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Telomere length analysis in Cushing's syndrome.
[cushing syndrome]
Hypercortisolism
in
Cushing
's
syndrome
(
CS
)
is
associated
with
increased
morbidity
and
mortality
.
Hypercortisolism
also
occurs
in
chronic
depressive
disorders
and
stress
,
where
telomere
length
(
TL
)
is
shorter
than
in
controls
.
We
hypothesized
that
shortening
of
telomere
might
occur
in
CS
and
contribute
to
premature
aging
and
morbidity
.
To
investigate
TL
in
CS
patients
compared
with
controls
.
Seventy
-
seven
CS
patients
(
14
males
,
59
pituitary
,
17
adrenal
,
and
one
ectopic
;
21
with
active
disease
)
were
compared
with
77
gender-
,
age-
,
and
smoking-matched
controls
.
Fifteen
CS
were
evaluated
longitudinally
,
during
active
disease
and
after
remission
of
hypercortisolism
.
Leukocyte
TL
was
measured
by
telomere
restriction
fragment-
Southern
technique
.
Clinical
markers
were
included
in
a
multiple
linear
regression
analysis
to
investigate
potential
predictors
of
TL
.
M
ean
TL
in
CS
patients
and
controls
was
similar
(
7667
vs
7483
 
bp
,
NS
)
.
After
adjustment
for
age
,
in
the
longitudinal
evaluation
,
TL
was
shorter
in
active
disease
than
after
remission
(
7273
vs
7870
,
P
<
0
.
05
)
.
Age
and
dyslipidemia
were
negative
predictors
(
P
<
0
.
05
)
,
and
total
leukocyte
count
was
a
positive
predictor
for
TL
(
P
<
0
.
05
)
.
As
expected
,
a
negative
correlation
was
found
between
TL
and
age
(
CS
,
R
=
-
0
.
400
and
controls
,
R
=
-
0
.
292
;
P
<
0
.
05
)
.
No
correlation
was
found
between
circulating
cortisol
,
duration
of
exposure
to
hypercortisolism
or
biochemical
cure
and
TL
.
Even
though
in
the
cross-sectional
comparison
of
CS
and
controls
no
difference
in
TL
was
found
,
in
the
longitudinal
evaluation
,
patients
with
active
CS
had
shorter
TL
than
after
biochemical
cure
of
hypercortisolism
.
These
preliminary
results
suggest
that
hypercortisolism
might
negatively
impact
telomere
maintenance
.
Larger
studies
are
needed
to
confirm
these
findings
.
Diseases
Validation
Diseases presenting
"premature aging"
symptom
alexander disease
cadasil
cushing syndrome
kindler syndrome
werner syndrome
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