Session: SAT 1-25-Glucocorticoid Actions & HPA Axis
Poster Board SAT-25
Objectives; The aim of this study was to clarify the prediction marker of VTE in pre-operative patients with CS.
Design and Methods; Twenty-seven pre-operative patients with CS and Subclinical CS due to pituitary adenoma, adrenal adenoma, or ectopic ACTH syndrome, who diagnosed at Kobe University Hospital from 2002 to 2012, were included in this study. Patients were divided to two groups; D-dimer (+); serum D-dimer levels ³a 1 mg/ml (n = 11) or D-dimer (-); serum D-dimer levels < 1mg/ml (n = 16), and compared various risk factors related to VTE. Patients who already treated with anti-coagulant drugs were excluded.
Results; Serum cortisol levels at mid-night and after low-dose dexamethasone suppression test (LDDST) were significantly higher in D-dimer (+) than in D-dimer (-) (26.6 ± 10.8 vs 14.8 ± 6.7 mg/dl, p < 0.01 and 23.0 ± 6.8 vs 14.6 ± 7.4 mg/dl, p < 0.01, respectively), while cortisol levels at morning and 24 hour urinary free cortisol (UFC) levels did not show differences (22.4 ± 11.7 vs 16.1 ± 5.6 mg/dl, p = 0.12 and 512 ± 446 vs 230 ± 253 mg/24h, p = 0.09, respectively). The aPTT were significantly shortened in D-dimer (+) than in D-dimer (-) (23.8 ± 3.3 vs 29.0 ± 7.9 sec, p < 0.05). Linear regression analysis revealed that both cortisol levels at mid-night and after LDDST were negatively correlated with the aPPT (r = - 0.45, p < 0.05 and r = - 0.53, p < 0.05, respectively).
Conclusion; High serum cortisol levels at mid-night and after LDDST, both of which negatively correlated with the aPTT, were associated with elevated levels of D-dimer rather than morning cortisol levels or UFC levels. These results suggest that a sustained exposure to high cortisol levels at night increases susceptibility to thrombogenesis in CS.
Nothing to Disclose: HF, TT, YH, GI, YT
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