Cushing’s Disease & Clot Dynamics

  • Research type

    Research Study

  • Full title

    Elucidation of the Potential Cardiovascular Risk Factors and Clot Dynamics in Patients with Cushing’s Disease.

  • IRAS ID

    240508

  • Contact name

    Robert Douglas Murray

  • Contact email

    robertmurray@nhs.net

  • Sponsor organisation

    Research and Innovation Centre, Leeds Teaching Hospitals NHS Trust

  • Duration of Study in the UK

    3 years, 0 months, 0 days

  • Research summary

    Cushing’s syndrome (CS) is the consequence of long-term exposure to excess of the steroid hormones. The most common reason for CS is steroid treatment for diseases of inflammation. Cushing’s disease (CD) is rare and occurs when a benign pituitary tumour produces an excess amount of adrenocorticotropic hormone which in turn stimulates the adrenal glands to make excess of the natural steroid, cortisol. CS leads to high blood pressure, diabetes, increases in fat mass and cholesterol, and a tendency to form blood clots. Patients with CS have a death rate equating to 50% at five years if untreated, predominantly due to diseases of blood vessels (heart attacks, strokes). Following treatment to normalise levels of cortisol, death rates improve, but remain two-fold greater than the background population. Even five years after remission, these individuals continue to have increased rates of obesity, high blood pressure and diabetes.\nWe aim to comprehensively examine markers of risk of blood vessel disease in long-term survivors of CD including body composition (fat and muscle mass); blood fats; 24-hour blood pressure monitoring; continuous sugar monitoring over 14 days using a non-invasive probe; and blood clot formation. For the latter, we will quantify factors involved in forming and breaking down clots, and will use novel techniques to directly measure how quickly clots form and are broken down, and assess how dense these clots become. We will also study patients with a recent diagnosis of CD and examine these parameters before surgery and post-operatively. \nThis work will provide a model for patients who have received long-term treatment with steroids for other medical conditions, and for whom an increased death rate, not fully explainable by their underlying disease itself, has been shown. Future studies of these individuals will be performed if abnormalities are detected in this initial study of CD patients.

  • REC name

    Yorkshire & The Humber - Leeds West Research Ethics Committee

  • REC reference

    18/YH/0337

  • Date of REC Opinion

    27 Sep 2018

  • REC opinion

    Favourable Opinion