Endocrine Disorders and Peripheral Arterial Disease - A Series of Reviews Cushing Syndrome-Cortisol Excess

P Poredos; G H Schernthaner; A Blinc; D P Mikhailidis; M Jensterle; P Anagnostis; P L Antignani; K Bajuk Studen; M Šabović; M K Jezovnik

doi:10.2174/0115701611272145231106053914

Endocrine Disorders and Peripheral Arterial Disease - A Series of Reviews Cushing Syndrome-Cortisol Excess

Curr Vasc Pharmacol. 2023 Nov 30. doi: 10.2174/0115701611272145231106053914. Online ahead of print.

Authors

P Poredos^{1

2}, G H Schernthaner³, A Blinc^{1

2}, D P Mikhailidis⁴, M Jensterle^{5

2}, P Anagnostis⁶, P L Antignani⁷, K Bajuk Studen^{8

2}, M Šabović^{1

2}, M K Jezovnik⁹

Affiliations

¹ Department of Vascular Diseases, University Medical Centre, Ljubljana, Slovenia.
² Faculty of Medicine, Department of Internal Medicine, University of Ljubljana, Ljubljana, Slovenia.
³ Department of Medicine 2, Division of Angiology, Medical University of Vienna, Vienna, Austria.
⁴ Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London Medical School, University College London (UCL) and Department of Clinical Biochemistry, Royal Free Hospital Campus (UCL), London, UK.
⁵ Vascular Centre Nuova Villa Claudia, Rome, Italy.
⁶ Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁷ Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre, Ljubljana, Slovenia.
⁸ Department of Nuclear Medicine, University Medical Centre, Ljubljana, Slovenia.
⁹ The University of Texas Health Science Center at Houston, Department of Advanced Cardiopulmonary Therapies and Transplantation, Houston, Texas, USA.

PMID: 38038006
DOI: 10.2174/0115701611272145231106053914

Abstract

Cushing syndrome (CS), characterised by endogenous or exogenous glucocorticoid hormone excess, is associated with several systemic complications, including impaired glucose metabolism, which often becomes clinically manifest as diabetes mellitus (DM). In addition, CS can harm the arterial wall because of hyperglycaemia, dyslipidaemia, hepatic steatosis, and central obesity. These metabolic disorders promote atherosclerosis by synthesising adipokines, leptin, and proinflammatory cytokines. Lower limb arterial complications in CS are common and significantly impact morbidity and mortality. Furthermore, CS, in combination with DM, is likely to cause more diffuse vascular disease that predominantly affects distal arterial beds. In conclusion, CS promotes atherosclerosis, including peripheral artery disease, by causing functional and morphological deterioration of the arterial vessel wall and increasing the presence of classical risk factors of atherosclerosis.

Keywords: Cortisol excess; atherogenesis; insulin resistance.; metabolic syndrome.