D-dimer as a significant marker of deep vein thrombosis in patients with subclinical or overt Cushing's syndrome
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概要
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Venous thromboembolism (VTE) is frequently associated with hypercortisolemia. This retrospective single-center study aimed to clarify the significance of plasma D-dimer levels for VTE screening in patients with subclinical or overt Cushing's syndrome (soCS). A total of 72 consecutive treatment-naïve patients with soCS diagnosed at Kobe University Hospital between 2002 and 2014 were enrolled. Patients with both lower extremity ultrasound and D-dimer measurement data (n = 19) were recruited in study 1 and divided into 2 groups, a deep vein thrombosis (DVT) (-) group (n = 12) and DVT (+) group (n = 7) for a comparison of the associated factors. The age and D-dimer levels were higher in the DVT (+) group than in the DVT (-) group (p = 0.04 and 0.02, respectively). A receiver operating characteristic analysis found that D-dimer level ≥2.6 μg/mL correlated with the presence of DVT (sensitivity, 100%; specificity, 91.7%). Next, patients with D-dimer measurement data (n = 36) were recruited in study 2 and divided into 2 groups according to D-dimer level: D-dimer (-), <1 μg/mL group (n = 23) and D-dimer (+), ≥1 μg/mL group (n = 13); the groups were compared with respect to various VTE-related risk factors. A logistic regression analysis revealed that elevated cortisol level after low-dose dexamethasone suppression was a significant risk factor for D-dimer elevation (OR = 1.21, p = 0.02). In conclusion, these data demonstrate that a D-dimer level ≥2.6 μg/mL is an indicator of DVT in treatment naïve patients with soCS and suggests that relatively high autonomous cortisol secretion may be associated with thrombus formation.
- 一般社団法人 日本内分泌学会の論文
著者
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Takahashi Michiko
Division Of Bioproduction Science Faculty Of Horticulture Chiba University
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Takahashi Yutaka
Division Of Diabetes Metabolism And Endocrinology Department Of Internal Medicine Kobe University Gr
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Nishizawa Hitoshi
Division Of Diabetes Metabolism And Endocrinology Department Of Internal Medicine Kobe University Gr
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Hirota Yushi
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine
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FUKUOKA Hidenori
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine
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IGUCHI Genzo
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine
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SUDA Kentaro
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Bando Hironori
Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
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Hirota Yushi
Division of Diabetes and Endocrinology, Kobe University Hospital, Kobe 650-0017, Japan
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Takeuchi Takehito
Division of Diabetes and Endocrinology, Kobe University Hospital, Kobe 650-0017, Japan
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Matsumoto Ryusaku
Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
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Takahashi Michiko
Division of Diabetes and Endocrinology, Kobe University Hospital, Kobe 650-0017, Japan
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NISHIZAWA Hitoshi
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine
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- D-dimer as a significant marker of deep vein thrombosis in patients with subclinical or overt Cushing's syndrome