Asymmetric Dimethylarginine Levels and Atherosclerosis Markers in Cushing Syndrome

Objective: As a consequence of hypercortisolism, Cushing syndrome (CS) is frequently observed with other diseases that are associated with atherosclerosis, including diabetes mellitus, dyslipidemia, hypertension, and obesity. Cardiovascular disease (CVD) is the primary cause of mortality and morbidity in CS. We investigate CVD risk markers such as asymmetric dimethylarginine (ADMA), lipoprotein-associated phospholipase A2 (Lp-PLA2), highsensitive C-reactive protein (hsCRP), homocysteine, lipid levels, ankle-brachial index (ABI), and carotid intimamedia thickness (CIMT) in CS.Methods: Our study included 27 patients with CS and 27 age-, sex-, body mass index (BMI)-, and comorbid disease–matched control subjects.Results: Plasma ADMA levels were significantly lower in the CS group than the control group (P = .013). Total cholesterol, low-density lipoprotein, triglycerides, high-density lipoprotein, and apolipoprotein A1 and apolipoprotein B levels were higher in patients with CS than the control group (P<.05). We did not find any statistically significant differences in levels of hsCRP, Lp-PLA2, or homocysteine or CIMT and ABI measurements between the CS group and comorbidity-matched control group (P>.05).Conclusion: We found that ADMA levels were lower in CS, the finding that should be further investigated. Levels of hsCRP, Lp-PLA2, and homocysteine levels and CIMT and ABI measurements were similar between the CS group and comorbidity-matched control group. None of these markers was prominent to show an increased risk of CVD in CS, independent of the comorbidities of CS.Abbreviations:ABI = ankle-brachial indexApo = apolipoproteinADMA = asymmetric dimethylarginineBMI = body mass indexCVD = cardiovascular diseaseCIMT = carotid intima-media thicknessCS = Cushing syndromeDM = diabetes mellitusDDAH = dimethylarginine dimethylaminohydrolaseELISA = enzyme-linked immunosorbent assayHDL = high-density lipoproteinhsCRP = high-sensitive C-reactive proteinHOMA-IR = homeostatic model assessment of insulin resistanceHT = hypertensionLDL = low-density lipoproteinLp-PLA2 = lipoprotein-associated phospholipase A2Lp-a = lipoprotein aNO = nitric oxide