoli, Gelsy Arianna ; Di Minno, Matteo Nicola Dario</creatorcontrib><description>Background: Several studies reported an increased cardiovascular (CV) risk in Cushing's syndrome (CS). We performed a meta-analysis on the impact of CS on major markers of atherosclerosis.
Methods: Studies on intima-media thickness (IMT), carotid plaques prevalence, and flow-mediated dilation (FMD) in CS patients and controls were searched in the PubMed, Web of Science, Scopus, and EMBASE. Differences between cases and controls were expressed as mean difference (MD) with 95% confidence intervals (95%CI) for continuous variables, and as Odds Ratio (OR) with 95%CI for dichotomous variables.
Results: Fourteen studies (332 CS, 462 controls) were included. Compared with controls, CS patients showed higher IMT (MD: 0.20 mm; 95% CI: 0.12, 0.28; p < .001), increased prevalence of carotid plaques (OR: 8.85, 95%CI: 4.09, 19.14; p < .001), and lower FMD (MD: −2.65%; 95% CI: −3.65, −1.65; p < .001). Difference in IMT and in the prevalence of carotid plaques was confirmed also in patients with CS remission (MD: 0.24 mm; 95% CI: 0.07, 0.40; p = .005 and OR: 9.88, 95%CI: 2.69, 36.3; p < 0.001, respectively). Regression models showed that age, diabetes, obesity, ACTH-dependent CS, serum and urinary cortisol levels impacted on the observed difference in IMT.
Conclusions: CS is significantly associated with markers of subclinical atherosclerosis and CV risk. These findings could help establish more specific CV prevention strategies in this clinical setting.
Key messages
A series of studies reported an increased cardiovascular risk in patients with Cushing's syndrome (CS).
In the present meta-analysis we demonstrated that CS is associated with an increased intima-media thickness, higher prevalence of carotid plaques, and lower flow-mediated dilation as compared with controls.
These data consistently suggest the need for a strict monitoring of early signs of subclinical atherosclerosis in CS patients</description><identifier>ISSN: 0785-3890</identifier><identifier>EISSN: 1365-2060</identifier><identifier>DOI: 10.1080/07853890.2016.1252055</identifier><identifier>PMID: 27763781</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Adolescent ; Adult ; atherosclerosis ; Atherosclerosis - complications ; Atherosclerosis - metabolism ; Biomarkers - metabolism ; Cardiovascular Diseases - complications ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - metabolism ; cardiovascular risk ; Carotid Intima-Media Thickness ; Cushing Syndrome - complications ; Cushing Syndrome - epidemiology ; Cushing Syndrome - metabolism ; Cushing Syndrome - pathology ; Cushing's syndrome ; Endothelium - physiopathology ; Female ; flow-mediated dilation ; Humans ; Hydrocortisone - blood ; Hydrocortisone - urine ; hypercortisolism ; Intima-media thickness ; Male ; Middle Aged ; Obesity - epidemiology ; Prevalence ; Prospective Studies</subject><ispartof>Annals of medicine (Helsinki), 2017-04, Vol.49 (3), p.206-216</ispartof><rights>2016 Informa UK Limited, trading as Taylor & Francis Group 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c366t-76252f8ae081921306a468db1f785794a50034c08a40ece65ccc0b96b3caedd13</citedby><cites>FETCH-LOGICAL-c366t-76252f8ae081921306a468db1f785794a50034c08a40ece65ccc0b96b3caedd13</cites><orcidid>0000-0002-1701-7197 ; 0000-0001-8059-3819</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27763781$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lupoli, Roberta</creatorcontrib><creatorcontrib>Ambrosino, Pasquale</creatorcontrib><creatorcontrib>Tortora, Anna</creatorcontrib><creatorcontrib>Barba, Livia</creatorcontrib><creatorcontrib>Lupoli, Gelsy Arianna</creatorcontrib><creatorcontrib>Di Minno, Matteo Nicola Dario</creatorcontrib><title>Markers of atherosclerosis in patients with Cushing's syndrome: a meta-analysis of literature studies</title><title>Annals of medicine (Helsinki)</title><addtitle>Ann Med</addtitle><description>Background: Several studies reported an increased cardiovascular (CV) risk in Cushing's syndrome (CS). We performed a meta-analysis on the impact of CS on major markers of atherosclerosis.
Methods: Studies on intima-media thickness (IMT), carotid plaques prevalence, and flow-mediated dilation (FMD) in CS patients and controls were searched in the PubMed, Web of Science, Scopus, and EMBASE. Differences between cases and controls were expressed as mean difference (MD) with 95% confidence intervals (95%CI) for continuous variables, and as Odds Ratio (OR) with 95%CI for dichotomous variables.
