Hyperhomocysteinemia in patients with Cushing's syndrome

Massimo Terzolo, Barbara Allasino, Sandra Bosio, Elena Brusa, Fulvia Daffara, Massimo Ventura, Emiliano Aroasio, Gianna Sacchetto, Giuseppe Reimondo, Alberto Angeli, Clara Camaschella

Research output: Contribution to journalArticle

Abstract

We evaluated serum homocysteine concentrations and the C677T polymorphism of the gene encoding for methylene tetrahydrofolate reductase, a key enzyme for homocysteine metabolism, in 57 patients with Cushing's syndrome, 41 with active disease, and 16 in remission after successful surgery and 105 blood donors. The patients with active Cushing's syndrome had significantly higher serum homocysteine levels and lower folate concentrations than either the patients in remission or controls. The presence of a statistically significant difference in homocysteine concentrations among the three groups was confirmed after adjustment for confounding variables. In a multiple regression model, homocysteine levels were significantly associated with midnight serum cortisol levels (beta = 0.33, P = 0.01), which is the most sensitive marker of endogenous hypercortisolism, and serum folate levels (beta = -0.32, P = 0.02). The distribution of methylene tetrahydrofolate reductase genotypes was not different between patients and controls. In conclusion, active hypercortisolism is associated with hyperhomocysteinemia and reduced serum folate concentrations, whereas the patients in remission have homocysteine concentrations comparable with healthy subjects. Low serum folate concentrations do not fully account for the increase in homocysteine levels that are positively correlated with cortisol levels. Hyperhomocysteinemia may be key to the prothrombotic state and increased cardiovascular risk of Cushing's syndrome.

Original languageEnglish
Pages (from-to)3745-3751
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume89
Issue number8
DOIs
Publication statusPublished - Aug 2004

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Hyperhomocysteinemia
Cushing Syndrome
Homocysteine
Folic Acid
Serum
Methylenetetrahydrofolate Reductase (NADPH2)
Hydrocortisone
Gene encoding
Confounding Factors (Epidemiology)
Blood Donors
Polymorphism
Metabolism
Surgery
Healthy Volunteers
Blood
Genotype
Enzymes
Genes

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Terzolo, M., Allasino, B., Bosio, S., Brusa, E., Daffara, F., Ventura, M., ... Camaschella, C. (2004). Hyperhomocysteinemia in patients with Cushing's syndrome. Journal of Clinical Endocrinology and Metabolism, 89(8), 3745-3751. https://doi.org/10.1210/jc.2004-0079

Hyperhomocysteinemia in patients with Cushing's syndrome. / Terzolo, Massimo; Allasino, Barbara; Bosio, Sandra; Brusa, Elena; Daffara, Fulvia; Ventura, Massimo; Aroasio, Emiliano; Sacchetto, Gianna; Reimondo, Giuseppe; Angeli, Alberto; Camaschella, Clara.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 89, No. 8, 08.2004, p. 3745-3751.

Research output: Contribution to journalArticle

Terzolo, M, Allasino, B, Bosio, S, Brusa, E, Daffara, F, Ventura, M, Aroasio, E, Sacchetto, G, Reimondo, G, Angeli, A & Camaschella, C 2004, 'Hyperhomocysteinemia in patients with Cushing's syndrome', Journal of Clinical Endocrinology and Metabolism, vol. 89, no. 8, pp. 3745-3751. https://doi.org/10.1210/jc.2004-0079
Terzolo M, Allasino B, Bosio S, Brusa E, Daffara F, Ventura M et al. Hyperhomocysteinemia in patients with Cushing's syndrome. Journal of Clinical Endocrinology and Metabolism. 2004 Aug;89(8):3745-3751. https://doi.org/10.1210/jc.2004-0079
Terzolo, Massimo ; Allasino, Barbara ; Bosio, Sandra ; Brusa, Elena ; Daffara, Fulvia ; Ventura, Massimo ; Aroasio, Emiliano ; Sacchetto, Gianna ; Reimondo, Giuseppe ; Angeli, Alberto ; Camaschella, Clara. / Hyperhomocysteinemia in patients with Cushing's syndrome. In: Journal of Clinical Endocrinology and Metabolism. 2004 ; Vol. 89, No. 8. pp. 3745-3751.
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