6533b7dafe1ef96bd126e378

RESEARCH PRODUCT

Pasireotide treatment reduces cardiometabolic risk in Cushing’s disease patients: an Italian, multicenter study

Davide IacuanielloFrancesco FerraùA. ColaoErika MessinaRosario PivonelloCarla GiordanoCarla ScaroniAngela AlibrandiMarco BoscaroS. CannavòValentina GuarnottaMarialuisa ZilioAdriana AlbaniAlessandro Ciresi

subject

MaleEndocrinology Diabetes and MetabolismCardiometabolic risk Cushing’s disease hypercortisolism pasireotide visceral adiposity indexLongitudinal StudieDisease030204 cardiovascular system & hematologySettore MED/13 - Endocrinologiachemistry.chemical_compound0302 clinical medicineEndocrinologyRisk FactorsMedicineLongitudinal StudiesProspective StudiesAdiposityFramingham Risk ScoreCushing’s diseaseCushing’s diseaseMiddle AgedPasireotideDiabetes and MetabolismHeart DiseaseItalyAtherosclerosiObesity AbdominalFemaleSomatostatinHumanAdultmedicine.medical_specialtyWaistHeart DiseasesHypercortisolism030209 endocrinology & metabolismIntra-Abdominal Fat03 medical and health sciencesMetabolic DiseasesInternal medicineDiabetes mellitusCardiometabolic risk; Cushing’s disease; Hypercortisolism; Pasireotide; Visceral adiposity index; Endocrinology Diabetes and Metabolism; EndocrinologyHumansPituitary ACTH Hypersecretionbusiness.industryRisk FactorCushing's diseaseAnthropometryAtherosclerosismedicine.diseasePasireotideCardiometabolic riskMetabolic DiseaseVisceral adiposity indexProspective StudiechemistryObservational studybusiness

description

Purpose: Patients with Cushing’s disease (CD) experience metabolic alterations leading to increased cardiovascular mortality. Recently, the visceral adiposity index (VAI) has been proposed as a marker of visceral adipose tissue dysfunction (ATD) and of the related cardiometabolic risk. We aimed to evaluate the impact of 12-month pasireotide treatment on cardiometabolic risk in CD patients. Methods: This is a multicentre, prospective, and observational study. Sixteen CD patients, referred to the Endocrine Units of the University Hospitals of Messina, Napoli, Padova, and Palermo (Italy), successfully treated with pasireotide for 12 month have been enrolled. In all patients, we assessed anthropometric, clinical, and biochemical parameters and calculated VAI, ATD severity, Framingham, and atherosclerotic cardiovascular disease (ASCVD) risk scores, before and after 6 and 12 months of treatment with pasireotide (1200–1800 mcg/daily). Results: Before starting pasireotide treatment, ATD was present in 7/16 patients (mild in 2/16, moderate in 3/16, and severe 2/16). After 12 months of treatment: (i) 24h-urinary free cortisol levels (p = 0.003), BMI (p < 0.001), waist circumference (p = 0.001), LDL-cholesterol (p = 0.033), total-cholesterol (p = 0.032), triglycerides (p = 0.030), VAI (p = 0.015), and ATD severity (p = 0.026) were significantly decreased as compared to baseline; (ii) ATD was present in only 1/16 patients; (iii) prevalence of diabetes mellitus (p = 0.015) and HbA1c levels (p = 0.001) were significantly increased as compared to baseline; (iv) Framingham and ASCVD risk scores were not significantly different from pre-treatment values. Conclusions: Twelve-month pasireotide treatment significantly reduces VAI and ATD in CD patients. These positive effects on cardiometabolic risk occur despite no change in Framingham and ASCVD risk scores and the increase in the prevalence of diabetes mellitus.

yearjournalcountryeditionlanguage
2018-01-01
10.1007/s12020-018-1524-5http://hdl.handle.net/11588/709501