ECE2018 Poster Presentations: Adrenal and Neuroendocrine Tumours Adrenal cortex (to include Cushing's) (70 abstracts)
The renin-angiotensin-aldosteron system in primary adrenal insufficiency
Peter Wolf 1 , Johanna Mayr 1 , Marko Poglitsch 2 , Alois Gessl 1 , Anton Luger 1 , Yvonne Winhofer 1 & Michael Krebs 1
1Medical University of Vienna, Vienna, Austria; 2Attoquant Diagnostics, Vienna, Austria.
Background: Despite adequate hormone replacement therapy, evidence suggests that mortality is increased in patients suffering from primary adrenal insufficiency (AI), mainly because of cardiovascular diseases. Since activation of the renin-angiotensin-aldosteron system (RAAS) plays an important role in the development of hypertension and cardiovascular disease we aimed to investigate, if there are differences in AI compared to healthy controls.
Methods: Eight patients with AI (female n=5; male n=3; age 56±21; BMI 22,8±2,8 kg/m2; mean blood pressure 140/83 mmHg)) and eight matched healthy volunteers (female n=5; male n=3; age 52±21; BMI 25,2±4,3 kg/m2; mean blood pressure 135/84 mmHg) were included. Blood was drawn in the morning in the fasting state to measure serum electrolytes, renin-, aldosterone, cortisol and ACTH concentrations. Assessment of physiologically active angiotensin concentrations and equilibrium analysis was performed by RAS fingerprint measurements.
Results: In patients suffering from AI RAAS activity was increased with significantly elevated concentrations of renin (P=0.027), angiotensin-1 (P=0.022), angiotensin-2 (P=0.032), angiotensin-1-7 (P=0.03) and angiotensin-1-5 (P=0.03), as well as in a reduction in aldosteron-angiotensin-2 ratio (AA2-Ratio, P=0.003) compared to controls, resulting in a characteristic RAAS fingerprint. Plasma renin activity was strongly correlated with the sum of angiotensin-1+ angiotensin-2 (r=0.983; P< 0.01).
Conclusions: AI is associated with a unique RAAS fingerprint. Physiologically active angiotensin concentrations are highly elevated, despite adequate hormone replacement therapy. This might contribute to the reported increased cardiovascular risk and should be investigated in future trials.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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