Dhingra Atul, Ganie Mohd Ashraf, Dharmshaktu Pramila, Chakraborty Semanti, Jyotsna Viveka P, Gupta Nandita
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Horm Metab Res. 2019 May;51(5):309-314. doi: 10.1055/a-0879-5122. Epub 2019 May 9.
Atherosclerotic cardiovascular events are one of the common causes of mortality in patients with Cushing's syndrome (CS). Atherogenic dyslipidemia is more common among South Asian Indians as compared to other ethnicities and is likely to worsen among patients with CS. This retrospective study was done over 5 years at a single institute to evaluate the pattern of lipid abnormalities in subjects with CS and the changes in lipid parameters after surgical control of hypercortisolemia. The study was done in two parts. In the first part, records of patients with CS diagnosed over 3 years were retrospectively reviewed. Hormonal and metabolic parameters including fasting plasma glucose (FPG), post prandial plasma glucose (PPPG), HbA1c, serum lipids, serum cortisol and plasma ACTH were recorded. In the second part, lipid parameters were rechecked among patients who underwent surgery and a median follow up of 4±2 months after remission. Out of the 126 patients diagnosed with endogenous CS over 3 years, 100 patients were eligible for inclusion in the study. At baseline, sixty five (65%) patients had dyslipidemia as defined by the NCEP-ATPIII criteria. 47 out of 63 (74.6%) subjects achieved remission after surgical management of CS. 32 (68.1%) of these patients had dyslipidemia prior to surgery. After excluding 1 death, 26 of 46 (56.5%) subjects had dyslipidemia after the follow up period. Lipid abnormalities are common among South Asian Indian subjects with endogenous CS and the pattern persists in most of them, 3 months after surgical correction of hypercortisolism.
动脉粥样硬化性心血管事件是库欣综合征（CS）患者常见的死亡原因之一。与其他种族相比，致动脉粥样硬化性血脂异常在南亚印度人中更为常见，并且在CS患者中可能会恶化。这项回顾性研究在一家机构进行了5年，以评估CS患者的脂质异常模式以及高皮质醇血症手术控制后脂质参数的变化。该研究分为两个部分。在第一部分中，回顾性分析了3年以上诊断为CS的患者记录。记录了包括空腹血糖（FPG）、餐后血糖（PPPG）、糖化血红蛋白（HbA1c）、血脂、血清皮质醇和血浆促肾上腺皮质激素（ACTH）在内的激素和代谢参数。在第二部分中，对接受手术的患者进行了脂质参数复查，并在缓解后进行了4±2个月的中位随访。在3年以上诊断为内源性CS的126例患者中，100例符合纳入研究的条件。基线时，根据NCEP-ATPIII标准，65例（65%）患者存在血脂异常。63例患者中有47例（74.6%）在CS手术治疗后达到缓解。这些患者中有32例（68.1%）在手术前存在血脂异常。排除1例死亡病例后，46例患者中有26例（56.5%）在随访期后存在血脂异常。脂质异常在南亚印度裔内源性CS患者中很常见，并且在大多数患者中，高皮质醇血症手术纠正3个月后这种模式仍然存在。
