Activity of selected coagulation factors in overt and subclinical hypercortisolism

Świątkowska−Stodulska, Renata; Skibowska-Bielińska, Anna; Wiśniewski, Piotr; Sworczak, Krzysztof

doi:10.1507/endocrj.ej14-0539

Cited by 18 publications

(11 citation statements)

References 35 publications

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“…Even subclinical hormonal activity, results in coexistence of metabolic diseases: Cushing Syndrome-(CS) and Subclinical Cushing Syndrome (SCS), pheochromocytoma (PHEO) [10][11][12] and coagulation disorders: CS, SCS [13][14][15]. In fact, patients with adrenal incidentalomas have a high prevalence of obesity, hypertension (HT) and diabetes mellitus (DM) [11,12,16,17].…”

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Adipokine and cytokine levels in non-functioning adrenal incidentalomas (NFAI)

2018

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Due to the fact that overweight or obesity is accompanied by hormonally active adrenal tumors: Cushing Syndrome-(CS) and Subclinical Cushing Syndrome (SCS), it is of high interest the correlation between different adipokines and cytokines secreted by adipose tissue, with metabolic disorders and hormonal activity in this group. Even in non-functioning adrenal incidentalomas (NFAI) elevated risk for cardiovascular disease and metabolic syndrome was demonstrated. The aim of the study was to investigate plasma adiponectin, leptin, resistin, tumor necrosis factor α (TNFα), interleukin 6 (IL6) and monocyte chemoattractant protein 1 (MCP1) levels in patients with NFAIs and healthy subjects. The study included 18 NFAI patients and 18 healthy subjects. The groups were homogeneous in terms of age, sex and body mass index (BMI). Patients with NFAI showed significantly higher circulating levels of pro-inflammatory cytokines compared to healthy controls (MCP 1: p < 0.001; TNFα p = 0.021; IL6 p = 0.012). On the other hand, adiponectin concentration was significantly lower in the NFAI group (p = 0.034). The serum leptin and resistin concentrations did not differ significantly between the two groups. Acquired results were not dependent on glucocorticoid and catecholamine secretion in NFAI patients. Also, there were no clear correlations between BMI and cytokine levels. It is possible that increased risk for cardiovascular and metabolic diseases reported in NFAI patients is at least partially dependent on adipose tissue activity.

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Adipokine and cytokine levels in non-functioning adrenal incidentalomas (NFAI)

2018

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“…Patients with CS present higher levels of: FII, FV, FVIII, FIX, FXI, FXII, FVIII, and von Willebrand factor (vWF), as well as increased levels of fibrinolytic inhibitors, e.g., plasminogen activator inhibitor type 1 [1–4, 23]. Impact on hypercoagulability in CS depends on the degree of hypercortisolism.…”

Section: Discussionmentioning

confidence: 99%

“…Impact on hypercoagulability in CS depends on the degree of hypercortisolism. In Swiatkowska et al study, activity of FVIII was higher only in patients with overt CS, not with subclinical CS; however, vWF was increased in both groups [23]. The hypercoagulable state and impairment of fibrinolytic capacity in CS are associated with an increased risk of VTE and PE [5, 9].…”

Section: Discussionmentioning

confidence: 99%

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High-dose intravenous methylprednisolone therapy in patients with Graves’ orbitopathy is associated with the increased activity of factor VIII

Miśkiewicz

Milczarek-Banach

Rutkowska-Hinc

et al. 2018

J Endocrinol Invest

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Purpose Venous thromboembolic events (VTE), with their life-threatening manifestation as pulmonary embolism, are potential adverse effects of intravenous methylprednisolone (IVMP) pulse therapy, partially due to a hypercoagulable state. The aim of the study was to analyze the influence of IVMP on selected hemostatic parameters in patients with moderateto-severe Graves' orbitopathy (GO). Methods 26 euthyroid patients with GO were treated with 12 pulses of IVMP (6 × 0.5, 6 × 0.25 g every week). Hemostatic variables [factor (F) II, FV, FVII, FVIII, fibrinogen, antithrombin, activated partial thromboplastin time (aPTT), prothrombin time, international normalized ratio of prothrombin time, platelets and D-dimer] were analysed before, 24 and 48 h after 1st, 6th and 12th pulse. Results A constant, transient trend in changes of some hemostatic variables was observed after all assessed pulses. We discovered an increase in median activity of FVIII 24 and 48 h after pulses, with a shortening of aPTT 24 h after each IVMP pulse (p < 0.00005). FVII decreased 24 h after each pulse (p < 0.0005 after 1st and 12th, p < 0.00005 after 6th). Fibrinogen level decreased 48 h after each pulse (P < 0.00005). We did not observe any statistically significant changes in hemostatic parameters in the long-term evaluation. Therapy was concluded in one patient after the 9th pulse due to pulmonary embolism. Conclusions The increase of FVIII activity is a consequence of treatment with IVMP and occurs after each pulse. In patients with additional risk factors of VTE, anticoagulation prophylaxis should be considered.

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“…Nevertheless, there are no universally accepted hormonal criteria for SCS diagnosis [ 6 , 13 – 16 ]. A cortisol value of >5 μ g/dL after 1-mg dexamethasone suppression test (1-mg DST) is accepted as a sufficient criterion to diagnose SCS [ 15 – 17 ]. Patients with cortisol values between 1.8 μ g/dL and 5 μ g/dL in this test should also have at least one other criterion: lack of circadian cortisol secretion rhythm (late evening to morning serum cortisol % ratio exceeded 50%), decreased morning adrenocorticotropic hormone (ACTH) concentration (≤10 pg/mL), and/or increased 24-hour urinary free cortisol excretion [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Serum Adiponectin Level as a Predictor of Subclinical Cushing’s Syndrome in Patients with Adrenal Incidentaloma

Ünal

Ayturk

Aldemir

et al. 2016

International Journal of Endocrinology

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Subclinical Cushing's syndrome (SCS) is a condition of slight but chronic cortisol excess in patients with adrenal incidentaloma (AI) without typical signs and symptoms of Cushing's syndrome. Adiponectin has potent roles in modulating energy balance and metabolic homeostasis and acts in opposition to glucocorticoids. This study aimed to evaluate adiponectin level in SCS and nonfunctional AI (NAI) patients and its relation with metabolic parameters. Patients with AI (n = 40) and metabolically healthy controls (n = 30) were included. In AI patients and controls, detailed medical history assessment, physical examinations, anthropometric measurements, and laboratory measurements were performed. Age, body mass index, waist circumference, and lipid profiles were significantly higher and waist-to-hip ratio and adiponectin level were significantly lower in the AI patients than in the controls. The midnight cortisol and urinary free cortisol levels were significantly higher in the SCS patients (n = 8) than in the NAI patients (n = 32). Adiponectin level of the SCS group was significantly lower than those of the NAI and control groups. The sensitivity and specificity for an adiponectin level of ≤13.00 ng/mL in predicting the presence of SCS were 87.5% and 77.4%, respectively. In conclusion, adiponectin is valuable in predicting the presence of SCS in AI patients.

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Activity of selected coagulation factors in overt and subclinical hypercortisolism

Cited by 18 publications

References 35 publications

Adipokine and cytokine levels in non-functioning adrenal incidentalomas (NFAI)

Adipokine and cytokine levels in non-functioning adrenal incidentalomas (NFAI)

High-dose intravenous methylprednisolone therapy in patients with Graves’ orbitopathy is associated with the increased activity of factor VIII

Serum Adiponectin Level as a Predictor of Subclinical Cushing’s Syndrome in Patients with Adrenal Incidentaloma

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