Arnaldi Giorgio, Mancini Tatiana, Polenta Barbara, Boscaro Marco
Division of Endocrinology, Polytechnic University of the Marche Region, Ancona, Italy.
Pituitary. 2004;7(4):253-6. doi: 10.1007/s11102-005-1172-7.
Chronic cortisol hypersecretion causes central obesity, hypertension, insulin resistance, dyslipidemia, protrombotic state, manifestations which form a metabolic syndrome in all patients with Cushing's syndrome. These associated abnormalities determine an increased cardiovascular risk not only during the active phase of the disease but also long after the "biomedical remission". Clinical management of these patients should be particularly careful in identifying global cardiovascular risk. Considering that remission from hypercortisolism is often difficult to achieve care and control of all cardiovascular risk factors should be one of the primary goals during the follow up of these patients. Extending the indications of the recent consensus on Cushing's syndrome, we suggest to carry out an OGTT to avoid underestimation of diabetes mellitus, an echocardiography and Doppler ultrasonography of the epiaortic vessels in all patients at diagnosis and during follow-up.
慢性皮质醇分泌过多会导致中心性肥胖、高血压、胰岛素抵抗、血脂异常、血栓前状态，这些表现见于所有库欣综合征患者，构成一种代谢综合征。这些相关异常不仅在疾病活动期，而且在“生物医学缓解”很久之后都会增加心血管风险。对这些患者进行临床管理时，应特别谨慎地识别整体心血管风险。鉴于皮质醇增多症往往难以实现缓解，在这些患者的随访期间，对所有心血管危险因素的护理和控制应是主要目标之一。根据近期关于库欣综合征的共识扩大适应症，我们建议对所有患者在诊断时及随访期间进行口服葡萄糖耐量试验（OGTT），以避免低估糖尿病，同时进行超声心动图检查和主动脉弓血管多普勒超声检查。