Results: Fourteen studies (332 CS, 462 controls) were included. Compared with controls, CS patients showed higher IMT (MD: 0.20 mm; 95% CI: 0.12, 0.28; p < .001), increased prevalence of carotid plaques (OR: 8.85, 95%CI: 4.09, 19.14; p < .001), and lower FMD (MD: −2.65%; 95% CI: −3.65, −1.65; p < .001). Difference in IMT and in the prevalence of carotid plaques was confirmed also in patients with CS remission (MD: 0.24 mm; 95% CI: 0.07, 0.40; p = .005 and OR: 9.88, 95%CI: 2.69, 36.3; p < 0.001, respectively). Regression models showed that age, diabetes, obesity, ACTH-dependent CS, serum and urinary cortisol levels impacted on the observed difference in IMT.
Conclusions: CS is significantly associated with markers of subclinical atherosclerosis and CV risk. These findings could help establish more specific CV prevention strategies in this clinical setting.
Key messages
A series of studies reported an increased cardiovascular risk in patients with Cushing's syndrome (CS).
In the present meta-analysis we demonstrated that CS is associated with an increased intima-media thickness, higher prevalence of carotid plaques, and lower flow-mediated dilation as compared with controls.
These data consistently suggest the need for a strict monitoring of early signs of subclinical atherosclerosis in CS patients</description><subject>Adolescent</subject><subject>Adult</subject><subject>atherosclerosis</subject><subject>Atherosclerosis - complications</subject><subject>Atherosclerosis - metabolism</subject><subject>Biomarkers - metabolism</subject><subject>Cardiovascular Diseases - complications</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - metabolism</subject><subject>cardiovascular risk</subject><subject>Carotid Intima-Media Thickness</subject><subject>Cushing Syndrome - complications</subject><subject>Cushing Syndrome - epidemiology</subject><subject>Cushing Syndrome - metabolism</subject><subject>Cushing Syndrome - pathology</subject><subject>Cushing's syndrome</subject><subject>Endothelium - physiopathology</subject><subject>Female</subject><subject>flow-mediated dilation</subject><subject>Humans</subject><subject>Hydrocortisone - blood</subject><subject>Hydrocortisone - urine</subject><subject>hypercortisolism</subject><subject>Intima-media thickness</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Obesity - epidemiology</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><issn>0785-3890</issn><issn>1365-2060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v1DAQhi0EapfSnwDyjV6yjOO143CiWpWCVMQFztasM2EN-Vg8jqr99yTaLcdeZi7PO6P3EeKtgrUCBx-gcka7GtYlKLtWpSnBmBdipbQ1RQkWXorVwhQLdCleM_8GgLJScCEuy6qyunJqJegbpj-UWI6txLynNHLolhlZxkEeMEcaMsvHmPdyO_E-Dr_es-Tj0KSxp48SZU8ZCxywOy6h-U4XMyXMUyLJeWoi8RvxqsWO6fq8r8TPz3c_tl-Kh-_3X7e3D0XQ1uaisnON1iGBU3WpNFjcWNfsVDsXqeoNGgC9CeBwAxTImhAC7Gq70wGpaZS-Ejenu4c0_p2Is-8jB-o6HGic2CunjYEaqnJGzQkNc1lO1PpDij2mo1fgF8P-ybBfDPuz4Tn37vxi2vXU_E89KZ2BTycgDu2YenwcU9f4jMduTG3CIUT2-vkf_wBr7It7</recordid><startdate>20170403</startdate><enddate>20170403</enddate><creator>Lupoli, Roberta</creator><creator>Ambrosino, Pasquale</creator><creator>Tortora, Anna</creator><creator>Barba, Livia</creator><creator>Lupoli, Gelsy Arianna</creator><creator>Di Minno, Matteo Nicola Dario</creator><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1701-7197</orcidid><orcidid>https://orcid.org/0000-0001-8059-3819</orcidid></search><sort><creationdate>20170403</creationdate><title>Markers of atherosclerosis in patients with Cushing's syndrome: a meta-analysis of literature studies</title><author>Lupoli, Roberta ; Ambrosino, Pasquale ; Tortora, Anna ; Barba, Livia ; Lupoli, Gelsy Arianna ; Di Minno, Matteo Nicola Dario</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c366t-76252f8ae081921306a468db1f785794a50034c08a40ece65ccc0b96b3caedd13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>atherosclerosis</topic><topic>Atherosclerosis - complications</topic><topic>Atherosclerosis - metabolism</topic><topic>Biomarkers - metabolism</topic><topic>Cardiovascular Diseases - complications</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - metabolism</topic><topic>cardiovascular risk</topic><topic>Carotid Intima-Media Thickness</topic><topic>Cushing Syndrome - complications</topic><topic>Cushing Syndrome - epidemiology</topic><topic>Cushing Syndrome - metabolism</topic><topic>Cushing Syndrome - pathology</topic><topic>Cushing's syndrome</topic><topic>Endothelium - physiopathology</topic><topic>Female</topic><topic>flow-mediated dilation</topic><topic>Humans</topic><topic>Hydrocortisone - blood</topic><topic>Hydrocortisone - urine</topic><topic>hypercortisolism</topic><topic>Intima-media thickness</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Obesity - epidemiology</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lupoli, Roberta</creatorcontrib><creatorcontrib>Ambrosino, Pasquale</creatorcontrib><creatorcontrib>Tortora, Anna</creatorcontrib><creatorcontrib>Barba, Livia</creatorcontrib><creatorcontrib>Lupoli, Gelsy Arianna</creatorcontrib><creatorcontrib>Di Minno, Matteo Nicola Dario</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of medicine (Helsinki)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lupoli, Roberta</au><au>Ambrosino, Pasquale</au><au>Tortora, Anna</au><au>Barba, Livia</au><au>Lupoli, Gelsy Arianna</au><au>Di Minno, Matteo Nicola Dario</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Markers of atherosclerosis in patients with Cushing's syndrome: a meta-analysis of literature studies</atitle><jtitle>Annals of medicine (Helsinki)</jtitle><addtitle>Ann Med</addtitle><date>2017-04-03</date><risdate>2017</risdate><volume>49</volume><issue>3</issue><spage>206</spage><epage>216</epage><pages>206-216</pages><issn>0785-3890</issn><eissn>1365-2060</eissn><abstract>Background: Several studies reported an increased cardiovascular (CV) risk in Cushing's syndrome (CS). We performed a meta-analysis on the impact of CS on major markers of atherosclerosis.
Methods: Studies on intima-media thickness (IMT), carotid plaques prevalence, and flow-mediated dilation (FMD) in CS patients and controls were searched in the PubMed, Web of Science, Scopus, and EMBASE. Differences between cases and controls were expressed as mean difference (MD) with 95% confidence intervals (95%CI) for continuous variables, and as Odds Ratio (OR) with 95%CI for dichotomous variables.
Results: Fourteen studies (332 CS, 462 controls) were included. Compared with controls, CS patients showed higher IMT (MD: 0.20 mm; 95% CI: 0.12, 0.28; p < .001), increased prevalence of carotid plaques (OR: 8.85, 95%CI: 4.09, 19.14; p < .001), and lower FMD (MD: −2.65%; 95% CI: −3.65, −1.65; p < .001). Difference in IMT and in the prevalence of carotid plaques was confirmed also in patients with CS remission (MD: 0.24 mm; 95% CI: 0.07, 0.40; p = .005 and OR: 9.88, 95%CI: 2.69, 36.3; p < 0.001, respectively). Regression models showed that age, diabetes, obesity, ACTH-dependent CS, serum and urinary cortisol levels impacted on the observed difference in IMT.
Conclusions: CS is significantly associated with markers of subclinical atherosclerosis and CV risk. These findings could help establish more specific CV prevention strategies in this clinical setting.
Key messages
A series of studies reported an increased cardiovascular risk in patients with Cushing's syndrome (CS).
In the present meta-analysis we demonstrated that CS is associated with an increased intima-media thickness, higher prevalence of carotid plaques, and lower flow-mediated dilation as compared with controls.
These data consistently suggest the need for a strict monitoring of early signs of subclinical atherosclerosis in CS patients</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>27763781</pmid><doi>10.1080/07853890.2016.1252055</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-1701-7197</orcidid><orcidid>https://orcid.org/0000-0001-8059-3819</orcidid></addata></record> |
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| subjects | Adolescent Adult atherosclerosis Atherosclerosis - complications Atherosclerosis - metabolism Biomarkers - metabolism Cardiovascular Diseases - complications Cardiovascular Diseases - epidemiology Cardiovascular Diseases - metabolism cardiovascular risk Carotid Intima-Media Thickness Cushing Syndrome - complications Cushing Syndrome - epidemiology Cushing Syndrome - metabolism Cushing Syndrome - pathology Cushing's syndrome Endothelium - physiopathology Female flow-mediated dilation Humans Hydrocortisone - blood Hydrocortisone - urine hypercortisolism Intima-media thickness Male Middle Aged Obesity - epidemiology Prevalence Prospective Studies |
| title | Markers of atherosclerosis in patients with Cushing's syndrome: a meta-analysis of literature studies |
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