Cardiovascular Complications And Risk Factors Analysis In Patients With Cushing’s Syndrome

Objective: The clinical data of patients with Cushing’s syndrome at the First Affiliated Hospital of China Medical University were collected to compare the cardiovascular complications of Cushing’s syndrome patients with different etiologies and to analyze the risk factors of cardiovascular complications.Research object and methods: The patients diagnosed as Cushing’s syndrome who were hospitalized at the First Affiliated Hospital of China Medical University from August 2009 to November 2017 were collected and divided into the pituitary group,the pituitary group(Cushing’s disease group)and adrenal gland group(adrenal Cushing syndrome group)according to the cause.General data(gender,age,BMI,course of disease,etc.),blood pressure measurements,laboratory tests(general laboratory tests such as serum lipids,ACTH,serum Cor and other endocrine hormone related tests,As well as carotid artery color Doppler ultrasonography,lower limb arterial ultrasound,cardiac structure and left cardiac function determination,12-lead ECG or Dynamic electrocardiogram,etc.).In the analysis of related factors,univariate analysis was based on whether complications occur.Multivariate correlation analysis was carried out by multivariate Logistic regression analysis model.Results:1,The cortisol level(8am,24am)and abnormal glucose metabolism in the pituitary group were significantly higher than those in the adrenal gland group,and the difference was statistically significant(P<0.05).2,There was no significant difference in the proportion of left ventricular structural abnormalities between the pituitary group and the adrenal gland(p>0.05).The abnormalities of hypertension,abnormal glucose metabolism,and abnormal coagulation in the left ventricular structural abnormalities group were higher than those in the normal left ventricular structural group,and the left ventricle The structurally abnormal group was dominated by women,and the difference was statistically significant(p<0.05).Multivariate analysis suggested that abnormal glucose metabolism was a risk factor for left ventricular structural abnormalities.3,The proportion of abnormal left ventricular function in the pituitary group was higher than that in the adrenal gland group,and the difference was statistically significant(p<0.05).Univariate analysis suggested that the course of disease in the normal left ventricular function group was higher than that in the left ventricular dysfunction group,and the difference was statistically significant(p<0.05),multivariate analysis suggested that abnormal glucose metabolism was a risk factor for left ventricular dysfunction.4,Forthe analysis of global left ventricle structure and/or function abnormalities,univariate analysis suggested that the incidence of hypertension,proportion of abnormal glucose metabolism,elevation of ATII(antimposition),and TG levels were higher in patients with abnormal left ventricular structure and/or dysfunction.In the whole left ventricular structure and/or function group,the difference was statistically significant(p<0.05).Multivariate analysis suggested that abnormal glucose metabolism was a risk factor for abnormal left ventricular structure and/or function;5,The incidence of arrhythmia in the pituitary group was higher than that in the adrenal gland group,and the difference was statistically significant(p<0.01).Univariate analysis suggested that the LDL cholesterol level was higher in the arrhythmia group than in the arrhythmia group.The difference was statistically significant(p<0.05),multivariate analysis suggested that LDL is a risk factor for arrhythmia;6,There was no significant difference in the ratio of ST-T changes between the pituitary and adrenal glands(p>0.05).Univariate analysis suggested that the levels of TG and HbA1 c were higher in patients with ST-T changes than in those without ST-T changes.The BMI was lower in the group than in the non-ST-T group.The difference was statistically significant(p<0.05).Multivariate analysis suggested that the course of disease was a risk factor for ST-T changes.7,There was no significant difference in the proportion of carotid lesions between the pituitary and adrenal glands(p>0.05).The percentage of plaques in the adrenal glands was higher than that in the pituitary gland group.The difference was statistically significant(p<0.05).Patients with carotid artery disease group had higher HomA-IR and ATII levels(recumbent position)than those without carotid artery disease group(p<0.05).Multivariate analysis suggested that age was a risk factor for carotid artery disease.8,There was no significant difference in the proportion of arterial lesions in the lower extremity between the pituitary and adrenal glands(p>0.05).Univariate analysis suggested that the disease course,HbA1 c,and ATII in patients with lower extremity arterial disease were higher than those without lower extremity disease.The HDL in arterial disease group was lower than that in arterial disease without lower extremity.The difference was statistically significant(p<0.05).Multivariate analysis showed that gender and age were risk factors for arterial disease of lower extremities.9,Based on the analysis of overall peripheral vascular disease,univariate analysis suggested that patients with peripheral vascular disease had higher HomA-IR and ATII levels(decubitus)than those without peripheral vascular disease,and patients with peripheral vascular disease had low levels of HDL and serum potassium.In the absence of peripheral vascular lesions,the difference was statistically significant(p<0.05).Multivariate analysis suggested that age was a risk factor for peripheral vascular lesions.Conlusions: 1.Patients in the pituitary group had significantly higher cortisol levels(8am,24am)and abnormal glucose metabolism than those in the adrenal gland group.2,In the pituitary group,the incidence of abnormal left ventricular dysfunction and arrhythmia was significantly higher than that of the adrenal gland.3,Multivariate analysis: Abnormal glucose metabolism was associated with left ventricular structural abnormalities,left ventricular dysfunction,and overall left ventricular structural and/or functional risk factors.Low-density lipoprotein was a risk factor for arrhythmia;the course of disease was ST-T changes.Risk factors;gender,age are risk factors for lower extremity arterial disease;age is a risk factor for carotid artery disease and whole peripheral vascular disease.