查看文章

Background: Recently the pathophysiological role of endothelin (ET) has been presumed in a number of adrenal disorders such as primary hyperaldosteronism, pheochromocytoma and adrenocortical insufficiency.

Aim: The aim of the present study was to evaluate circulating ET-1 levels in patients with endogenous Cushing’s syndrome.

Methods and results: Plasma ET-1 levels were determined by highly sensitive RIA. Thirteen untreated subjects with Cushing’s syndrome were studied: eight women and five men of mean age 44.2^ 9.5 years (SD). In ten of them, Cushing’s disease had been diagnosed and three had adrenal adenomas. ET-1 was 3-fold higher in the patient group than in age-matched healthy controls (n ¼ 13): 1.59^ 0.78 vs 0.46^ 0.20 pmol/l respectively, P, 0.001. In adrenal adenoma patients, ET-1 was not significantly higher than in the Cushing’s disease subjects (1.84^ 0.67 vs 1.51^ 0.83 pmol/l respectively, P. 0.05). In three patients who died of severe cardiovascular complications, plasma ET-1 was significantly higher than in the remaining patients (2.34^ 0.35 pmol/l, P, 0.05). A positive correlation was found between the total cholesterol (6.94^ 1.75 mmol/l) and ET-1 levels in the patients with Cushing’s syndrome: r ¼ þ0. 73, P, 0.02. No correlation was observed, however, between the levels of ET-1 and blood pressure (183^ 37/106^ 18mmHg), plasma cortisol levels (455.2^ 74.5 nmol/l) or urinary cortisol excretion (1463^ 726 nmol/24 h). The successful treatment and correction of hypercortisolism in seven patients led to insignificant reduction in plasma ET from 1.34^ 0.69 to 0.73^ 0.53 pmol/l, P. 0.05.

Conclusion: Our results …