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Cardiovascular risk and white matter lesions after endocrine control of Cushing's syndrome
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Objective: Cushing's syndrome (CS) is associated with high cardiovascular risk. White matter lesions (WML) are common on brain magnetic resonance imaging (MRI) in patients with increased cardiovascular risk. AIM: To investigate the relationship between cardiovascular risk, WML, neuropsychological performance and brain volume in CS. Design/methods: Thirty-eight patients with CS (23 in remission, 15 active) and 38 controls sex-, age- and education-level matched underwent a neuropsychological and clinical evaluation, blood and urine tests and 3Tesla brain MRI. WML were analysed with the Scheltens scale. Ten-year cardiovascular risk (10CVR) and vascular age (VA) were calculated according to an algorithm based on the Framingham heart study. Results: Patients in remission had a higher degree of WML than controls and active patients (P<0.001 and P=0.008 respectively), which did not correlate with cognitive performance in any group. WML severity positively correlated with diastolic blood pressure (r=0.659, P=0.001) and duration of hypertension (r=0.478, P=0.021) in patients in remission. Both patient groups (active and in remission) had higher 10CVR (P=0.030, P=0.041) and VA than controls (P=0.013, P=0.039). Neither the 10CVR nor the VA correlated with WML, although both negatively correlated with cognitive function and brain volume in patients in remission (P<0.05). Total brain volume and grey matter volume in both CS patient groups were reduced compared to controls (total volume: active P=0.006, in remission P=0.012; grey matter: active P=0.001, in remission P=0.003), with no differences in white matter volume between groups. Conclusions: Patients in remission of Cushing's syndrome (but not active patients) have more severe white matter lesions than controls, positively correlated with diastolic pressure and duration of hypertension. Ten-year cardiovascular risk and vascular age appear to be negatively correlated with the cognitive function and brain volume in patients in remission of Cushing's syndrome.
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SANTOS VIVES, Alicia, RESMINI, Eugenia, GÓMEZ-ANSÓN, Beatriz, CRESPO, Iris, GRANELL, Esther, VALASSI, Elena, PIRES, Patricia, VIVES-GILABERT, Yolanda, MARTÍNEZ MOMBLÁN, Ma. antonia, JUAN, Manuel de, MATARÓ SERRAT, Maria, WEBB, S. m. (susan m.). Cardiovascular risk and white matter lesions after endocrine control of Cushing's syndrome. _European Journal of Endocrinology_. 2015. Vol. 173, núm. 6, pàgs. 765-775. [consulta: 20 de gener de 2026]. ISSN: 0804-4643. [Disponible a: https://hdl.handle.net/2445/119115]